This article was exclusively written for The European Sting by Ms. Gabriela de Mattos Laube and Ms. Mariana Dias Lopes Barud, two fourth year medical students currently studying in Medical Sciencies College of São José dos Campos – Humanitas. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.
The World Health Organization, in December 2019, was informed about the emergence of several cases of pneumonia in Wuhan, China, which were caused by a new type of coronavirus, previously unidentified in humans. On March 11, 2020, the WHO declared a pandemic caused by the new respiratory disease, COVID-19. This pathology is an infection caused by SARS-COV-2 and was initially associated with respiratory symptoms. However, lately, several neurological symptoms are also observed in many patients.
The pathophysiological process is related to the viral ability to enter the brain parenchyma through the blood-brain barrier, cerebrospinal fluid and retrograde transport in neuronal axons, seeing the virus has neurotropism, especially in the cortical and hypothalamic areas. Through its various direct and indirect pathophysiological mechanisms, the SARS-COV-2 virus has the ability to cause microvascular and neuroinflammatory lesions, causing cognitive impairment related to memory loss. Thus, the impact on memory is a consequence of neurological damage and may be a risk factor for the development of future neurodegenerative disorders, including Alzheimer’s disease and other types of dementia.
In this way, we can see the impact of the disease on the quality of life of infected people. Although the real long-term effects of the infection are not known, it’s possible to demonstrate the impact of the daily activities of individuals infected by SARS-COV-2. Besides to memory loss, many patients have difficulty concentration and attention problems, decreased ability to solve problems and changes in speech articulation. Therefore, the complexity of the profile of this virus in the human body is evident, for this reason is a great ideia to think about post-COVID patient care.
The Central Nervous System has an incredible ability to promote morphological and functional changes to the injuries caused, a process known as neuroplasticity. Through stimuli and cognitive training is possible to recover or enhance functions of the injured areas, even if it’s necessary to displace neuronal areas for this purpose. When we practice mental challenge exercises we activate hippocampal areas responsible for consolidating memories, being able to recover the functioning of damaged areas by the SARS-COV-2 infection.
Therefore, it’s very important to inform patients about the efficiency of practicing activities that stimulate the Central Nervous System. Reasoning games like Sudoku, puzzles, memory games, dominoes and word searches are efficient to stimulate neuroplasticity and reduce the neurological symptoms associated with COVID-19. A complete neuropsychological assessment is extremely important, including measurement of response time, cognitive flexibility and processing speed for the evaluation and treatment of attentional and memory changes in patients treated post-COVID.
References
Rodrigues FA, Pinto MS et al. Memory loss in recovered patients COVID-19 | Ibero-American Review 2021 Nov 3; Available from: https://periodicorease.pro.br/rease/article/view/2715/1097
Bayat, Amir-Hossein et al. “COVID-19 causes neuronal degeneration and reduces neurogenesis in human hippocampus. Apoptosis: an international journal on programmed cell death, 1–17. 25 Jul. 2022, doi:10.1007/s10495-022-01754-9
Lu, Y., Li, X., Geng, D.et al (2020). Cerebral Micro-Structural Changes in COVID-19 Patients – An MRI-based 3-month Follow-up Study. EClinicalMedicine, 25, 100484. https://doi.org/10.1016/j.eclinm.2020.100484
About the authors
This article was exclusively written for the European Sting by Ms. Gabriela de Mattos Laube e Ms. Mariana Dias Lopes Barud, a fourth year medical students currently studying in Medical Sciencies College of São José dos Campos – Humanitas. They are affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of Sting.
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