Prolonged brain dysfunction in COVID-19 survivors: A pandemic in its own right?


COVID-19 survivors face not only physical symptoms. A large study recently showed that their mental health is affected, too.
FG Trade/Getty Images

Chris Robinson, University of FloridaOne in three survivors of COVID-19, those more commonly referred to as COVID-19 long-haulers, suffered from neurologic or psychiatric disability six months after infection, a recent landmark study of more than 200,000 post-COVID-19 patients showed.

Researchers looked at 236,379 British patients diagnosed with COVID-19 over six months, analyzing neurologic and psychiatric complications during that time period. They compared those individuals to others who had experienced similar respiratory illnesses that were not COVID-19.

They found a significant increase in several medical conditions among the COVID-19 group, including memory loss, nerve disorders, anxiety, depression, substance abuse and insomnia. Additionally, the symptoms were present among all age groups and in patients who were asymptomatic, isolating in home quarantine, and those admitted to hospitals.

The results of this study speak to the seriousness of long-term consequences of COVID-19 infection. Numerous reports of brain fog, post-traumatic stress disorder, heart disease, lung disease and gastrointestinal disease have peppered the media and puzzled scientists over the past 12 months, begging the question: What effect does COVID-19 have on the body long after the acute symptoms have resolved?

I am an assistant professor of neurology and neurosurgery and can’t help but wonder what we have learned from past experience with other viruses. One thing in particular stands out: COVID-19 consequences will be with us for quite some time.

Red Cross volunteers from 1918 wearing masks.
Red Cross volunteers during the 1918 flu pandemic.
Apic/Getty Images

Learning from history

Past virus outbreaks, such as the 1918 flu pandemic and the SARS epidemic of 2003, have provided examples of the challenges to expect with COVID-19. And, the long-term effects of other viral infections help provide insight.

Several other viruses, including a large majority of those that cause common upper and lower respiratory infections, have been shown to produce such chronic symptoms as anxiety, depression, memory problems and fatigue. Experts believe that these symptoms are likely due to long-term effects on the immune system. Viruses trick the body into producing a persistent inflammatory response resistant to treatment.

Myalgic encephalomyelitis, also known as chronic fatigue syndrome, is one such illness. Researchers believe this condition results from continuous activation of the immune system long after the initial infection has resolved.

In contrast to other viral infections, the COVID-19 survivors in the study reported persistent symptoms lasting more than six months, with no significant improvement over time. The abundance of psychiatric symptoms was also notable and likely attributable to both infection and pandemic-related experience.

These findings are leading researchers to hypothesize several mechanisms following acute COVID-19 infection that may lead to long-haul COVID-19. With the known historical context of chronic symptoms following other viruses, doctors and researchers may have a glimpse into the future of COVID-19 with the potential to create therapies to alleviate patients’ persistent symptoms.

A male psychiatrist who had COVID-19.
Scott Krakower, a psychiatrist, poses in front of his home on July 8, 2020 in Port Washington on Long Island, N.Y. Krakower is a COVID-19 long-hauler.
Johannes Eisele/AFP via Getty Images

When does COVID-19 really end?

COVID-19 is now known to be a disease that affects all organ systems, including the brain, lungs, heart, kidneys and intestines.

Several theories exist as to the cause of chronic, lingering symptoms. Hypotheses include direct organ damage from the virus, continual activation of the immune system after acute infection and persistent lasting virus particles that find safe harbor within the body.

To date, autopsy studies have not confirmed the presence or overabundance of COVID-19 particles in the brain, making the immune theories the most likely cause of brain dysfunction.

Some recovered COVID-19 patients detail significant improvement or resolution of long symptoms following inoculation with the COVID-19 vaccine. Others report improvement following a short course of steroids. The most plausible explanation for the direct effects of long COVID-19 on the brain are due to its body-wide connections and the fact that COVID-19 is a multi-organ disease.

These findings may point to a direct immune related cause of long COVID-19, though no real answers yet exist to define the true cause and duration of the disease.

The post-COVID-19 world

In February, the National Institutes of Health announced a new initiative to study long COVID-19, now collectively defined as Post-Acute Sequelae of SARS-CoV-2. The NIH created a fund of US$1.15 billion to study this new disease. The aims of the study include the cause of long-term symptoms, the number of people affected by the disease and vulnerabilities leading to long COVID-19.

In my view, public health officials should continue to be open and transparent when discussing the short- and long-term effects of COVID-19. Society as a whole needs the best information possible to understand its effects and resolve the problem.

COVID-19 remains and will continue to be one of the largest socioeconomic problems across the world as we begin to recognize the true long-term impacts of the disease. Both the scientific and research communities should continue to be diligent in the fight long after the acute infections are gone. It appears that the chronic effects of the disease will be with us for some time to come.

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Chris Robinson, Assistant Professor of Neurology and Neurosurgery, University of Florida

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Lao Christians Expelled from Village Suffer Critical Illnesses


One dead, two hospitalized; village chief threatens other residents.

DUBLIN, May 14 (CDN) — In spite of assurances of religious rights by officials in March, Lao Christians expelled from a village in Saravan Province in January are suffering from a prolonged lack of adequate food and clean water.

The lack of basic resources has led to diarrhea, dehydration, eye and skin infections, fainting and general weakness for the Christians expelled from Katin village, and one person has died, Human Rights Watch for Lao Religious Freedom (HRWLRF) reported.

A Christian who went by the single name of Ampheng died suddenly in April while praying for one of two other Christians who were hospitalized with illnesses caused by their living conditions, an HRWLRF spokesman told Compass. The exact cause and date of Ampheng’s death were not immediately known.

Expelled from their village at gunpoint on Jan. 18 for failing to renounce their faith, the 48 Christians were forced to build temporary shelters at the edge of the jungle, about six kilometers (nearly four miles) away from the village.

They have since survived on food found in the jungle and water from a hand-dug well that is unfit for cooking or drinking, sources told HRWLRF.

District officials in early May gave the Christians permission to return to Katin village and take rice from their family rice barns to prevent starvation, said another source on condition of anonymity.

In addition, some of the Christians have returned to tend their family rice fields, fearing that if the fields are completely abandoned they may lose the right to cultivate them next year. Water buffaloes essential for farm work, however, were confiscated in January along with the Christians’ homes and registration papers, according to HRWLRF.

When the Christians interred Ampheng at the local burial ground, district officials fined them for failing to produce the required proof of house registration, according to HRWLRF.

Katin’s village chief recently warned other residents that their personal possessions would be confiscated if they had any contact with the expelled Christians. If any family continued to maintain contact despite repeated warnings, their own homes would be torn down, the chief reportedly said.

Official reactions to the plight of the Christians have been mixed. In March, a delegation of provincial and district officials led by Gov. Khamboon Duangpanya visited the Christians at their jungle site and assured them of their legal right to embrace the faith of their choice and to live anywhere in the district.

Just days earlier, however, the district head, identified only as Bounma, summoned seven of the Christians to his office and said that he would not tolerate the existence of Christianity in areas under his control. (See “Lao Officials Visit Expelled Christians, Give Assurances,” March 19.)

High level officials failed to intervene last July when villagers seized a Christian identified only as Pew and poured rice wine down his throat, killing him by asphyxiation. Village officials later fined Pew’s family for erecting a cross on his grave, and then detained 80 Christians in a school compound, denying them food and pressuring them to renounce their faith.

The heads of 13 families then signed documents renouncing Christianity in order to protect their children, but most resumed attendance at worship meetings within a few months.

Provincial officials did call a meeting in September 2008 asking Katin authorities to respect Lao religious laws and allow the Christians freedom to worship, but their request was ignored.

A communist country, Laos is 1.5 percent Christian and 67 percent Buddhist, with the remainder unspecified. Article 6 and Article 30 of the Lao Constitution guarantees the right of Christians and other religious minorities to practice the religion of their choice without discrimination or penalty.

Report from Compass Direct News 

17 more Christian men thrown into prison in Eritrea


Military officials on Saturday, March 27, 2010, arrested 17 young men gathered for prayer in a town called Segenaite in southern Eritrea, Africa. The men are apparently Christian soldiers doing their compulsory national military service. They belong to various churches, reports Open Doors USA.

The men are being held in a Segenaite Police Station prison cell. It is not clear whether they will be moved to another of Eritrea’s detention centers.

These arrests bring to 28 the reported number of Christians arrested since the beginning of March for their refusal to stop worshiping outside of the government sanctioned Eritrean Orthodox, Catholic and Evangelical Lutheran churches.

Sources announced in February that approximately 2,200 Christians remain in prison for their refusal to stop practicing their faith outside of the government sanctioned religious groups. The figure is significantly lower than the figure released at the beginning of 2009. Sources explained to Open Doors that many of those released were let go because of poor health. Most were also released on very strict bail conditions. Additionally, many other Christians have been released only to be sent back to the military in anticipation of a renewed war with neighboring Ethiopia. At least 12 Christians have died while being incarcerated in Eritrean prison camps.

Eritrea is ranked No. 11 on this year’s Open Doors World Watch List of 50 countries which are the worst persecutors of Christians.

Open Doors recently received the translation of a letter from a pastor of an Eritrean church written to his wife from prison.

My dearest wife;

God, by His holy will, has prolonged my prison sentence to five years and four month. I very much long for the day that I will be reunited with you my dear wife, our children and God’s people in the church.

My dear, listen to me; not only as a wife, but also as a Christian woman who has come to understand who God is and how deep and mysterious His ways are. Yes! I love you, I love the children and I would love to be free in order to serve God. But, in here, God has made me not only a sufferer for His Name’s sake in a prison of this world over which Christ has won victory, but also a prisoner of His indescribable love and grace.

I am testing and experiencing the love and care of our Lord every day. When they first brought me to this prison, I had thoughts which were contrary to what the Bible says. I thought the devil had prevailed over the church and over me. I thought the work of the gospel in Eritrea was over. But it did not take one day for the Lord to show me that He is a sovereign God and that He is in control of all things – even here in prison.

The moment I entered my cell, one of the prisoners called me and said, ‘Pastor, come over here. Everyone in this cell is unsaved. You are very much needed here.’ So, on the same day I was put in prison, I carried on my spiritual work.

My dear, the longer I stay in here, the more I love my Savior and tell the people here about His goodness. His grace is enabling me to overcome the coldness and the longing that I feel for you and for our children. Sometimes I ask myself, ‘Am I out of my mind? Am I a fool?’ Well, isn’t that what the apostle had said, ‘Whether I am of sound mind or out of my mind, it is for the sake of Christ.’ (2 Cor. 5:13)

My most respected wife, I love you more than I can say. Please help the children understand that I am here as a prisoner of Christ for the greater cause of the gospel.

— From a pastor in bonds in Eritrea

An estimated 100 million Christians worldwide suffer interrogation, arrest and even death for their faith in Christ, with millions more facing discrimination and alienation. Open Doors supports and strengthens believers in the world’s most difficult areas through Bible and Christian literature distribution, leadership training and assistance, Christian community development, prayer and presence ministry and advocacy on behalf of suffering believers.

Report from the Christian Telegraph 

Armenian Christian leader put to ‘Évin’ prison in Iran


Pastor Vahik Abrahamian, an Armenian Christian residing in Tehran, Iran, who was visiting a friend, upon his return to his home was arrested in Tehran by plainclothes security officers, reports FCNN. The manner in which he was arrested and the prolonged detention in Evin notorious prison, has created grave concern amongst the Iranian Christian community, particularly with family and friends.

"As per reports by FCNN correspondents and sources within the country, on Saturday 20th February 2010 (1 Esfand 1388) plainclothes security officers arrested 44 years old ‘Vahik Abrahamian’ , who is an Armenian Christian leader, as he was departing a friend’s house who was visiting Iran from Europe.

The manner in which Pastor Abrahamian was arrested is very unsettling and indeed ambiguous. As per received reports, 3 plainclothes security agents who were in a green Peugeot vehicle, swarmed upon Mr. & Mrs. Abrahamian as they were departing their friends house.

What is quite uncommon in any similar incident, one of the agents was filming the whole episode with a handheld camera. The agents showed an arrests warrant with permission to ‘shoot to kill’. After searching their vehicle and seizing all personal belongings, they set Mrs. Abarahmian free and took Pastor Vahik to Evin prison.

As per FCNN reports, wife and parents and extended family and friends of this Armenian Christian leader, are extremely concerned for the well being of the prisoner and are completely in state of shock. Mrs. Abrahamian has been unwilling or afraid to discuss the matter with anyone.

All Pastor Vahik’s family and friends vouch for his meek, humble and Godly character. All are unanimous that he was not only God fearing and law abiding citizen but was also very compassionate and sensitive particularly to the drug addicts and reached out to serve them. All are totally convinced that his character is beyond reproach and are hoping that this grave misunderstanding by the authorities will clear and he will be set free.

It’s noteworthy that Pastor Abrahamian had dual Dutch and Iranian citizenship, yet chose to live, work and serve in his native country Iran, staying close to aging mother and family.

As per obtained reports, there are many unanswered questions with regards to the circumstances leading to his arrest which is normally conducted in detaining known terrorists or political activists. The authorities have neither commented why this extraordinary measures were taken and nor why is he being held for such lengthy period. It’s also unclear who is holding this law abiding ordinary citizen and which authority has ordered his arrest! It seems that we have a long wait to hear from Islamic republic Juridical and legal authorities about reason of his arrest.

The received reports indicate that after elapse of over a month from his arrest, there is complete silence by Iranian Legal and juridical authorities and so far he has been denied appointment of a lawyer or visits by next of keen. Mother, Wife, brother and extended family are extremely concerned for his well being and are grief stricken with no clear and promising news.

At this time we would like to beseech all Christian community in Iran and overseas to fast and pray for his release and also pray for other Christians arrested in the last days and weeks in various cities in Iran. May God in His grace intervene in this situation and let’s hope that he will unite with his family bringing great joy and relief in the festive days of the Nowruz’ spring in Iran.

Report from the Christian Telegraph 

Baseless Case Against Turkish Christians Further Prolonged


Justice Ministry receives international inquiry about progress of trial.

SILIVRI, Turkey, February 15 (CDN) — Barely five minutes into the latest hearing of a more than three-year-old case against two Christians accused of “insulting Turkishness and Islam,” the session was over.

The prosecution had failed to produce their three final witnesses to testify against Hakan Tastan and Turan Topal for alleged crimes committed under Article 301 of the Turkish penal code. The same three witnesses had failed to heed a previous court summons to testify at the last hearing, held on Oct. 15, 2009.

This time, at the Jan. 28 hearing, one witness employed in Istanbul’s security police headquarters sent word to inform the court that she was recovering from surgery and unable to attend. Of the other two witnesses, both identified as “armed forces” personnel, one was found to be registered at an address 675 miles away, in the city of Iskenderun, and the other’s whereabouts had not yet been confirmed.

So the court issued instructions for the female witness to be summoned a third time, to testify at the next hearing, set for May 25. The court ordered the witness in Iskenderun to submit his “eyewitness” testimony in writing to the Iskenderun criminal court, to be forwarded to the Silivri court. No further action was taken to summon the third witness.

International Inquiry

Judge Hayrettin Sevim, who has presided over the last five hearings on the case, informed the plaintiff and defense lawyers that recently his court had been requested to supply the Justice Ministry with a copy of relevant documents and details from the case file.

An inquiry outside Turkey about the progress of the case, he said, prompted the request.

Seven different state prosecutors have been assigned to the case since Prosecutor Ahmet Demirhuyuk declared at the fourth hearing in July 2007 that “not a single concrete, credible piece of evidence” had been produced to support the accusations against the Protestant defendants. After Demihuyuk recommended that the charges be dropped and the two Christians acquitted, he was removed from the case.

Originally filed in October 2006, the controversial Article 301 case accused Tastan and Topal, both former Muslims who converted to Christianity, of slandering the Turkish nation and Muslim religion while involved in evangelistic activities in Silivri, an hour’s drive west of Istanbul in northwestern Turkey.

After Turkey enacted cosmetic changes in the wording of Article 301 in May 2008, all cases filed under this law require formal permission from the justice minister himself to go on to trial.

According to the Turkish Justice Ministry, only eight of more than 900 Article 301 cases sent for review since the law’s revision have been approved for prosecution. On Friday (Feb. 12) the Justice Ministry declined in writing a Compass request last month for a list of the eight cases in question.

Despite the lack of any legally credible evidence against Tastan and Topal, the Silivri case is one of those eight cases personally approved by the Justice Minister.

According to a CNNTURK report dated Dec. 8, 2009, U.S. President Barack Obama raised the Article 301 issue with Turkish Prime Minister Recep Tayyip Erdogan during their last face-to-face meeting in Washington, D.C.

“I think those asking about this don’t know what Article 301 is,” Erdogan reportedly said. “Until now it has only happened to eight persons.”

This month the Organization for Security and Cooperation in Europe criticized Turkey’s revision of Article 301, declaring that the government should simply abolish the law.

The Parliamentary Assembly of the Council of Europe (PACE) in Strasbourg also warned earlier this month that Turkey is violating Article 10 of the European Convention on Human Rights to the extent that the European Court of Human Rights may impose sanctions on Turkey over Article 301.

Noting that the Assembly welcomed previous amendments to the law, the most recent PACE report declares it “deplores the fact that Turkey has not abolished Article 301.”

Report from Compass Direct News 

SAUDI ARABIA: AUTHORITIES RELEASE CHRISTIAN BLOGGER


Kingdom silences convert, prohibits him from leaving country.

LOS ANGELES, April 16 (Compass Direct News) – In a surprise move, a Saudi Christian arrested in January for describing his conversion from Islam and criticizing the kingdom’s judiciary on his blog site was released on March 28 with the stipulation that he not travel outside of Saudi Arabia or appear on media.

Hamoud Saleh Al-Amri (previously reported as Hamoud Bin Saleh), 28, reportedly attributed his release to advocacy efforts by the Arab Network for Human Rights Information (ANHRI). The Cairo-based organization had campaigned for his release along with other rights groups, reported Christian advocacy organization Middle East Concern (MEC).

Gamal Eid, director of ANHRI, told Compass by telephone that he believed his organization had nothing to do with Al-Amri’s release. Rather, he said he believed officials were loath to keep a person of questionable mental stability in prison.

“He is mentally not stable, because he had the courage to say in his blog that he is a Christian,” Eid said. “Anyone in his right mind in Saudi Arabia wouldn’t do that.”

The country’s penalty for “apostasy,” or leaving Islam, is death, although in recent years there have been no known cases of kingdom citizens formally convicted and sentenced with capital punishment for the offense.

This was not the first imprisonment for Al-Amri. He was detained in 2004 for nine months and in 2008 for one month before he was re-arrested on Jan. 13 of this year, and Eid said the young blogger was tortured during the first two incarcerations.

Al-Amri’s treatment during this latest imprisonment is unknown. After his previous releases he had contacted Eid’s office, but the ANHRI director said he has not done so since being released from Riyadh’s Eleisha prison, known for its human rights abuses.

“He was mistreated the first two times he was imprisoned, but this time I don’t know, because he hasn’t contacted me,” said Eid. “In the past he was mistreated with sleep deprivation, prolonged solitary confinement and a continuous barrage of physical torture and insults.”

The advocate added that it is likely Al-Amri was mistreated during his recent imprisonment.

“I consider anyone who declares his religion to be anything than Islam to be extremely brave and courageous, but this extreme courage bordering on carelessness is madness, because he knows what could happen in Saudi,” Eid said. “I’m not a doctor, but I find this extreme.”

Al-Amri has become isolated from his family and lives alone, Eid said, but he said he was unable to comment on the convert’s current situation.

 

Blog Blocked

Following Al-Amri’s latest arrest, MEC reported, Saudi authorities blocked access to his blog inside Saudi Arabia. Google then locked it, claiming there was a technical violation of terms of service. On Feb. 5 it was reportedly restored due to public pressure – after his March 28 release, Al-Amri had credited his release to ANHRI’s efforts on his blog, www.christforsaudi.blogspot.com – but yesterday Compass found the site did not work.

Eid said he was not surprised the blog was blocked.

“That’s what I expected,” he said. “But he will probably start another blog – it’s not difficult.”

Saudi Arabia’s ruling monarchy restricts media and other forms of public expression, though authorities have shown some tolerance for criticism and debate since King Abdullah bin Abdul Aziz Al Saud officially ascended to the throne in 2005, according to the U.S. Department of State.

“Arabic countries are the worst on the list of censoring the Internet and are at the top of the list of antagonizing the freedom of the Internet,” said Eid. “But the Internet is still a good venue, because people are still able to express their views despite the government’s effort to curtail their efforts.”

In his blog prior to his arrest, Al-Amri had criticized the government for quashing individual rights.

“A nation which lives in this system cannot guarantee the safety of its individuals,” he wrote. “Preserving their rights from violation will always be a matter of concern, as the rights of a citizen, his dignity and humanity will always be subject to abuse and violation by those few who have absolute immunity provided to them by the regime.”

Eid of ANHRI described lack of civil law in Saudi Arabia as “extreme.” Citizens can be tortured endlessly, he said, adding that Saudis who openly state Christian faith face severe danger.

Although there have been recent moves towards reform, Saudi Arabia restricts political expression and allows only a strict version of Sunni Islam to be publicly practiced, according to MEC.

Political critic Fouad Ahmad al-Farhan became the first Saudi to be arrested for Web site postings on Dec. 10, 2007; he was released in April 2008.

Eid said he believes the lenient action of the Saudi authorities is a welcome move in a country where “there is no such thing as religious freedom.” In fact the move could encourage people of other faiths to speak up.

“This will open the door to whoever wants to express his belief, whether Christian, Hindu or other,” he said.

Saudis who choose a faith other than Islam and express it may face extra-judicial killings. In August 2008, a 26-year-old woman was killed for disclosing her faith on a Web site. Fatima Al-Mutairi reportedly had revealed on Web postings that she had left Islam to become a Christian.

Gulfnews.com reported on Aug. 12, 2008 that her father, a member of the religious police or Commission for Promotion of Virtue and Prevention of Vice, cut out her tongue and burned her to death “following a heated debate on religion.” Al-Mutairi had written about hostilities from family members after they discovered she was a Christian, including insults from her brother after he saw her Web postings about her faith. Some reports indicated that her brother was the one who killed her.

She had reportedly written an article about her faith on a blog of which she was a member under the nickname “Rania” a few days before her murder.

Report from Compass News Direct