Terrifying ‘post-COVID syndrome’ is next focus for researchers in Bay Area and beyond

The end of the pandemic feels tantalizingly near as vaccines arrive and the pace of new infections slows. But a new coronavirus mystery is set to keep researchers busy in the Bay Area and across the country for years to come. Doctors call the medical conundrum “post-acute COVID syndrome.” Scientists prefer “post-acute sequelae of SARS-CoV-2 infection.” But those suffering from the multitude of frightening symptoms that don’t go away just call themselves “long-haulers.”

“Thousands of researchers across the United States are going to be developing projects to study this problem,” said Dr. Michael Peluso, an infectious disease expert who manages a UCSF study of long-haulers with funding for 250 participants. “There will be a huge effort to do this now, and it will far exceed the small studies that have existed so far.”

At UCSF, 20 of the first 100 people in the study of long-haulers reported persistent brain fog — including forgetfulness, trouble thinking of words, and disorganized thinking that led to missed deadlines. Of the 20, 14 had never been to the hospital for their COVID, so the changes couldn’t be blamed on side effects often associated with immobility or drugs administered during a long stay for treatment.

Dr. Joanna Hellmuth, a neurologist, took a closer look at the 14, whose median age was 39. Cognitive symptoms in patients recovering from COVID-19 may “last months or longer after acute illness,” Hellmuth and her colleagues reported in a study published Feb. 2 on the online site SpringerLink. They also found that traditional tests for detecting dementia in elderly people showed nothing wrong with this group.

Instead, the problem looked similar to the kind of brain fog associated with HIV, which is linked to inflammation and an overactive immune system. But questions remain. “Is this a direct impact of the virus? Or an indirect impact of the inflammation? What if the immune system is instead making antibodies against the brain — a postinfectious autoimmune process?” The neurologist has submitted a grant proposal to find the answers.