Tackling the science behind the ‘long COVID’


Meet UBC researchers studying the long-term effects of COVID-19

The number of COVID-19 cases in Canada is declining, vaccine deployment is accelerating, and public health restrictions are easing across the country. Meanwhile, thousands of Canadians are still struggling with long-term complications months after contracting the virus.

Known as the “long haul,” people with post-acute COVID-19 suffer from persistent and in some cases life-altering symptoms ranging from extreme fatigue, shortness of breath and heart palpitations. brain fog and depression.

Meet some of the researchers at UBC School of Medicine who are working with our partners to fight the long-term effects of COVID-19 in an effort to find answers and improve the lives of patients.

Dr Anita Palepu on the full spectrum of the disease

Dr. Anita Palepu, professor at UBC and head of the department of medicine, is the Vancouver site manager for a national study, CANCOV, which assesses the full range of short and long-term outcomes after COVID-19 .

“We initially thought COVID-19 was a respiratory disease, but what we learned is that it is a multisystem disease, affecting multiple organs, brain, heart, kidneys and from the liver to the gastrointestinal tract, ”says Dr Palepu.

The study, also conducted at sites in Quebec, Ontario and Alberta, examines the myriad health consequences of COVID-19 in patients as well as their family caregivers. A key objective of the research is to determine clinical risk factors, as well as the rate of recovery across the spectrum of the disease.

“We initially thought COVID-19 was a respiratory disease, but what we learned is that it is a multisystem disease, affecting multiple organs, brain, heart, kidneys and from the liver to the gastrointestinal tract. “

Dr Anita Palepu

“There is growing evidence that once vaccinated, people with post-acute COVID-19 syndrome may show improvement in symptoms over time,” says Dr. Palepu. “This is certainly an area of ​​interest that we will explore further. “

In addition to his role as Site Manager, Dr Palepu, who is also Head of the Department of Medicine at Providence Health Care, is part of a larger team of experts helping to oversee patient-oriented research and activities. ongoing clinics in St. Paul’s Hospital Post-COVID-19 Recovery Clinic, one of three clinics in the Lower Mainland providing specialist care and follow-up to patients with long-term symptoms.

“Research priorities are guided by researchers, with the partnership of patients,” explains Dr Palepu.

Dr Chris Carlsten on Lung Health

When COVID-19 emerged, Dr. Chris Carlsten, professor at UBC and head of the division of respiratory medicine, and his team immediately began following patients discharged from the hospital.

“At the time, very little was known about the lingering lung problems that survivors face and the care they would need,” says Dr Carlsten.

In a two-year study examining respiratory results, researchers continued to track and monitor COVID-19 patients, capturing CT scans and regularly testing their lung function.

The first results, published last fall, revealed that three-quarters of patients hospitalized for COVID-19 showed symptoms months later. CT scans have shown that one in five people have lung scarring, an indicator of future compromised lung function, says Dr Carlsten.

Today, the emerging findings reveal a striking new observation: While patients begin to show signs of improvement based on their test and imaging results, their reported symptoms are not improving proportionately.

In 40 to 50 percent of cases, Dr Carlsten says patients report shortness of breath three to six months later, despite the objective improvements seen in testing.

“Breathing is a vital necessity and when you feel like you can’t breathe enough it’s fundamentally worrying,” says Dr Carlsten. “By identifying the respiratory challenges patients continue to face, our research will be able to inform and guide the care they need to move forward.”

Dr Teresa Liu-Ambrose on Brain Health

Dr. Teresa Liu-Ambrose, Professor in the Department of Physiotherapy at UBC, is known internationally for her work on healthy aging and the aging of the brain.

When the pandemic struck, she quickly turned her attention to studying the long-term impacts of the new virus on patients’ cognition and brain function.

“Since the start of the pandemic, there is consistent evidence that COVID-19 has an impact on the brain, ranging from infection to stroke to delirium,” says Dr. Liu-Ambrose, director of the Laboratory of Aging, Mobility and Cognitive Neuroscience at UBC.

Collaborating with researchers from across the country, Dr. Liu Ambrose is co-leading a national study that includes eight research sites in Canada.

Together, they measure cognitive function and acquire brain scans from Canadians aged 55 to 80, who are enrolled in the Canadian Longitudinal Study on Aging. Researchers will then compare the function, brain structure and brain function of adults with suspected or confirmed COVID-19 to those who have no symptoms or who test negative.

Recent evidence suggests that some of the impacts of COVID-19 on the brain are more subtle, including silent strokes, which may contribute to the risk of developing dementia, according to Dr. Liu-Ambrose.

“By advancing our understanding of the more subtle impacts of COVID-19 on the brain and cognition, we can implement early screening and interventions, which will ultimately improve outcomes for Canadians.”

Dr Teresa Liu-Ambrose

“Despite their name, silent strokes have a significant impact on our cognition and generally increase in severity over time,” she says.

“By advancing our understanding of the more subtle impacts of COVID-19 on the brain and cognition, we can implement early screening and interventions, which will ultimately improve outcomes for Canadians,” he adds. it.

Dr Lakshmi Yatham on mental health

Dr Lakshmi Yatham, professor at UBC and head of the department of psychiatry, is involved in a number of studies exploring the psychological toll of the pandemic.

“New research shows that if you are diagnosed with COVID-19, your risk of developing symptoms of a mental disorder – ranging from depression and anxiety to post-traumatic stress disorder – is almost as high as 40 percent, ”says Dr Yatham.

There are a host of factors behind this increased risk, Dr Yatham says, including stress associated with fear of the unknown and being diagnosed with a new illness, isolation from social supports during recovery. and trauma resulting from life-saving procedures, such as being placed on a ventilator.

Inflammation caused by the disease may also play a role.

“Whenever there is inflammation in the body, there is an increased risk of developing psychiatric and neurological problems,” says Dr. Yatham.

In partnership with Dr Daniel Vigo of the Department of Psychiatry and Dr Raymond Ng of the School of Biomedical Engineering, the research team uses machine learning algorithms and connects BC population data, data from COVID-19 test and health administration data to identify clinical data. and demographic characteristics that predict who is at risk for developing mental disorders.

“As we emerge from the pandemic, our social behaviors will return to a new normal, but the mental health effects may take much longer to resolve. This is why moving forward, it is so important that we continue to build resilience and deploy early intervention strategies.

Dr Lakshmi Yatham

“Ultimately, we hope to have a system that will help us identify those at increased risk, which will allow us to target those people early on in order to prevent and minimize adverse mental health effects,” Dr Yatham said.

As Regional Chief of Psychiatry for Vancouver Coastal Health and Providence Health and Head of the Department of Psychiatry at UBC, Dr Yatham facilitated the establishment of the COVID-19 Psychiatric Clinic at St. Paul’s Hospital, which provides assessment and treatment for people who have been treated for COVID-19 at Vancouver Coastal Health and Providence Health Care hospitals.

“As we emerge from the pandemic, our social behaviors will return to a new normal, but the mental health effects may take much longer to resolve,” Dr Yatham said. “This is why, moving forward, it is so important that we continue to build resilience and deploy early intervention strategies. “

Dr Yatham is also collaborating with international researchers on COH-FIT, a mental and physical health survey that helps researchers around the world determine how mental health services can evolve to meet current needs and how we can individually cope with anxiety. In addition, he is collaborating with researchers in Australia, the United States, New Zealand, the Netherlands and the United Kingdom to examine the impact of lockdowns on the mental health of people with pre-existing mental disorders.

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Posted: July 5, 2021


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