Chronic Fatigue, Depression and Anxiety Symptoms in Long COVID Are Strongly Predicted by Neuroimmune and Neuro- Oxidative Pathways Which Are Caused by the Inflammation during Acute Infection
HK Al-Hakeim et al in Michael Maes’ lab report in J. Clinical Medicine (2023) on very important findings about immune and oxidative changes in long COVID with “physio- somatic (chronic fatigue syndrome and somatic symptoms) and affective (depression and anxiety) symptoms. The severity of the long COVID physio-affective phenome is largely predicted by increased peak body temperature (BT) and lowered oxygen saturation (SpO2) during the acute infectious phase….. We recruited 86 patients with long COVID (3–4 months after the acute phase) and 39 healthy controls and assessed serum C-reactive protein (CRP), caspase 1, interleukin (IL) 1?, IL-18, IL-10, myeloperoxidase (MPO), advanced oxidation protein products (AOPPs), total antioxidant capacity (TAC), and calcium (Ca), as well as peak BT and SpO2 during the acute phase. Results: Cluster analysis revealed that a significant part (34.9%) of long COVID patients (n = 30) show a highly elevated NT (neurotoxicity) index as computed based on IL-1?, IL-18, caspase 1, CRP, MPO, and AOPPs. Partial least squares analysis showed that 61.6% of the variance in the physio-affective phenome of long COVID could be explained by the NT index, lowered Ca, and peak BT/SpO2 in the acute phase and prior vaccinations with AstraZeneca or Pfizer. The most important predictors of the physio-affective phenome are Ca, CRP, IL-1?, AOPPs, and MPO. Conclusion: The infection–immune–inflammatory core of acute COVID-19 strongly predicts the development of physio-affective symptoms 3–4 months later, and these effects are partly mediated by neuro-immune and neuro-oxidative pathways.”
Editors Note: These finding are important as they may lead to new treatment interventions. BNN readers are reminded of a previous BNN article by investigators from Yale (written by by Isabella Backman on Dec. 13, 2022) that in a new case study, they found that guanfacine plus N-acetylcysteine (which is an anti-inflammatory, anti-oxidant, and glutathione precursor) “mitigated and sometimes eliminated the cognitive impairment known as “brain fog” that often accompanies long COVID.
Ecstasy Use Increases Serotonin Receptors in Women
MDMA, better known as the drug ecstasy, has been found to reduce serotonin axons in animals. A small study by Di Iorio et al. published in the Archives of General Psychiatry in 2012 suggests that the drug also has detrimental effects on serotonin signaling in humans.
The researchers used positron emission tomography (PET) scans to identify serotonin receptors in the brains of 10 women who had never used ecstasy and 14 who had used the drug at least five times before and then abstained for at least 90 days. The team found significantly greater cortical serotonin2A receptor nondisplaceable binding potential (serotonin2ABPND, an indicator of serotonin receptors) in abstaining MDMA users than in those women who had never used the drug.
The increase in serotonin receptors observed in these ecstasy users could be a sign of chronic serotonin neurotoxicity. Loss of serotonin nerve terminals decreases serotonin levels and secondarily results in the production of more serotonin receptors. Thus, one explanation for the receptor increase is that it is prompted by the decrease in serotonin transmission that MDMA is known to cause.
The higher levels of serotonin2ABPND were found in several regions of the MDMA users’ brains: occipital-parietal, temporal, occipito-temporal-parietal, frontal, and frontoparietal. Lifetime use of the drug was associated with serotonin2ABPND in the frontoparietal, occipitotemporal, frontolimbic, and frontal regions. There were no regions in which the MDMA users had lower levels of receptors than women in the control group. The duration of the ecstasy users’ abstinence from using the drug had no effect on levels of serotonin2ABPND observed, suggesting that the effects might be long-lasting, if not permanent.
Editor’s Note: Given serotonin’s importance in brain function and the drug’s popularity for recreational use, this finding has implications both for ecstasy users and for research on serotonin signaling. Ecstasy is supposed to be a “love drug,” but people should show their serotonin nerve terminals some love and look after them by avoiding the drug.
