The Uniformed Services University and the National Institutes of Health led a study with eyebrow raising results: that the cause of lingering symptoms associated with COIVD-19, from headaches to feelings of fuzziness or brain fog, originate not from nerve cells but rather small blood vessels. Titled “Microvascular Injury in the Brain of Patients with COVID-19,” the findings were just published in the New England Journal of Health. As commented by the study lead, Dr. Dan Perl, professor of pathology at USU and director of the USU Brain Tissue Repository, the study findings raised important questions about COVID-19 as well as how to understand the cause of acute and persistent neurologic symptoms given the ongoing impact of the pandemic on the civilian and military populations.
TrialSite offers a summary breakdown of this latest COVID-19 finding written up by Sarah Marshall, Medical Affairs Officer with the Uniformed Services University, a health science university that falls under the Assistant Secretary of Defense for Health Affairs.
What research sites led this study?
This study represented a notable collaboration involving not only the United States Uniformed Services University, the National Institute of Neurological Disorders and Stroke at the National Institutes of Health but also the University of Auckland in New Zealand, the University of Michigan, the Joint Pathology Center, the New York University School of Medicine, and the University of Iowa. The full published study can be found here.
What question did this investigation seek to answer?
What is the cause or origin of persistent symptoms lasting long beyond recovery from COVID-19
What is the study summary?
Using high-resolution MRI scanning of brain tissue, the research team evaluated the brains of 13 patients who passed due to COVID-19. Note that these patients mostly passed while not hospitalized.
What did they find?
Ms. Marshall reports the team found “focal hyperintensities,” which are associated with small blood vessels evidencing inflammation and damage to their walls. Examples of damage include evidence that fibrinogen, a protein, leaked from the blood into adjacent brain regions.
Were the researchers able to detect evidence of lasting SARS-CoV-2 in the brain?
No. Despite the fact that the team used sophisticated and advanced “sensitive techniques,” the team wasn’t able to identify any trace levels of the pathogen. They also found scant evidence of nerve cell damage.
Who was the lead investigator?
Dr. Dan Perl, professor of pathology at USU and director of the USU Brain Tissue Repository.
A number of other study authors can be found here.
What is Dr. Per’s Point of View as to the findings?
Dr. Perl had a number of quotes for USU’s Ms. Marshall, declaring, “COVID-19 seems to have a propensity to damage small blood vessels in the brain, rather than the nerve cells themselves.” Perl pointed out considerable gaps precluding any conclusions, saying, “While it was tempting to connect our findings of specific brain locations of involvement to specific clinical manifestations, the cases examined had very little associated clinical information. So this could not be done.”
What is the Uniformed Services University?
Based in Bethesda, MD, the Uniformed Services University (USU) serves an important mission: to support the readiness of the U.S. military personnel as well as the health and well-being of the military community, by educating and developing uniformed health professionals, scientists, and leaders. USU conducts cutting-edge, military-relevant research and provides operational support to units around the world.
USU is affiliated with many military and civilian teaching hospitals, maintains a medical school, and represents a federal service postgraduate academy.
Clinical trials there fall under the Office of the Vice President for Research (VPR), established at USU to facilitate, promote and oversee ongoing research efforts. USU has on average of about 500 research protocols at any given time covering a variety of scientific areas, including basic biological areas central to the mission of the Military Health System.