Brain fog after Covid-19 has similarities to ‘chemo brain’ in humans and mice | Hacker News Reader

Brain fog after Covid-19 has similarities to ‘chemo brain’ in humans and mice

med.stanford.edu

169 pointsamichail48 comments

> Because other viral infections can cause brain inflammation, the researchers studied brain changes in mice after mild respiratory infection with H1N1 influenza, the viral strain that caused the 2009 “swine flu” and 1918 “Spanish flu” pandemics. The goal was to compare cognition-linked molecular changes after H1N1 to those seen after COVID-19. One week after infection, the H1N1 flu and SARS-CoV-2 infections caused similar patterns of cytokine elevation in the central nervous system, microglial reactivity and loss of oligodendrocytes in white matter. But seven weeks after infection, although the cytokine profiles had some overlap, including increased inflammatory chemokine CCL11, they differed. Effects on the hippocampus were similar in the two types of infections, but microglial reactivity and oligodendrocyte loss in white matter were not present after seven weeks following H1N1 infection.

So it's not just a flu.

It would be more interesting to compare SARS-CoV-2 with endemic common cold coronaviruses. In particular HCoV-OC43 appears to be quite similar in terms of genetics and typical symptoms.

https://doi.org/10.1111/1751-7915.13889

When I was trying to dig through the chaff eventually I found the magic phrase viral tropism.

It's complicated. You have the ability of the virus to infect particular tissues. Sometimes viruses have a primary and secondary attack. What the viruses life cycle is in the host. Chicken pox's isn't influenza's. There is the ability of the virus to evade and suppress the immune response. And finally you have the point that viruses can trigger autoimmune responses.

I saw lots of back and forth about neurological stuff. Best response was from someone that studies neurology that pointed out that 'the brain' is made up of dozens of cell types. Viral damage or an autoimmune attack on any of those can be very ungood.

Also I think about 50-60 years ago the medical profession lost interest in respiratory viruses. So much information is absent, out dated, or the result of 50 years of telephone.

> Also I think about 50-60 years ago the medical profession lost interest in respiratory viruses. So much information is absent, out dated, or the result of 50 years of telephone.

Wait what? Really?

You do a literature search which I did years before the pandemic and there is almost nothing.

I always thought "chemo brain" was just a cop out until my mother had her bout with breast cancer.

She was a very opinionated and capable woman. Now she can't carry a conversation or remember where she put her socks.

It's been nearly 4 years and she still ain't firing on all cylinders.

It killed the cancer but the cognitive cost was great.

Sorry to hear that. My mum's had noticeable cognitive decline from breast cancer chemo too, physically more frail from it too.

Fortunately, sort of, she mostly thinks it's my dad who's lost a few marbles and doesn't seem to realise it's her, or at least is still too stubborn to admit it. And her grandchildren not only still have their grandmother but they don't yet see (or understand) the decline which is perhaps the best blessing of all. But it's still sad to have to see.

> I always thought "chemo brain" was just a cop out until my mother had her bout with breast cancer

Why would you or anyone think it was a cop out?

Our culture puts such a strong emphasis on self-reliance that people who experience conditions that are "in their head," or even just poorly understood, are broadly perceived as lazy and dishonest. It's often only when it hits close to home that people are able to overcome this bias.

Sounds a lot like my experience with severe ADHD.

Today that "chemo brain" is a thing.

Unfortunatey, last week I learned that I'm starting chemo in a few weeks.

I had hoped to WFH during rads & chemo in a slightly diminished capacity. Should I expect very dimished?

While you're undergoing cancer treatment, you're going to be too fatigued to worry much about your cognitive performance. I wouldn't expect to be able to distinguish lower productivity as a result of "chemo brain" from lower productivity as a result of all the non-cognitive side effects until several weeks after your active treatment is done.

Taking off as much time as you're able to rest on and after treatment days will go a long way to helping you feel better the rest of the time.

As others have said, it's impossible to say because every person and every treatment is different.

I received treatment for testicular cancer in late 2012 through early 2013. I tried so hard to WFH during chemo because I hadn't been at my job long enough to take FMLA and I needed to keep the health insurance to, you know, get the chemo, and I couldn't afford both COBRA and rent at the time.

There was no way I could actually concentrate on anything when I hurt so much that I couldn't sleep, let alone actually do my job. I ended up going so deep into negative PTO that for the following two years that I was at that place I was never able to take another day off.

You can't know until you start... My wife was driving herself to the chemo and she was shopping afterwards. However the nurse said that her experience was quite exceptional, peoples are usually floored by Taxol. During radiations she was miserable, it was like a second degree burn all over her chest.

It depends. I had Hodgkin's Lymphoma and had chemo for about 5 months over a year ago. Everyone reacts differently as some have various symptoms that can be worse or better than others. Some people are miserable in bed while others it not so bad and tolerable. It can also vary on the type of chemo treatment you are receiving.

Hang in there!

My father developed a bad rash approximately a year ago that won't go away. He also developed his first ever bloodclot. The rash could be from the eliquis, but his Dr thinks its from chemo. His lung cancer is successfully in remission for now, but the stage 4 COPD doesn't care. Anyhow, I learned recently that a rash is one of the more common side effects.

Good luck with your treatment.

You won't know - Everyone reacts differently and there's different chemos.

I do know someone who had very few side effects from chemo and worked full time the entire time at an active job without any real issues - logics/scheduling was the biggest problem for him.

You should avoid working if at all possible. Source: I'm barely a month out from completing chemo and radiation.

Have you seen mortgate rates lately?!? /s

My boss will be fairly chill about letting me WFH and contribute fewer hours, so I'll hope for the best. Worst case I'll try figure out if/how I can go on short-term disability.

Everyone has a different experience. However, chemo just sucks.

My wife went through it all and asked at the beginning: "Should I take off work?" To which my response was "You can be miserable and bored, or you can be miserable and busy. Your choice." Staying busy, at least, gets your mind off of it if you can swing it.

On the other hand, my wife sailed through radiation with nary a problem while the other folks around her had terrible problems.

Good luck. I hope you fare well.

I'm hoping to keep busy and stay paid. Fingers X'd that I don't need to go on disability!

Were hobbies off the table?

Not at all. If you'd rather do hobbies, you do you.

However, I do find that most people don't have hobbies that they can spend 8+ hours a day on and remain happy doing them. I do, but that's not very typical.

My wife loves her work and the people she works with. So, that was fine, too.

Work also serves as a slight "forcing function" so that you kinda have to get up and do something even if you're a little not up for it while you would just blow off a hobby.

It's all about whatever keeps you going.

I'll agree with the others that it really depends. I'm watching a family member who would like to work be unable to focus for long enough to get much work done. I suspect in his case it is pain mixed with the chemo and fatigue which makes good work difficult. Right now this is in the first couple weeks of treatment, I'm trying to be optimistic but also prepared for this to continue as treatment does. But now I have something else to watch out for I guess.

Either way, best of luck.

You are going to be so tired, you won't even be able to sleep.

Not necessarily but you should be prepared for it.

>Could fused neurons explain COVID-19’s ‘brain fog’?

https://www.science.org/content/article/could-fused-neurons-...

The problem with the concept of covid-induced brain fog is that the symptoms of brain fog are indistinguishable from general anxiety. I'm still not convinced that brain fog is a legitimate, medical outcome of having covid, as opposed to a culturally-conditioned response that's dependent on one's perception of the severity of covid. Anecdotally, among the people I know in real life, the only ones that have complained about post-covid brain fog are those that already tend to be hypochondriacs or doomers.

Long covid is very real and is not anxiety. There have been studies linking post covid fatigue and conditions to viral persistence and micro clotting. This type of post covid is just anxiety discourse is incredibly harmful.

This kind of discourse has been par for the course for as long as "mental illness" has existed. I don't know a single chronically ill person who hasn't gone through being undermined and treated this way.

Post viral syndrome has been been recognized for decades and linked to a wide variety of different viruses. So although the exact mechanisms aren't clearly understood there's no reason to think that SARS-CoV-2 couldn't cause similar effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1710789/

But in terms of specific symptoms, a recent study found only a weak correlation between confirmed COVID-19 and brain fog. Other persistent symptoms such as anosmia are much more common.

https://doi.org/10.1038/s41591-022-01909-w

This is just a case where the tools we have for examination are lacking and subjective symptom description barring specific indicators is pretty useless from a research standpoint.

From the linked article

> those with COVID-19 had greater microglial reactivity than those in the control group, in a pattern that matched what was found in the mice.

This is evidence that brain fog isn't just "a culturally-conditioned response." Rather, we can physically measure an impact of covid on the brain.

This is a great point! In order to find out, perhaps we should engage some experts at a leading research institution to do some wider studies that are able to account for such factors. Maybe Stanford could do it?

I can't distinguish your comment from cognitive impairment either, but I do you the favour of assuming you're capable of evaluating and describing what's going in your head, and you'd do well to do the same for others.

Anecdotally, my brother developed long covid, with both physical (increased heart rate, increased recovery time from simple tasks like walking up stairs) and mental (only occasional brain fog). Never had these problems prior to covid. He's one of the most level-headed people I know, and is not prone to over-reacting to pretty much anything (his wife does that for him).

If he says he personally experiences a thing, I'll trust his word over an armchair therapist on the internet any day of the week.

You don’t need to rely on anecdata, there are a ton of studies on this. For example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685075/

I wonder how this compares to damage from impact brain trauma?

And I wonder if there will be some kind of long-term disability assistance for people who suffer from these syndromes.

nah but canada is expanding MAID to cover the homelessness you'll end up in due to not being able to work. kinda surprised they beat the US to that one but I'm sure we'll catch up.

Not to be confused w/ "pregnancy brain" that occurs during and up to 1 year after pregnancy in women.

https://www.nature.com/articles/nn.4458

I wonder if parallels to the HSVrelated viral infections and association w/ Alzheimer's and other dementias...leaky BBB?

Yes it's possible

https://content.iospress.com/articles/journal-of-alzheimers-...

"In mice"

> relied on studies of mice with mild SARS-CoV-2 infection and postmortem human brain tissue collected early in the pandemic.

The study looked at both mice and human brains, and observed similar effects in both.

Inmiced. Thanks!

Btw, the study looked at both human and mice brains.

Ok, we've put humans in there too. Thanks!

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