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Published on: January 20, 2023
Traumatic Brain Injury in the Long-COVID Era
1Department of Anatomy, Physiology, and Genetics, School of Medicine, Uniformed Services University, Bethesda, Maryland, USA.
Insights
Understanding long-COVID/PASC and traumatic brain injury (TBI) requires a holistic approach. Examining biological backgrounds and biomarkers can improve TBI patient management.
Area of Science:
- Neuroscience
- Immunology
- Infectious Diseases
Background:
- Biological background factors (age, sex, comorbidities, medications) significantly influence outcomes after traumatic brain injury (TBI).
- The extensive research on coronavirus disease 2019 (COVID-19) and its chronic form, long-COVID (post-acute sequelae SARS-CoV-2 infection/PASC), offers insights into disease holism and organ system interconnectivity.
- A comprehensive approach is crucial for understanding TBI-induced conditions.
Purpose of the Study:
- To review current knowledge on long-COVID/PASC and its pathologies.
- To outline the pathobiological changes induced by TBI (endophenotypes).
- To explore the intersection of long-COVID/PASC and TBI pathobiologies and propose improved clinical management strategies for TBI patients.
Main Methods:
- Literature review of long-COVID/PASC and TBI research.
- Analysis of pathobiological mechanisms and endophenotypes in TBI.
- Discussion of the interplay between long-COVID/PASC and TBI.
Main Results:
- Long-COVID/PASC research highlights the importance of biological background in disease trajectory and outcomes.
- TBI induces specific pathobiological changes (endophenotypes).
- The intersection of long-COVID/PASC and TBI suggests shared or interacting pathobiologies.
Conclusions:
- Considering individual biological background factors is essential for effective TBI management.
- Incorporating mechanistic molecular biomarkers can enhance clinical decision-making for TBI patients.
- A holistic, systems-biology approach is vital for advancing TBI care.
Abstract:
Major determinants of the biological background or reserve, such as age, biological sex, comorbidities (diabetes, hypertension, obesity, etc.), and medications (e.g., anticoagulants), are known to affect outcome after traumatic brain injury (TBI). With the unparalleled data richness of coronavirus disease 2019 (COVID-19; ∼375,000 and counting!) as well as the chronic form, long-COVID, also called post-acute sequelae SARS-CoV-2 infection (PASC), publications (∼30,000 and counting) covering virtually every aspect of the diseases, pathomechanisms, biomarkers, disease phases, symptomatology, etc., have provided a unique opportunity to better understand and appreciate the holistic nature of diseases, interconnectivity between organ systems, and importance of biological background in modifying disease trajectories and affecting outcomes. Such a holistic approach is badly needed to better understand TBI-induced conditions in their totality. Here, I briefly review what is known about long-COVID/PASC, its underlying-suspected-pathologies, the pathobiological changes induced by TBI, in other words, the TBI endophenotypes, discuss the intersection of long-COVID/PASC and TBI-induced pathobiologies, and how by considering some of the known factors affecting the person's biological background and the inclusion of mechanistic molecular biomarkers can help to improve the clinical management of TBI patients.
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