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| Meta Title | The Secrets of Covid âBrain Fogâ Are Starting to Lift | WIRED |
| Meta Description | Scientists are getting closer to understanding the neurology behind the memory problems and cognitive fuzziness that an infection can trigger. |
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| Boilerpipe Text | Paige was having
a great start to 2021. Her health was the best it had ever been. She loved her job and the people she worked with as a communications manager for a conservation nonprofit. She could get up early in the mornings to work on creative projects. Things were looking âreally, really good,â she saysâuntil she got
Covid-19
.
While the initial infection was not fun, what followed was worse. Four weeks later, when Paige (who asked to be identified only by her middle name) had recovered enough to go back to work full-time, she woke up one day with an overwhelming fatigue that just never went away. It was accompanied by a loss of mental sharpness, part of a suite of sometimes hard-to-pin-down symptoms that are often referred to as
Covid-19 âbrain fog,â
a general term for sluggish or fuzzy thinking. âI spent most of 2021 making decisions like: Is this the day where I get a shower, or I go up and microwave myself a frozen dinner?â Paige recalls. The high-level writing required for her job was out of the question. Living with those symptoms was, in her words, âhell on earth.â
Many of these
hard-to-define
Covid-19 symptoms can
persist over time
âweeks, months, years. Now, new research in the journal
Cell
is shedding some light on the biological mechanisms of how Covid-19 affects the brain. Led by researchers Michelle Monje and Akiko Iwasaki, of Stanford and Yale Universities respectively, scientists determined that in mice with mild Covid-19 infections, the virus disrupted the normal activity of several brain cell populations and left behind signs of inflammation. They believe that these findings may help explain some of the cognitive disruption experienced by Covid-19 survivors and provide potential pathways for therapies.
For the past 20 years, Monje, a neuro-oncologist, had been trying to understand the neurobiology behind chemotherapy-induced cognitive symptomsâsimilarly known as âchemo fog.â When Covid-19 emerged as a major immune-activating virus, she worried about the potential for similar disruption. âVery quickly, as reports of cognitive impairment started to come out, it was clear that it was a very similar syndrome,â she says. âThe same symptoms of impaired attention, memory, speed of information processing, dis-executive functionâit really clinically looks just like the âchemo fogâ that people experienced and that weâd been studying.â
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In September 2020, Monje reached out to Iwasaki, an immunologist. Her group had already established a mouse model of Covid-19, thanks to their Biosafety Level 3 clearance to work with the virus. A mouse model is engineered as a close stand-in for a human, and this experiment was meant to mimic the experience of a person with a mild Covid-19 infection. Using a viral vector, Iwasakiâs group introduced the
human ACE2 receptor
into cells in the trachea and lungs of the mice. This receptor is the point of entry for the Covid-causing virus, allowing it to bind to the cell. Then they shot a bit of virus up the miceâs noses to cause infection, controlling the amount and delivery so that the virus was limited to the respiratory system. For the mice, this infection cleared up within one week, and they did not lose weight.
Coupled with biosafety regulations and the challenges of cross-country collaboration, the security precautions required by the pandemic created some interesting work constraints. Because most virus-related work had to be done in Iwasakiâs laboratory, the Yale scientists would take advantage of overnight shipping to fly samples across the country to Monjeâs Stanford laboratory where they could be analyzed. Sometimes, they would need to film experiments with a GoPro camera to make sure that everybody could see the same thing. âWe made it work,â Monje says.
Most Popular
Once the mice had been infected with the virus, the scientists assessed the levels of cytokines in their blood and cerebrospinal fluid (the liquid surrounding the brain) at seven days and seven weeks after infection. Cytokines are markers secreted by the immune system, and they are critical in regulating inflammation. Not only were certain cytokines elevated in the cerebrospinal fluid at both time periods, but the scientists saw an increase of microglia reactivity in the subcortical white matter of the brainâthe squishy white tissue rife with nerve fibers that makes up over half of the brainâs volume. That was another sign of potential trouble.
Microglia are sort of like the central nervous systemâs hungry scavengers. They are immune cells that clean up the brain by chomping on dead and unwanted neural debris, among other important functions. âThereâs a unique subpopulation of microglia in the white matter called axon tract microglia,â Monje says. These have a specific genetic signature, she continues, and âare exquisitely sensitive to a wide range of insults,â like inflammatory or toxic stimuli.
In response to these stimuli, microglia can become perpetually reactive. One consequence is that they can begin eating away at needed neurons or other brain cells, which further disrupts the brainâs homeostasis. In the case of Covid-19, the scientists found that this reactivity persisted even at seven weeks after infection. Monjeâs team had seen similar elevation in this activity following chemotherapy and in brain samples from human patients who were infected with Covid-19. In the hippocampus (the area of the brain closely associated with memory), this overenthusiastic cleanup effort can deter the creation of new neurons, which are linked to maintaining healthy memory.
To figure out what exactly caused the microglia to become reactive, the researchers looked for the cytokines that had reached elevated levels. Specifically, Anthony Fernandez Castaneda, a postdoctoral researcher in Monjeâs laboratory and a study coauthor, found CCL11âa factor that can decrease the generation of new neurons and impair learning or memory. âThe elevated CCL11 result was very interesting, because it could potentially explain why some Covid survivors experience cognitive symptoms,â he says.
In a second phase of the experiment, the researchers gave shots of CCL11 to a separate group of mice. Then they examined tissue from their brains to discover where the microglia had been reactive, and where fewer new neurons had grown. That turned out to be in the hippocampusâindicating that CCL11 acted on very specific cell populations in a memory-related area of the brain.
Next, the scientists decided to investigate the effects of mild Covid-19 infection on myelinating oligodendrocytesâbrain cells that generate the myelin âpaddingâ around neurons to provide insulation for better inter-neuron communication. Previously, work done by Anna Geraghty (another postdoctoral fellow in Monjeâs lab and study coauthor) had focused on how chemotherapy affects this process. Myelin loss in the mice treated with chemo was found to be directly linked with deficits in short-term memory and attention. âEven minor adjustments in those myelin can actually impact neuronal communication in quite diverse ways,â she says. âLosing that ability to adaptively respond to neuronal activity led to persistent cognitive impairments in these mice.â
Most Popular
Geraghty recalls staying in the lab late at night during the Christmas holiday to finish the analysis of how Covid-19 affected that padding in mouse neurons. The result: The infected mice had lost approximately one-third of their mature oligodendrocytes, and had a statistically significant drop in myelination compared to mice in a control group. The magnitude of myelin loss was almost identical to what the lab had discovered when studying mice and chemo. She excitedly texted the results to Monje. âThere was just a big moment in my brain of, âOh my gosh, this data is incredibly interesting,ââ Geraghty recalls.
Joanna Hellmuth, a cognitive neurologist at UC San Francisco who was unaffiliated with the study, notes that the âmouse data is very compelling,â and more studies are needed to see how these results translate into treatments for human patientsâlike Paige or others struggling with long Covid and cognitive symptoms. Figuring out which drugs to try first, though, could benefit from understanding the biological cause of brain fog symptoms. ââBrain fogâ is a colloquial term,â says Hellmuthâand it âkind of delegitimizes peoplesâ having a neurological disorder.â
Wes Ely, a pulmonary and critical care specialist at Vanderbilt University Medical Center who was unaffiliated with the study, believes that such studies can lead to future therapeutic development. âThis work paves the path towards both pharmacological, neuropsychological, and cognitive rehabilitative mechanisms to rebuild brain power,â he says.
For example, Monje thinks, some drug candidates that already worked in âchemo fogâ animal models might be useful for treating Covid-related cognitive symptoms. She hopes to test these candidates on the Covid-19 mouse model to see if they help.
The team would also like to investigate other questions, like whether these neurological effects are different after even longer periods of time, or if they are different following a breakthrough infection after vaccination. Theyâd also like to compare what theyâve found in Covid-19 mouse models to neurological reactions to another famous virusâH1N1, which causes swine flu. The team had found that in a mouse model of H1N1, the drop in oligodendrocytes and increase in microglial reactivity in the subcortical white matter generally normalized by seven weeksâunlike for the Covid-infected mice. They also found that, in mice infected with either virus, CCL11 was elevated in the cerebrospinal fluid. Monje hopes to study what she calls this âprominent shared mechanismâ in further detail.
While Monje and Iwasakiâs work has given researchers a better idea of how Covid might affect the brain, it may take years before there is a working treatment for patients. For Paige, the time cannot come soon enough. In 2022, she got Covid again. âIâm just praying for medicine, praying for treatment,â she says. |
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# The Secrets of Covid âBrain Fogâ Are Starting to Lift
Scientists are getting closer to understanding the neurology behind the memory problems and cognitive fuzziness that an infection can trigger.

Photograph: Jose Calvo/Science Source
Save this story
Save this story
Paige was having a great start to 2021. Her health was the best it had ever been. She loved her job and the people she worked with as a communications manager for a conservation nonprofit. She could get up early in the mornings to work on creative projects. Things were looking âreally, really good,â she saysâuntil she got [Covid-19](https://www.wired.com/tag/covid-19).
While the initial infection was not fun, what followed was worse. Four weeks later, when Paige (who asked to be identified only by her middle name) had recovered enough to go back to work full-time, she woke up one day with an overwhelming fatigue that just never went away. It was accompanied by a loss of mental sharpness, part of a suite of sometimes hard-to-pin-down symptoms that are often referred to as [Covid-19 âbrain fog,â](https://www.wired.com/story/confused-about-covid-brain-fog-doctors-have-questions-too/) a general term for sluggish or fuzzy thinking. âI spent most of 2021 making decisions like: Is this the day where I get a shower, or I go up and microwave myself a frozen dinner?â Paige recalls. The high-level writing required for her job was out of the question. Living with those symptoms was, in her words, âhell on earth.â
#### Content
To honor your privacy preferences, this content can only be viewed on the site it [originates](https://player.spokenlayer.net/v1-wired-science?__v=linear&url=http://www.wired.com/story/the-secrets-of-covid-brain-fog-are-starting-to-lift) from.
Many of these [hard-to-define](https://www.wired.com/story/to-help-people-with-long-covid-scientists-need-to-define-it/) Covid-19 symptoms can [persist over time](https://www.wired.com/story/exactly-how-many-people-long-covid/)âweeks, months, years. Now, new research in the journal [*Cell*](https://www.cell.com/cell/fulltext/S0092-8674\(22\)00713-9) is shedding some light on the biological mechanisms of how Covid-19 affects the brain. Led by researchers Michelle Monje and Akiko Iwasaki, of Stanford and Yale Universities respectively, scientists determined that in mice with mild Covid-19 infections, the virus disrupted the normal activity of several brain cell populations and left behind signs of inflammation. They believe that these findings may help explain some of the cognitive disruption experienced by Covid-19 survivors and provide potential pathways for therapies.
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For the past 20 years, Monje, a neuro-oncologist, had been trying to understand the neurobiology behind chemotherapy-induced cognitive symptomsâsimilarly known as âchemo fog.â When Covid-19 emerged as a major immune-activating virus, she worried about the potential for similar disruption. âVery quickly, as reports of cognitive impairment started to come out, it was clear that it was a very similar syndrome,â she says. âThe same symptoms of impaired attention, memory, speed of information processing, dis-executive functionâit really clinically looks just like the âchemo fogâ that people experienced and that weâd been studying.â
### WIRED's Guide to How the Universe Works
Your weekly roundup of the best stories on health care, the climate crisis, new scientific discoveries, and more.
In September 2020, Monje reached out to Iwasaki, an immunologist. Her group had already established a mouse model of Covid-19, thanks to their Biosafety Level 3 clearance to work with the virus. A mouse model is engineered as a close stand-in for a human, and this experiment was meant to mimic the experience of a person with a mild Covid-19 infection. Using a viral vector, Iwasakiâs group introduced the [human ACE2 receptor](https://www.wired.com/story/meet-ace2-the-enzyme-at-the-center-of-the-covid-19-mystery/) into cells in the trachea and lungs of the mice. This receptor is the point of entry for the Covid-causing virus, allowing it to bind to the cell. Then they shot a bit of virus up the miceâs noses to cause infection, controlling the amount and delivery so that the virus was limited to the respiratory system. For the mice, this infection cleared up within one week, and they did not lose weight.
Coupled with biosafety regulations and the challenges of cross-country collaboration, the security precautions required by the pandemic created some interesting work constraints. Because most virus-related work had to be done in Iwasakiâs laboratory, the Yale scientists would take advantage of overnight shipping to fly samples across the country to Monjeâs Stanford laboratory where they could be analyzed. Sometimes, they would need to film experiments with a GoPro camera to make sure that everybody could see the same thing. âWe made it work,â Monje says.
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Once the mice had been infected with the virus, the scientists assessed the levels of cytokines in their blood and cerebrospinal fluid (the liquid surrounding the brain) at seven days and seven weeks after infection. Cytokines are markers secreted by the immune system, and they are critical in regulating inflammation. Not only were certain cytokines elevated in the cerebrospinal fluid at both time periods, but the scientists saw an increase of microglia reactivity in the subcortical white matter of the brainâthe squishy white tissue rife with nerve fibers that makes up over half of the brainâs volume. That was another sign of potential trouble.
Microglia are sort of like the central nervous systemâs hungry scavengers. They are immune cells that clean up the brain by chomping on dead and unwanted neural debris, among other important functions. âThereâs a unique subpopulation of microglia in the white matter called axon tract microglia,â Monje says. These have a specific genetic signature, she continues, and âare exquisitely sensitive to a wide range of insults,â like inflammatory or toxic stimuli.
In response to these stimuli, microglia can become perpetually reactive. One consequence is that they can begin eating away at needed neurons or other brain cells, which further disrupts the brainâs homeostasis. In the case of Covid-19, the scientists found that this reactivity persisted even at seven weeks after infection. Monjeâs team had seen similar elevation in this activity following chemotherapy and in brain samples from human patients who were infected with Covid-19. In the hippocampus (the area of the brain closely associated with memory), this overenthusiastic cleanup effort can deter the creation of new neurons, which are linked to maintaining healthy memory.
To figure out what exactly caused the microglia to become reactive, the researchers looked for the cytokines that had reached elevated levels. Specifically, Anthony Fernandez Castaneda, a postdoctoral researcher in Monjeâs laboratory and a study coauthor, found CCL11âa factor that can decrease the generation of new neurons and impair learning or memory. âThe elevated CCL11 result was very interesting, because it could potentially explain why some Covid survivors experience cognitive symptoms,â he says.
In a second phase of the experiment, the researchers gave shots of CCL11 to a separate group of mice. Then they examined tissue from their brains to discover where the microglia had been reactive, and where fewer new neurons had grown. That turned out to be in the hippocampusâindicating that CCL11 acted on very specific cell populations in a memory-related area of the brain.
Next, the scientists decided to investigate the effects of mild Covid-19 infection on myelinating oligodendrocytesâbrain cells that generate the myelin âpaddingâ around neurons to provide insulation for better inter-neuron communication. Previously, work done by Anna Geraghty (another postdoctoral fellow in Monjeâs lab and study coauthor) had focused on how chemotherapy affects this process. Myelin loss in the mice treated with chemo was found to be directly linked with deficits in short-term memory and attention. âEven minor adjustments in those myelin can actually impact neuronal communication in quite diverse ways,â she says. âLosing that ability to adaptively respond to neuronal activity led to persistent cognitive impairments in these mice.â
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Geraghty recalls staying in the lab late at night during the Christmas holiday to finish the analysis of how Covid-19 affected that padding in mouse neurons. The result: The infected mice had lost approximately one-third of their mature oligodendrocytes, and had a statistically significant drop in myelination compared to mice in a control group. The magnitude of myelin loss was almost identical to what the lab had discovered when studying mice and chemo. She excitedly texted the results to Monje. âThere was just a big moment in my brain of, âOh my gosh, this data is incredibly interesting,ââ Geraghty recalls.
Joanna Hellmuth, a cognitive neurologist at UC San Francisco who was unaffiliated with the study, notes that the âmouse data is very compelling,â and more studies are needed to see how these results translate into treatments for human patientsâlike Paige or others struggling with long Covid and cognitive symptoms. Figuring out which drugs to try first, though, could benefit from understanding the biological cause of brain fog symptoms. ââBrain fogâ is a colloquial term,â says Hellmuthâand it âkind of delegitimizes peoplesâ having a neurological disorder.â
Wes Ely, a pulmonary and critical care specialist at Vanderbilt University Medical Center who was unaffiliated with the study, believes that such studies can lead to future therapeutic development. âThis work paves the path towards both pharmacological, neuropsychological, and cognitive rehabilitative mechanisms to rebuild brain power,â he says.
For example, Monje thinks, some drug candidates that already worked in âchemo fogâ animal models might be useful for treating Covid-related cognitive symptoms. She hopes to test these candidates on the Covid-19 mouse model to see if they help.
The team would also like to investigate other questions, like whether these neurological effects are different after even longer periods of time, or if they are different following a breakthrough infection after vaccination. Theyâd also like to compare what theyâve found in Covid-19 mouse models to neurological reactions to another famous virusâH1N1, which causes swine flu. The team had found that in a mouse model of H1N1, the drop in oligodendrocytes and increase in microglial reactivity in the subcortical white matter generally normalized by seven weeksâunlike for the Covid-infected mice. They also found that, in mice infected with either virus, CCL11 was elevated in the cerebrospinal fluid. Monje hopes to study what she calls this âprominent shared mechanismâ in further detail.
While Monje and Iwasakiâs work has given researchers a better idea of how Covid might affect the brain, it may take years before there is a working treatment for patients. For Paige, the time cannot come soon enough. In 2022, she got Covid again. âIâm just praying for medicine, praying for treatment,â she says.
## More From WIRED on Covid-19
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- Can medicine recover from the [pandemicâs superbug surge](https://www.wired.com/story/the-pandemic-fueled-a-superbug-surge-can-medicine-recover/?itm_campaign=BottomRelatedStories_Coronavirus&itm_content=footer-recirc)?
- [The secrets of Covid âbrain fogâ](https://www.wired.com/story/the-secrets-of-covid-brain-fog-are-starting-to-lift/?itm_campaign=BottomRelatedStories_Coronavirus&itm_content=footer-recirc) are starting to lift
- [Rapid at-home Covid tests](https://www.wired.com/story/best-rapid-at-home-covid-19-test-kits/?itm_campaign=BottomRelatedStories_Coronavirus&itm_content=footer-recirc)âand where to find them
- [Need a face mask](https://www.wired.com/gallery/best-face-masks/?itm_campaign=BottomRelatedStories_Coronavirus&itm_content=footer-recirc)? Here are ones we like to wear
- Read all of [our coronavirus coverage here](https://www.wired.com/tag/coronavirus/?itm_campaign=BottomRelatedStories_Coronavirus&itm_content=footer-recirc)
[Maggie Chen](https://www.wired.com/author/maggie-chen/) is a scientist and science journalist who enjoys watching heart cells beat under a microscope or writing about health, biotech, and history. ... [Read More](https://www.wired.com/author/maggie-chen)
Contributor
Topics[COVID-19](https://www.wired.com/tag/covid-19/)[viruses](https://www.wired.com/tag/viruses/)[Neuroscience](https://www.wired.com/tag/neuroscience/)[diseases](https://www.wired.com/tag/diseases/)[medicine](https://www.wired.com/tag/medicine/)[coronavirus](https://www.wired.com/tag/coronavirus/)
### WIRED's Guide to How the Universe Works
Your weekly roundup of the best stories on health care, the climate crisis, new scientific discoveries, and more.
Read More
[](https://www.wired.com/story/a-billionaire-backed-startup-wants-to-grow-organ-sacks-to-replace-animal-testing/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[A Billionaire-Backed Startup Wants to Grow 'Organ Sacks' to Replace Animal Testing](https://www.wired.com/story/a-billionaire-backed-startup-wants-to-grow-organ-sacks-to-replace-animal-testing/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
R3 Bio has a bold idea for replacing lab animals: genetically-engineered whole organ systems that lack a brain. The long-term goal, says a cofounder, is to make human versions.
Emily Mullin
[](https://www.wired.com/snake-bros-antivenom-index-zoos-influencers-chris-gifford/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[Snake Bros Keep Getting Bitten by Their Lethal Pets. Only Zoos Can Save Them](https://www.wired.com/snake-bros-antivenom-index-zoos-influencers-chris-gifford/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
Your venomous serpent bites you, and the clock is ticking. Americaâs zookeepersâand a cooler full of rare antivenomâare your best chance of survival.
Claire McNear
[](https://www.wired.com/story/marine-animals-in-the-strait-of-hormuz-dont-get-a-ceasefire/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[Marine Animals in the Strait of Hormuz Donât Get a Ceasefire](https://www.wired.com/story/marine-animals-in-the-strait-of-hormuz-dont-get-a-ceasefire/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
As ships return to the Strait of Hormuz, mines, sonar, and congestion continue to reshape the Gulf beneath the surface.
Evangeline Elsa
[](https://www.wired.com/story/no-one-knows-where-us-vaccine-policy-goes-next/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[No One Knows Where US Vaccine Policy Goes Next](https://www.wired.com/story/no-one-knows-where-us-vaccine-policy-goes-next/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
Robert F. Kennedy Jr.âs sweeping changes to federal vaccine guidance are paused for now. But even if theyâre reversed, lasting damage has already been done.
Emily Mullin
[](https://www.wired.com/story/hassan-took-a-bike-ride-now-hes-one-of-the-thousands-missing-in-gaza/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[Hassan Took a Bike Ride. Now Heâs One of the Thousands Missing in Gaza](https://www.wired.com/story/hassan-took-a-bike-ride-now-hes-one-of-the-thousands-missing-in-gaza/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
In a place denied access to basic forensic technologyâand where people disappear into Israeli detentionâthe fate of thousands remains unknown. One of them is an autistic teenager.
Mahmoud Mushtaha
[](https://www.wired.com/story/gaza-war-al-shifa-hospital-ghosts/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[The Ghosts of Al-Shifa Hospital](https://www.wired.com/story/gaza-war-al-shifa-hospital-ghosts/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
Months into a supposed ceasefire in Gaza, doctors still have to smuggle in basic medical suppliesâand treat new casualties of war.
Spencer Ackerman
[](https://www.wired.com/story/andurils-real-war-is-with-itself/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[Anduril Wants to Own the Future of War Tech. Mishaps, Delays, and Challenges Abound](https://www.wired.com/story/andurils-real-war-is-with-itself/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
From drones to missiles to submarines, the \$30.5 billion defense startup wants to transform how the tools of war are made. Itâs not all going as planned.
Paresh Dave
[](https://www.wired.com/story/book-excerpt-your-data-will-be-used-against-you-andrew-guthrie-ferguson/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[Your Body Is Betraying Your Right to Privacy](https://www.wired.com/story/book-excerpt-your-data-will-be-used-against-you-andrew-guthrie-ferguson/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
Attachment to smart devices and biometric surveillance leaves Americans more vulnerable to police searches than ever. Left unchecked it will only get worse.
Andrew Guthrie Ferguson
[](https://www.wired.com/story/get-ready-for-a-year-of-chaotic-weather-in-the-us/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[Get Ready for a Year of Chaotic Weather in the US](https://www.wired.com/story/get-ready-for-a-year-of-chaotic-weather-in-the-us/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
A massive Western heat wave and a potential El Niño event raise concerns about a long stretch of unpredictable and extreme weather.
Molly Taft
[](https://www.wired.com/story/a-single-strike-wont-shut-off-the-gulfs-desalination-system/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[A Single Strike Wonât Shut Off the Gulfâs Desalination System](https://www.wired.com/story/a-single-strike-wont-shut-off-the-gulfs-desalination-system/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
The Gulfâs water system is built with layers of backup, but it relies on continuous operation to hold.
Dana Alomar
[](https://www.wired.com/story/what-happens-when-you-cant-get-a-death-certificate-in-gaza/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[What Happens When You Canât Get a Death Certificate in Gaza](https://www.wired.com/story/what-happens-when-you-cant-get-a-death-certificate-in-gaza/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
For families of the missing, systemic obstacles to identifying remains and locating people in Israeli detention has created a kind of social and legal purgatory.
Mahmoud Mushtaha
[](https://www.wired.com/story/a-new-implant-aims-to-rewire-the-brain-to-help-stroke-patients/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
[A New Implant Aims to Rewire the Brain to Help Stroke Patients](https://www.wired.com/story/a-new-implant-aims-to-rewire-the-brain-to-help-stroke-patients/#intcid=_wired-article-bottom-recirc_2f28f1a6-80da-43d1-b4e8-8d05a3d518c4_roberta-similarity1)
Epia Neuroâs brain-computer interface will include a motorized glove to help stroke patients recover movement in their hand.
Emily Mullin
[](https://www.wired.com/v2/offers/wira01035?source=Site_0_JNY_WIR_DESKTOP_FOOTER_0_US_ACQ_NLI_QUICK_PAY_GENERIC_ZZ_PANELA)
[](https://www.wired.com/)
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| Readable Markdown | Paige was having a great start to 2021. Her health was the best it had ever been. She loved her job and the people she worked with as a communications manager for a conservation nonprofit. She could get up early in the mornings to work on creative projects. Things were looking âreally, really good,â she saysâuntil she got [Covid-19](https://www.wired.com/tag/covid-19).
While the initial infection was not fun, what followed was worse. Four weeks later, when Paige (who asked to be identified only by her middle name) had recovered enough to go back to work full-time, she woke up one day with an overwhelming fatigue that just never went away. It was accompanied by a loss of mental sharpness, part of a suite of sometimes hard-to-pin-down symptoms that are often referred to as [Covid-19 âbrain fog,â](https://www.wired.com/story/confused-about-covid-brain-fog-doctors-have-questions-too/) a general term for sluggish or fuzzy thinking. âI spent most of 2021 making decisions like: Is this the day where I get a shower, or I go up and microwave myself a frozen dinner?â Paige recalls. The high-level writing required for her job was out of the question. Living with those symptoms was, in her words, âhell on earth.â
Many of these [hard-to-define](https://www.wired.com/story/to-help-people-with-long-covid-scientists-need-to-define-it/) Covid-19 symptoms can [persist over time](https://www.wired.com/story/exactly-how-many-people-long-covid/)âweeks, months, years. Now, new research in the journal [*Cell*](https://www.cell.com/cell/fulltext/S0092-8674\(22\)00713-9) is shedding some light on the biological mechanisms of how Covid-19 affects the brain. Led by researchers Michelle Monje and Akiko Iwasaki, of Stanford and Yale Universities respectively, scientists determined that in mice with mild Covid-19 infections, the virus disrupted the normal activity of several brain cell populations and left behind signs of inflammation. They believe that these findings may help explain some of the cognitive disruption experienced by Covid-19 survivors and provide potential pathways for therapies.
For the past 20 years, Monje, a neuro-oncologist, had been trying to understand the neurobiology behind chemotherapy-induced cognitive symptomsâsimilarly known as âchemo fog.â When Covid-19 emerged as a major immune-activating virus, she worried about the potential for similar disruption. âVery quickly, as reports of cognitive impairment started to come out, it was clear that it was a very similar syndrome,â she says. âThe same symptoms of impaired attention, memory, speed of information processing, dis-executive functionâit really clinically looks just like the âchemo fogâ that people experienced and that weâd been studying.â
### WIRED's Guide to How the Universe Works
Your weekly roundup of the best stories on health care, the climate crisis, new scientific discoveries, and more.
In September 2020, Monje reached out to Iwasaki, an immunologist. Her group had already established a mouse model of Covid-19, thanks to their Biosafety Level 3 clearance to work with the virus. A mouse model is engineered as a close stand-in for a human, and this experiment was meant to mimic the experience of a person with a mild Covid-19 infection. Using a viral vector, Iwasakiâs group introduced the [human ACE2 receptor](https://www.wired.com/story/meet-ace2-the-enzyme-at-the-center-of-the-covid-19-mystery/) into cells in the trachea and lungs of the mice. This receptor is the point of entry for the Covid-causing virus, allowing it to bind to the cell. Then they shot a bit of virus up the miceâs noses to cause infection, controlling the amount and delivery so that the virus was limited to the respiratory system. For the mice, this infection cleared up within one week, and they did not lose weight.
Coupled with biosafety regulations and the challenges of cross-country collaboration, the security precautions required by the pandemic created some interesting work constraints. Because most virus-related work had to be done in Iwasakiâs laboratory, the Yale scientists would take advantage of overnight shipping to fly samples across the country to Monjeâs Stanford laboratory where they could be analyzed. Sometimes, they would need to film experiments with a GoPro camera to make sure that everybody could see the same thing. âWe made it work,â Monje says.
Most Popular
Once the mice had been infected with the virus, the scientists assessed the levels of cytokines in their blood and cerebrospinal fluid (the liquid surrounding the brain) at seven days and seven weeks after infection. Cytokines are markers secreted by the immune system, and they are critical in regulating inflammation. Not only were certain cytokines elevated in the cerebrospinal fluid at both time periods, but the scientists saw an increase of microglia reactivity in the subcortical white matter of the brainâthe squishy white tissue rife with nerve fibers that makes up over half of the brainâs volume. That was another sign of potential trouble.
Microglia are sort of like the central nervous systemâs hungry scavengers. They are immune cells that clean up the brain by chomping on dead and unwanted neural debris, among other important functions. âThereâs a unique subpopulation of microglia in the white matter called axon tract microglia,â Monje says. These have a specific genetic signature, she continues, and âare exquisitely sensitive to a wide range of insults,â like inflammatory or toxic stimuli.
In response to these stimuli, microglia can become perpetually reactive. One consequence is that they can begin eating away at needed neurons or other brain cells, which further disrupts the brainâs homeostasis. In the case of Covid-19, the scientists found that this reactivity persisted even at seven weeks after infection. Monjeâs team had seen similar elevation in this activity following chemotherapy and in brain samples from human patients who were infected with Covid-19. In the hippocampus (the area of the brain closely associated with memory), this overenthusiastic cleanup effort can deter the creation of new neurons, which are linked to maintaining healthy memory.
To figure out what exactly caused the microglia to become reactive, the researchers looked for the cytokines that had reached elevated levels. Specifically, Anthony Fernandez Castaneda, a postdoctoral researcher in Monjeâs laboratory and a study coauthor, found CCL11âa factor that can decrease the generation of new neurons and impair learning or memory. âThe elevated CCL11 result was very interesting, because it could potentially explain why some Covid survivors experience cognitive symptoms,â he says.
In a second phase of the experiment, the researchers gave shots of CCL11 to a separate group of mice. Then they examined tissue from their brains to discover where the microglia had been reactive, and where fewer new neurons had grown. That turned out to be in the hippocampusâindicating that CCL11 acted on very specific cell populations in a memory-related area of the brain.
Next, the scientists decided to investigate the effects of mild Covid-19 infection on myelinating oligodendrocytesâbrain cells that generate the myelin âpaddingâ around neurons to provide insulation for better inter-neuron communication. Previously, work done by Anna Geraghty (another postdoctoral fellow in Monjeâs lab and study coauthor) had focused on how chemotherapy affects this process. Myelin loss in the mice treated with chemo was found to be directly linked with deficits in short-term memory and attention. âEven minor adjustments in those myelin can actually impact neuronal communication in quite diverse ways,â she says. âLosing that ability to adaptively respond to neuronal activity led to persistent cognitive impairments in these mice.â
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Geraghty recalls staying in the lab late at night during the Christmas holiday to finish the analysis of how Covid-19 affected that padding in mouse neurons. The result: The infected mice had lost approximately one-third of their mature oligodendrocytes, and had a statistically significant drop in myelination compared to mice in a control group. The magnitude of myelin loss was almost identical to what the lab had discovered when studying mice and chemo. She excitedly texted the results to Monje. âThere was just a big moment in my brain of, âOh my gosh, this data is incredibly interesting,ââ Geraghty recalls.
Joanna Hellmuth, a cognitive neurologist at UC San Francisco who was unaffiliated with the study, notes that the âmouse data is very compelling,â and more studies are needed to see how these results translate into treatments for human patientsâlike Paige or others struggling with long Covid and cognitive symptoms. Figuring out which drugs to try first, though, could benefit from understanding the biological cause of brain fog symptoms. ââBrain fogâ is a colloquial term,â says Hellmuthâand it âkind of delegitimizes peoplesâ having a neurological disorder.â
Wes Ely, a pulmonary and critical care specialist at Vanderbilt University Medical Center who was unaffiliated with the study, believes that such studies can lead to future therapeutic development. âThis work paves the path towards both pharmacological, neuropsychological, and cognitive rehabilitative mechanisms to rebuild brain power,â he says.
For example, Monje thinks, some drug candidates that already worked in âchemo fogâ animal models might be useful for treating Covid-related cognitive symptoms. She hopes to test these candidates on the Covid-19 mouse model to see if they help.
The team would also like to investigate other questions, like whether these neurological effects are different after even longer periods of time, or if they are different following a breakthrough infection after vaccination. Theyâd also like to compare what theyâve found in Covid-19 mouse models to neurological reactions to another famous virusâH1N1, which causes swine flu. The team had found that in a mouse model of H1N1, the drop in oligodendrocytes and increase in microglial reactivity in the subcortical white matter generally normalized by seven weeksâunlike for the Covid-infected mice. They also found that, in mice infected with either virus, CCL11 was elevated in the cerebrospinal fluid. Monje hopes to study what she calls this âprominent shared mechanismâ in further detail.
While Monje and Iwasakiâs work has given researchers a better idea of how Covid might affect the brain, it may take years before there is a working treatment for patients. For Paige, the time cannot come soon enough. In 2022, she got Covid again. âIâm just praying for medicine, praying for treatment,â she says. |
| Shard | 99 (laksa) |
| Root Hash | 5736512710119187299 |
| Unparsed URL | com,wired!www,/story/the-secrets-of-covid-brain-fog-are-starting-to-lift/ s443 |