Leslie Ann Coles knew “almost immediately” something was wrong after her COVID-19 infection in January 2021.
The filmmaker from Woodbridge, Ont., had never had writer’s block in her life — but she couldn’t find the words to make revisions to a screenplay she’d been working on.
“It was really, really frightening,” Coles said.
Leslie Ann Coles poses for a photograph in Toronto on Wednesday, May 31, 2023. Coles knew “almost immediately” something was wrong after her COVID-19 infection in January 2021. THE CANADIAN PRESS/Nathan Denette
Her emotional state changed too.
“I’ve never in my life suffered from depression,” Coles said. “My friends refer to me as the eternal optimist.”
But her usual passion for life and work had waned, leaving her feeling “apathetic, for lack of a better word,” she said.
Researchers have been trying to understand what causes the many symptoms of long COVID, including neurological issues suffered by an estimated hundreds of thousands of Canadians like Coles.
Now, a team led by the Centre for Addiction and Mental Health (CAMH) has found physiological evidence of brain inflammation in people with cognitive and depressive symptoms months after their COVID-19 infections.
Autopsies of people who died in the midst of severe COVID-19 infection have previously shown they had brain inflammation, said Dr. Jeffrey Meyer, head of the neuroimaging program in mood and anxiety at CAMH and senior author of the study published Thursday in JAMA Psychiatry.
The current study shows brain inflammation inpeople who have recovered from acute COVID-19 but go on to have lasting neurological problems — even though their initial infection wasn’t severe, he said.
“These are people who’ve got long COVID and have actually not been hospitalized. They have mild to moderate severity acute COVID, but then have considerable symptoms thereafter,” Meyer said.
“Our study shows that there’s inflammation months to over a year later in people who’ve got long COVID.”
The researchers did positron emission tomography (PET) scans on the brains of 20 participantswho had started suffering from depression within three months of testing positive for COVID-19.
Most of them had additional cognitive issues associated with long COVID, including problems with memory and concentration, also known as “brain fog.”
The researchers compared those scans to 20 brain scans from “healthy” people that had been done prior to the pandemic.
They found that people who had long COVID had higher levels of translocator protein, or TPSO, in their brains. TSPO appears on glial cells, which increase with inflammation.
The most pronounced increase in inflammation was in two areas of the brain — the ventral striatum and dorsal putamen, the study said.
Those are parts of the brain associated with the ability to experience enjoyment, energy and motivation levels, cognitive processing and speed of movement.
“We know that when there’s injury to these brain regions you get some of the symptoms that we’re seeing in the people with long COVID,” Meyer said.
Long COVID sufferers have been eagerly awaiting these findings “for validation that brain fog is real and caused by functional changes from COVID-19,” said Susie Goulding, founder of the COVID Long-Haulers Canada online support group, which helped recruit study participants.
“This concrete evidence will hopefully bring understanding and guidance” to family doctors who encounter patients describing neurological symptoms after COVID infection, Goulding said in a text message to The Canadian Press.
Dr. Angela Cheung, co-lead of a national long COVID research network and senior physician-scientist at the University Health Network in Toronto, said the study confirms what long COVID researchers have suspected for some time.
“We have always thought that inflammation plays a part,” said Cheung, who was not involved in the CAMH study.
“It’s been difficult to measure inflammation in patients.” she said. “This study shows that in people with persistent depressive and cognitive issues, that there is neural inflammation in the brain.”
But Dr. Lakshmi Yatham, a psychiatrist at the University of British Columbia who researches mental health issues related to COVID-19, said that although the study is valuable, there are important limitations to consider.
“It’s a good first attempt to look at the inflammation. But you cannot at this stage attribute that the inflammation is what’s responsible for depressive symptoms,” Yatham said.
One limitation, he said, is that some of the participants had previous experiences with depression.
However, Meyer said those people made up fewer than half of the participants, and any past depressive symptoms had resolved before they got COVID-19.
Yatham said further study is needed using a control group of people who have recovered from COVID-19 and didn’t have long COVID to compare the levels of brain inflammation. That wasn’t possible in the CAMH study because the brain scans of the control group had been done prior to the pandemic.
One of the next steps for the CAMH team is to “test out whether some kinds of anti-inflammatory or inflammatory-altering medications might be helpful for long COVID,” said Meyer.
Cheung said other researchers are also planning anti-inflammatory medication studies.
Leslie Ann Coles has learned tactics to work around memory problems that persist to this day, including constantly writing things down and taking photos on her phone.
For her, like so many other long COVID sufferers, the next steps in research can’t come soon enough.
“I hope they find ways in which this study helps people with long COVID recover,” she said.
This report by The Canadian Press was first published June 1, 2023.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
