Organ Procurement and Transplantation Network (OPTN) Modernization Initiative | HRSA

Are you or a family member on a waiting list for a kidney, heart, or other organ transplant?  CMS and HRSA are working on finding and making available these organs for patients in need of an organ.

HRSA Makes Multi-Vendor Modernization Awards to Support the Nation’s Organ Transplant System

For the first time in 40 years, the Health Resources and Services Administration (HRSA) has awarded multiple contractors to apply their expertise and proven experience to improve the national organ transplant system. This transition from a single vendor to multiple vendors to support OPTN operations is a critical step in advancing innovation in the transplant system to better serve patients and their families. It also implements the bipartisan Securing the U.S. Organ Procurement and Transplantation Network Act signed by the President in September 2023.

As part of the first release of awards under the new Operations Transition contract, HRSA awarded multiple OPTN modernization awards to support critical actions, including:

1. Improving Patient Safety–Arbor Research Collaborative for Health will address patient safety and the policy compliance systems and processes overseen by the OPTN Board of Directors and the Membership and Professional Standards Committee to improve oversight of the multiple entities in the OPTN.  
2. Supporting OPTN IT Modernization: General Dynamics Information Technology, Inc. will focus on opportunities to improve the OPTN organ matching IT system and inform HRSA’s Next-Generation IT procurement and development work. 
3. Increasing Transparency and Public Engagement in OPTN Policy Development–Maximus Federal Services will advance opportunities to improve public visibility and engagement in the OPTN policy-making process including improving transparency around OPTN policy-making committees’ deliberations and actions.
4. Strengthening Patient-Centered Communications–Deloitte Consulting will focus on improving communications from the OPTN, within the OPTN, and, importantly, with patients and families. 
5. Improving OPTN Financial Management–Guidehouse Digital will address improvements for OPTN’s budget development and management systems and processes. 

Together with HRSA’s actions earlier this summer to create a separate OPTN Board of Directors and award a new OPTN Board Support vendor, HRSA is taking critical and historic steps to modernize and improve the National organ transplant system– while ensuring access to lifesaving transplants continues without disruption.   

Artificial Intelligence can enhance the process as well

I can significantly enhance the process of finding organs for transplantation in several ways:

1. Matching Donors and Recipients

Data Analysis: AI algorithms can analyze vast amounts of data from donor and recipient medical records to identify the best matches based on compatibility factors, such as blood type, tissue type, and other health criteria.

Predictive Modeling: Machine learning models can predict which donors are likely to have organs that will be accepted by specific recipients, improving the chances of successful transplants.

2. Optimizing Organ Allocation

Logistics Management: AI can optimize the logistics of organ transportation by predicting the best routes and timing for organ delivery, ensuring that organs are transported efficiently and arrive in the best condition.

Resource Allocation: AI systems can help allocate organs not just based on medical needs but also by considering factors like geographical location and waiting times, ensuring a fair distribution.

3. Identifying Potential Donors

Health Records Analysis: AI can analyze electronic health records to identify potential organ donors more quickly, including those who may not have been considered otherwise.

Risk Assessment: Machine learning can help assess the risk factors associated with potential donors, aiding in the decision-making process for organ donation.

4. Monitoring and Predicting Outcomes

Post-Transplant Monitoring: AI can monitor recipients post-transplant, analyzing data from wearable devices and health records to predict complications and optimize recovery.

Long-Term Outcome Predictions: AI models can provide insights into the long-term success of transplants, helping to refine future matching processes.

5. Public Awareness and Education

Engagement Tools: AI can be used in chatbots and apps to educate the public about organ donation, improving awareness and potentially increasing the number of registered donors.

Conclusion

By leveraging AI technologies, the organ transplantation process can become more efficient, leading to better matches, improved outcomes, and ultimately, saving more lives.

August 2024  Updates

Organ Procurement and Transplantation Network (OPTN) Modernization Initiative | HRSA

What's Happening In Your Stomach? - Gastric Alimetry Review

There is a huge demand for a better understanding of the workings of our gastric systems, and so far, nobody has been able to meaningfully collect digital health data about them. Although the stomach is controlled by an electrical conduction system that regulates its contractions, the signals are a hundred times weaker than the heart's.

Imagine a device you wear that will measure the electrical activity of your gut. The technical challenge so far was to find a way to capture these mild signals in a clinically reliable way. A reliable solution that could either be used by patients at home or at the point of care would be a hit.

The Alimetry device has received FDA clearance. However, for the most current and accurate status regarding FDA approvals, it's best to check the official FDA website or consult recent news sources. Regulatory statuses can change, and new approvals or indications may have been granted.

What is in the ‘Body Surface Gastric Mapping System’ package?

A charger dock – with 4 different adapters for all kinds of global outlets, making the device universally usable. The dock needs to be plugged in to charge the reader

A reader with Bluetooth connectivity and wireless charging capability, you only need to place it on the dock, no wires are needed here. One confusing thing: once you pair your reader with the tablet, it stops showing battery charging levels, even if you disconnect them. The tricky part is that the app also keeps showing the battery charge level it had when it was paired, so you need to unpair and pair them again if you want to see the actual figure while charging  

Two packages of disposable arrays and array templates, each pair separately sealed

An iPad mini preinstalled with the Alimetry app – and locked to its exclusive use

A user manual booklet with very detailed information on the device, its parts, the setup, and the whole process.

What will the test deliver?

The test aims to detect the causes of overlapping gastric symptoms with distinct underlying phenotypes. In this study, researchers tested 43 patients with indistinguishable symptoms and were able to identify two distinct subgroups. 

The Gastric Alimetry platform is currently being used in clinical practice to differentiate between chronic nausea and vomiting syndromes (NVSs) that originate in the gut and those that arise through a centrally mediated pathway—a phenotype often tied to anxiety and depression.

The 64-channel reading of the Alimetry devices focuses on the fact that gastric dysfunctions are associated with abnormalities in the gastric bioelectrical slow waves. As shown in this study, the device was efficient in differentiating between patients having gastric neuromuscular disease or dysregulation of the brain-gut interaction. 

The tracing looks much like an electroencephalogram with multiple channels covering the abdomen. 

Conclusion

References:

American Journal of Gastroenterology. (a peer-reviewed article listed in PubMed, from the National Library of Medicine (NIH)  The American Journal of Gastroenterology 118(6):p 1047-1057, June 2023  DOI: 10.14309/ajg.0000000000002077

The Gastric Alimetry device is a first-of-a-kind solution, fully fitting all principles of digital health. It is making patients the point of care and it targets a niche area with massive demand. I am eager to see where Body Surface Gastric Mapping develops in the coming years.

The total time requirement of such a test is significant, patients need to dedicate a total of 10.5 hours to it. The discomfort of the prolonged process is tolerable, many gastric diagnostic methods are much more demanding. If you have chronic NVS and would like to find a way to detect its causes, it is well worth the effort. 

At the moment it seems Alimetry is a good tool to detect the underlying causes of chronic NVS, and the company is working on how to apply it to other gastrointestinal conditions, including functional dyspepsia and gastroparesis.

What's Happening In Your Stomach? - Gastric Alimetry Review

Concierge Medicine---Consider it

Direct Primary Care, with a monthly prepaid contract.

If you are young and fairly healthy with minor issues this plan costs less than your health insurance plan. You can supplement it with a major medical plan.

Unger’s blog | SignatureMD

The Nobel Prize in Physics 1901 - An illuminating accident - NobelPrize.org

Wilhelm Conrad Röntgen
The Nobel Prize in Physics 1901

Born: 27 March 1845, Lennep, Prussia (now Remscheid, Germany)

Died: 10 February 1923, Munich, Germany

Affiliation at the time of the award: Munich University, Munich, Germany

 Röntgen studied cathode radiation, which occurs when an electrical charge is applied to two metal plates inside a glass tube filled with rarefied gas. Although the apparatus was screened off, he noticed a faint light on light-sensitive screens that happened to be close by. Further investigations revealed that this was caused by a penetrating, previously unknown type of radiation. X-ray radiation became a powerful tool for physical experiments and examining the body's interior.

The Nobel Prize in Physics 1901 - Speed read: An illuminating accident - NobelPrize.org

Salivary Enzyme Behind Our Carb Cravings May Have Unexpectedly Ancient History – NIH Director's Blog

                   

In today's world our diet is far different from that of prehistoric man and even that of several centuries ago. Modern diets now contain many processed and genetically modified wheats, grains and domesticated animals such as cows, poultry, and pigs.

These foods are altered by freezing, and preservation.  In addition to those alterations they are not fresh, nor eaten immediately after harvesting or processing.

The packaging is often plastic leading to contamination with micro plastic particles.

Studies reveal microplastic particles in water, and in our blood stream. Microplastics are not biologically active and remain for indefinite periods.  It is not yet known what effects this will have on living systems.

Microplastic particles in blood

Microscopy of Intestine. A,B controls. C,D post ingestion of MP

Digestion involves much more than just your stomach. The digestive process that fuels your body begins in your mouth each time you take a bite of food and chew. An enzyme in your saliva, called amylase, then starts to break down complex carbohydrates—or starches found in many fruits, vegetables, and grains—into simpler sugars to give you their sweet flavor followed by a burst of energy.

Amylase is the reason we’re so good at turning starch into calories, but it isn’t the same for everyone. There’s plenty of genetic variation in the number of salivary amylase genes (AMY1) our cells carry and, therefore, in how much of this essential starch-busting enzyme people have. Studies have suggested a link between changes in amylase gene copy numbers over time and both the rise of agriculture and starch-heavy diets. Now a study in Science , supported in part by NIH, suggests that extra copies of AMY1 are not only connected to our ability to effectively digest carbs, but also may be more ancient than previously known, arising even before modern humans split from Neanderthals and long before the advent of farming.

Genomic studies reveal the amylase protein has evolved since paleolithic times.

The new findings come from a research team led by Omer Gokcumen  at The University of Buffalo, NY, and Charles Lee  of The Jackson Laboratory for Genomic Medicine, Farmington, CT.

JAX Farmington, CT

JAX Bar Harbor, ME

This variation in amylase genes would have afforded our ancestors dietary flexibility, allowing them to adapt as diets changed over time. But these discoveries aren’t only fascinating from an evolutionary or historical point of view. They may also lead to new understandings of genetic differences among people today, with potentially important implications for our metabolisms, nutrition, and health.

NIH Director's Blog

Salivary Enzyme Behind Our Carb Cravings May Have Unexpectedly Ancient History – NIH Director's Blog

Lawmakers aim to block Medicare payment cuts to doctors, but clock is ticking

Lawmakers in Congress are working to prevent planned Medicare payment cuts to physicians, much to the relief of a host of healthcare organizations.

Republicans and Democrats have sponsored a bill to avoid Medicare’s scheduled reduction in physician payments for 2025. The Centers for Medicare & Medicaid Services have proposed a 2.8% cut in payments to doctors next year.  This despite the annual inflation rate of 2-5% annually.

The AMA said that Medicare payment rates have dropped 29% over the past 20 years, when including the higher costs of running practices. Doctors and their advocacy groups have said the continued cuts in recent years could hurt access to care, as physicians leave the profession or they opt not to accept Medicare patients.

On Tuesday, lawmakers introduced the legislation, dubbed the Medicare Patient Access and Practice Stabilization Act. U.S. Reps. Greg Murphy, R-N.C., and Jimmy Panetta, D-Calif., are the prime sponsors, but other lawmakers, Republicans and Democrats alike, are backing the measure.

In addition to averting the cuts, the legislation would give doctors increases in payments that are equivalent to half the Medicare Economic Index, which reflects changes in the annual operating costs for physicians.

“Medical inflation is much higher and the cost of seeing patients continues to rise,” Murphy said. “Unfortunately, reimbursements continue to decline, putting immense pressure on doctors to retire, close their practices, forgo seeing new Medicare patients, or seek a less efficient employment position. 

Many physicians merged with other physicians or agreed to be purchased by venture capitalists, supposedly improving effficiency having a larger group, and consolidating management.   None of this proved to be true, and the downward spiral has continued.

This bipartisan legislation would stop yet another year of reimbursement cuts, give them a slight inflationary adjustment, and protect Medicare for physicians and patients alike."

Lawmakers aim to block Medicare payment cuts to doctors, but clock is ticking

How are emergency departments in the US going to deliver high-quality care

How are emergency departments in the US going to deliver high-quality care if payments to emergency medicine practices continue to decrease from private insurance companies, government insurers, and patients - all at the same time? 

A strong emergency medicine system needs a stable funding source to deliver 24-7 care to acutely ill and injured people, no matter where they live or who they are. Do we really want to skimp on life-saving care?

Check out the article, "UnitedHealth Emails Reveal Tension Over Cuts to Doctor Pay" in Bloomberg by John Tozzi. Excerpt:

Doc Pay Cuts Sparked Strife at Insurer

UnitedHealth Group systematically cut its payments to out-of-network doctors for emergency department (ED) visits and mental health care, sparking internal tension, according to newly unsealed court documents reported by Bloombergopens in a new tab or window.

The records open a window into the workings of its UnitedHealthcare unit, the largest U.S. health insurer, and shed light on a bitter battle between financial heavyweights in the $5 trillion U.S. medical system,"UnitedHealth Group Inc. systematically cut what it paid for emergency room visits and mental health care to doctors outside of its network, sparking internal tension over how those changes were handled and the potential effect on members, newly unsealed court documents show.

The records open a window into the workings of its UnitedHealthcare unit, the largest US health insurer, and shed light on a bitter battle between financial heavyweights in the $5 trillion US medical system. Doctors have long blamed the company for refusing to fully cover their bills, with private equity-backed physician groups filing a string of lawsuits accusing it of shortchanging clinicians from outside of its insurance network.

...The senior vice president questioned plans to cut reimbursement levels for out-of-network emergency room visits. UnitedHealth had already reduced payments from 450% of what Medicare pays — the benchmark that many insurers use as a starting point for their own figures — to 250%, and the company planned to drop it further to 150%, according to the email.

How can an emergency room visit be out of network?  A patient with a critical condition such as crushing chest pain, loss of consciousness, stroke is taken to the nearest level I or II emergency deparrtment, by law. To do so otherwise would be against standard of care.

At the April trial, an executive testified that the company didn’t move forward with the deepest cuts, according to a transcript.

Such a cut would have put UnitedHealth below national averages: Employers and private insurers paid on average about 250% of Medicare’s reimbursement in 2022, researchers from the Rand Corp. reported, counting both in-network and out-of-network rates. Providers often accept discounted payments in exchange for network agreements that give them greater access to patients.

hashtag #emergencymedicine

#American College of Emergency Physicians

#American Academy of Emergency Medicine (AAEM)

#Society of Emergency Medicine Physician Assistants (SEMPA)

#Society for Academic Emergency Medicine

#Society of Physician Entrepreneurs

Numerous employers brought suite against UHC

‘Californian Votes Really Matter’: What the Election Could Mean for Reproductive Health | KQED

Dr. Sophia Yen finds it difficult to talk about the future her daughters could face under a second Trump presidency without tearing up.

Yen, co-founder of an organization specializing in reproductive care, fears their access to such vital care could be further limited if former President Donald Trump wins the election. And she’s not alone.

“How do I get two girls through college?” Yen asked, pointing to the fact that 1 in 4 undergraduate women have reported being sexually assaulted.

Nationwide, she said, reproductive rights have “already gone back. And we need to fix it.”

After the Supreme Court overturned Roe v. Wade in 2022, spurring some states to limit access to abortion, infant mortality rates increased — in Texas, by as much as 13%. Pinning down the maternal mortality rate is harder. According to a recent study from the Commonwealth Fund, women were more at risk of dying at or around childbirth in states with stricter abortion laws. In Texas, the maternal mortality rate rose 56% from 2019 to 2022, while nationally, it ticked up 11%, according to the research nonprofit Gender Equity Policy Institute.

According to a Gallup Poll released this summer, 54% of Americans identify as pro-choice, maintaining “historically high levels” of support for abortion rights since the overturning of Roe v. Wade. And 32% of registered voters said they would only vote for a candidate that shared the same views as them on abortion, up 8 points since 2020.

In an election featuring two candidates with wildly differing views on abortion who are polling extremely closely, Bay Area residents and experts are left to wait and see what the future of healthcare holds.

Even though state laws protect the right to an abortion in California, Yen — who is also a professor at Stanford Medical School — said the stakes are still high for abortion-rights voters in the Bay Area.

“For Californians, we think we’re protected,” she said. “But we’re not.”

In truth the Dobbs Act, rescinding the Federal decision to allow abortions, the Dobbs act moves the dedecision to the states.   Many states have already passed laws allowing abortion under certain circumstances.

alifornian Votes Really Matter’: What the Election Could Mean for Reproductive Health | KQED

Better Surgery?

Stop the B.S.

A decade ago, a Pew survey found that 92% of Americans preferred financial 𝘀𝘁𝗮𝗯𝗶𝗹𝗶𝘁𝘆 over upward 𝗺𝗼𝗯𝗶𝗹𝗶𝘁𝘆. If we asked for a healthcare equivalent today, the answer would be the same: people want a stable, functional, reliable healthcare system more than the latest drug, device, or procedure.

Yet, the system churns out endless “progress” and “innovation”:
💊 A new drug with fewer side effects!
🪚 A better surgical technique with less bleeding!
🩸 A blood test that cuts ER visit times by 12 minutes!

Medical research never asks: How do we make care feel stable and dependable? Where are the innovations that get you an appointment in 1 week instead of 2 months? Where is the NIH grant focused on creating day-to-day reliability?

Maybe we’re just building products that don’t fit what the “customer” wants. Do we have no product-market fit?

Mad In America

This article will be quite controversial to allopathic physicians who only treat illness with FDA-approved medications. However, some psychiatrists are more attuned to off-label or alternative treatments.

Several vitamin deficiencies have been linked to mental health issues. Here are some notable ones:

1. **Vitamin B12**: Deficiency can lead to cognitive decline, memory issues, and mood disturbances such as depression.

2. **Folate (Vitamin B9)**: Low levels are associated with depression and increased risk of mental disorders.

3. **Vitamin D**: Deficiency has been linked to depression, anxiety, and other mood disorders.

4. **Omega-3 Fatty Acids**: While not a vitamin, low levels can contribute to depression and cognitive decline.

5. **Vitamin B6**: Important for neurotransmitter synthesis; deficiency can lead to irritability and depression.

Maintaining a balanced diet rich in these vitamins can help support mental health. If you suspect a deficiency, it's advisable to consult a healthcare professional.

The Shamanic View of ‘Mental Illness’: Birth of a Healer

There is a distinct difference between 'healers' and physicians. Some physicians are healers. They call themselves "alternative medicine" or "integrative medicine".  

Relate topics:

Will Denial Make DSM’s Validity Problem Go Away?

The Drug-based Approach to Mental Illness Has Failed

Billions of Dollars Later, Neuroscientists Still Struggling to Address Mental Health Crisis

Scores of Papers by Top NIH Neuroscientist Eliezer Masliah Fall Under Suspicion

Masliah appeared as an ideal selection. The physician and neuropathologist conducted research at the University of California San Diego (UCSD) for decades, and his drive, curiosity, and productivity propelled him into the top ranks of scholars on Alzheimer’s and Parkinson’s disease. His roughly 800 research papers, many on how those conditions damage synapses, the junctions between neurons, have made him one of the most cited scientists in his field. His work on topics including alpha-synuclein—a protein linked to both diseases—continues to influence basic and clinical science.

After Science brought initial concerns about Masliah’s work to their attention, a neuroscientist and forensic analysts specializing in scientific work who had previously worked with Science produced a 300-page dossier revealing a steady stream of suspect images between 1997 and 2023 in 132 of his published research papers. (Science did not pay them for their work.) “In our opinion, this pattern of anomalous data raises a credible concern for research misconduct and calls into question a remarkably large body of scientific work,” they concluded.

Following an investigation, the National Institutes of Health (NIH) has made findings of research misconduct against Eliezer Masliah, M.D., due to falsification and/or fabrication involving re-use and relabeling of figure panels representing different experimental results in two publications. NIH will notify the two journals of its findings so that appropriate action can be taken. NIH initiated its research misconduct review process in May 2023 after it received allegations from the HHS Office of Research Integrity (ORI) that same month. NIH began its investigation phase in December 2023, concluded its investigation of these allegations on September 15, 2024, and notified HHS ORI of its findings.

Dr. Masliah joined the agency in the summer of 2016 as director of the Division of Neuroscience (DN) at the National Institute on Aging and an NIH intramural researcher investigating synaptic damage in neurodegenerative disorders. He has published numerous papers as an NIH intramural researcher. Currently, Dr. Masliah is not serving in the capacity of director of the NIA DN.

These findings alert those who depend upon peer-reviewed articles that are always subject to questioning and challenge.  That is the scientific method.

Capitalism Is Driven by Mental Illness

Beyond Pharmacare

Targeted: For Those Who Hear Voices, the ‘Broken Brain’ Explanation Is Harmful

Psychiatric Diagnoses Don’t Explain ‘Why’—Only ‘How’

Microbes and Mental Illness

Nearly a Third of Adolescents Getting Mental Health Treatment, Federal Survey Finds

The full Biblio is below.

Blogs Archives - Page 2 of 189 - Mad In America

Sleep is integral to cardiovascular health

Sleep is integral to cardiovascular health1,2. 

A possible relationship with poor or inadequate sleep cycles and the effect of poor sleeping habits may contribute to acute myocardial infarction.

Yet, the circuits that connect cardiovascular pathology and sleep are incompletely understood. It remains unclear whether cardiac injury influences sleep and whether sleep-mediated neural outputs contribute to heart healing and inflammation. 

Here we report that in humans and mice, monocytes are actively recruited to the brain after myocardial infarction (MI) to augment sleep, which suppresses sympathetic outflow to the heart, limiting inflammation and promoting healing. After MI, microglia rapidly recruit circulating monocytes to the brain’s thalamic lateral posterior nucleus (LPN) via the choroid plexus, where they are reprogrammed to generate tumor necrosis factor (TNF). In the thalamic LPN, monocytic TNF engages Tnfrsf1a-expressing glutamatergic neurons to increase slow-wave sleep pressure and abundance. 

Proposed interconnection between inflammation of myocardial infarction and sleep

Disrupting sleep after MI worsens cardiac function, decreases heart rate variability, and causes spontaneous ventricular tachycardia. After MI, disrupting or curtailing sleep by manipulating glutamatergic TNF signaling in the thalamic LPN increases cardiac sympathetic input which signals through the β2-adrenergic receptor of macrophages to promote a chemotactic signature that increases monocyte influx. 

Poor sleep in the weeks following acute coronary syndrome increases susceptibility to secondary cardiovascular events and reduces the heart’s functional recovery. 

In parallel, insufficient sleep in humans reprogrammes β2-adrenergic receptor-expressing monocytes toward a chemotactic phenotype, enhancing their migratory capacity. Collectively, our data uncover cardiogenic regulation of sleep after heart injury, which restricts cardiac sympathetic input, limiting inflammation and damage.

Long COVID is a Brain Injury

Recent research utilizing ultra-high-field MRI scans has identified microstructural abnormalities in the brainstems of COVID-19 survivors. These findings suggest a neuroinflammatory response that may explain the persistent symptoms of long COVID, such as breathlessness and brain fog. These findings highlight similarities between long COVID and traumatic brain injury, emphasizing the need for further investigation into shared inflammatory pathways and potential treatment strategies.

Brainstem Damage

Brain Stem Structural Abnormality

MRI shows brain microstructural changes after mild COVID-19

Ultra-high field (7 Tesla) MRI scans have uncovered microstructural abnormalities in the brainstems of COVID-19 survivors, persisting for months after hospitalization12. These changes, primarily localized in the pons and medulla regions, are consistent with a neuroinflammatory response2. The abnormalities were more pronounced in patients who experienced longer hospital stays, higher disease severity, and more prominent inflammatory responses during acute illness2. This groundbreaking imaging technique allows researchers to examine brainstem nuclei in living participants, providing unprecedented insights into the long-term neurological effects of COVID-193.

Severe Long Covid Inflammatory Reaction

MRI study spotlights the impact of long COVID on the brain

Symptoms

Persistent symptoms associated with brainstem damage in long COVID patients include breathlessness, fatigue, brain fog, and difficulties with blood pressure regulation12. These symptoms are believed to result from inflammation in areas of the brainstem responsible for controlling vital functions such as breathing and heart rate23. Interestingly, the symptom profile shares similarities with functional neurological disorders, chronic fatigue syndrome, and persistent post-concussive syndromes4. Research has shown that abnormalities in the medullary reticular formation, a region central to breathing control, may explain the long-lasting respiratory symptoms experienced by some patients

Brain Injury Parallels

Recent studies have uncovered striking similarities between long COVID and traumatic brain injury (TBI), particularly in terms of neuroinflammation and blood-brain barrier (BBB) disruption. Research using dynamic contrast-enhanced magnetic resonance imaging has revealed BBB disruption in patients with long COVID-associated cognitive impairment, commonly referred to as brain fog1. This BBB dysfunction is reminiscent of the vascular disruption observed in TBI cases.

The inflammatory response in both conditions appears to share common pathways:

Sustained systemic inflammation leading to increased production of cytokines and reactive oxygen species

Increased BBB permeability allows cytokines to penetrate the brain2

Activation of microglia and astrocytes, potentially interfering with neurotransmitter production

Possible persistence of viral antigens or autoantibodies contributing to chronic immune system activation2

These shared inflammatory mechanisms may explain why individuals with a history of both COVID-19 and TBI tend to experience more severe and prolonged symptoms3. The cumulative effect of neuroinflammation from previous brain injuries combined with the inflammatory impact of COVID-19 could create a "perfect storm" for persistent neurological symptoms34. This connection underscores the importance of considering a patient's history of brain trauma when assessing and treating long COVID symptoms.

Long COVID is a Brain Injury