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Long COVID and Alzheimer’s Disease: What is the Relationship?

As the COVID pandemic evolves, it has been increasingly apparent that a considerable number of infected individuals develop what is termed Long COVID. This is a chronic condition in which symptoms of coronavirus infection persist for more than two months after the acute illness. A large study identified a host of brain-related issues in patients previously infected with COVID. However, this study looked at mostly unvaccinated individuals.

In a recent large study published in JAMA Open Network, more than 16,000 individuals with confirmed COVID were surveyed. About 14% reported symptoms persisting two months or longer after their acute symptoms. 63% were women and 37% men. Increasing age above 40 was associated with greater risk of long COVID, while completion of a primary vaccination series prior to the acute illness decreased risk of long COVID.


Brain symptoms of COVID, both acute and long, are commonly labelled brain fog:


· Mental fatigue

· Headache

· Impaired focus and attention

· Difficulty with memory

· Slowing of reaction times

· Difficulties processing new information


and other cognitive symptoms. This is not Alzheimer’s disease (AD). AD certainly affects similar brain functions, but almost without exception, does not present with an antecedent acute respiratory or other infection and, critically important -- has a progressive course over years of cognitive symptoms and signs. Long COVID appears to be a non-progressive condition. Patients, although clearly impacted, are not progressively worsening.


Recently, there have been reports of naloxone, a drug used to treat alcohol and opioid addiction, helping some sufferers of long COVID. I would caution that these preliminary studies need confirmation in larger, controlled studies before naloxone can be used outside of clinical trials as a treatment of long COVID. At least 26 clinical trials investigating possible treatments are underway as of the summer of 2022.


Consulting your physician regarding management of your long COVID symptoms is step one. A return as tolerated to light to modest physical activity, a well-balanced diet, sufficiently long and quality sleep, and stress-reducing / relaxation activities should be of benefit, although I am unaware of controlled studies looking at these lifestyle factors.


Resources:

Perlis RH, Santillana M, Ognyanova K., et al. Prevalence and Correlates of Long COVID Symptoms Among US Adults. JAMA Netw Open. 2022;5(10):e2238804. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797782