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Long-term neurological consequences of COVID-19: the “silent wave”

Neurological brain disease concept

Is the world prepared for a wave of neurological consequences that may be on its way? COVID-19? This question is at the forefront of research at the Florey Institute of Neuroscience and Mental Health. A team of neuroscientists and clinicians are investigating the possible link between COVID-19 and increased risk of Parkinson’s, as well as measures to stay ahead of the curve.

“Although scientists are still learning how that SARS-CoV-2 The virus can invade the brain and central nervous system. The fact that it penetrates there is clear. Our best understanding is that the virus can offend brain cells and neurodegeneration may occur from there, ”said Professor Kevin Barnham of the Florey Institute of Neuroscience & Mental Health.

In a review article published on September 22, 2020, researchers highlighted the potential long-term neurological consequences of COVID-19, calling it a “silent wave”. They urgently call for measures to have more accurate diagnostic tools available for the early detection of neurodegeneration and a long-term monitoring approach for people infected with the SARS-CoV-2 virus.

The researchers report that neurological symptoms in people infected with the virus ranged from severe symptoms such as brain hypoxia (lack of oxygen) to more common symptoms such as loss of smell.

“We found that three out of four people infected with the SARS-CoV-2 virus reported an average loss of odor or a reduced odor. While this symptom may seem low on the surface, it actually says a lot about what’s going on inside, which means that the olfactory system responsible for the odor is acute inflammation, ”explained Leah Beauchamp, researcher at Florey.

Inflammation is believed to play an important role in the pathogenesis of neurogenerative diseases and has been particularly well studied in Parkinson’s disease. Further research on these diseases could prove critical to the future effects of SARS-CoV-2.

“We believe that odor loss is a new way to identify the risk of Parkinson’s disease early on. Knowing that around 90% of people experience odor loss in the early stages of Parkinson’s disease and a decade before motor symptoms appear, we feel we are on the right track, ”added Ms. Beauchamp.

The clinical diagnosis of Parkinson’s disease is currently based on the representation of a motor dysfunction. However, research shows that by this point 50-70% of dopamine cell loss in the brain has already occurred.

“By waiting to be diagnosed and treated for this stage of Parkinson’s disease, you have already missed the window in which neuroprotective therapies can have their intended effects. We’re talking about an insidious disease that affects 80,000 people in Australia and is set to double by 2040 before even considering the potential consequences of COVID. No disease-modifying therapies are currently available, ”said Professor Barnham.

Researchers hope to establish a simple, inexpensive screening protocol that aims to identify people in the community who are at risk of developing Parkinson’s disease, or who are in the early stages of the disease, at a time when in which therapies have the greatest potential to prevent the onset of motor dysfunction. They plan to submit the proposal for funding from the Australian Government’s Medical Research Future Funding program.

In addition, the team has developed two neuroprotective therapies currently under study and identified a cohort of subjects who are ideally suited to study the treatments. Their research provided new evidence that people with REM sleep behavior disorders are more likely to develop Parkinson’s disease.

Parkinson’s disease is a significant economic burden that costs the Australian economy more than $ 10 billion annually.

“We have to change the community and think that Parkinson’s is not a disease of old age. As we’ve heard time and again, the coronavirus doesn’t discriminate – and neither does Parkinson’s, “said Professor Barnham.

“We can gain an insight into the neurological consequences of the 1918 Spanish flu pandemic, which increased the risk of developing Parkinson’s disease by two to three times. Given that a virus pandemic has struck the world again, it is indeed very worrying to consider the potential global increase in neurological diseases that could develop along the way. “

He added, “The world was unprepared the first time, but it doesn’t have to be the same again. We now know what to do. In addition to a strategic approach to public health, tools for early diagnosis and better treatments will be crucial. “

Reference: “Parkinsonism as the third wave of the COVID-19 pandemic?” from Beauchamp, Leah C .; Finkelstein, David I .; Bush, Ashley I .; Evans, Andrew H and Barnham, Kevin J, September 22, 2020 Journal of Parkinson Disease.
DOI: 10.3233 / JPD-202211

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