Howard Aaron Aronow MD

A Note to Our Patients About The Coronavirus (COVID-19) Pandemic

The spike protein of SARS-CoV-2 can pass through the blood-brain barrier of mice. The protein likely causes the brain to release cytokines and spark neuroinflammation. The findings add to growing evidence that COVID-19 can enter the brain of those infected by the virus.

Alzheimer’s disease is a progressive neurological illness that impairs thinking and independence of millions of people worldwide. Today, more than 5 million Americans and more than 40 million people worldwide are living with Alzheimer’s disease and related dementias, and these numbers are growing rapidly. This disease destroys not only quality of life but also quantity it is the 3rd leading cause of mortality in people over 65, behind cancer and heart disease. Alzheimer’s disease is usually diagnosed in people 65 and older, but it starts earlier with subtle neurological changes occurring years or even decades before symptoms appear. Many people are experiencing the early, often unrecognized, signs of mild cognitive impairment.

In record numbers, Americans are anxious, worried, sleep-deprived, distracted, and depressed. The Covid-19 pandemic’s triple whammy of an invisible and omnipresent threat (coronavirus infection), profound disruptions in daily life, and uncertainty for the future has thrust many people into a chronic, high-stress state that is, let’s just say, less than optimal for rational thinking or any other sort of higher-order cognitive functioning.

May you enjoy good health and prosperity not only at Hanukkah, but throughout the year!

Silent new brain lesions detected on the MRI of children with anti-myelin oligodendrocyte glycoprotein antibody-related disease did not reliably predict clinical relapse.https://bit.ly/2ISEfmm

In a live social media chat, Dr. Anthony Fauci announced a few days ago that the first doses of a safe coronavirus vaccine are set to become available in late December this year or early January 2021. This is, of course, if everything continues to go smoothly. Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID), was referring to two candidate vaccines currently underway: one in development by Moderna Therapeutics in collaboration with NIAID, and the other in development by Pfizer in partnership with BioNTech. Since then, Pfizer announced a 90% effectiveness rate for its candidate vaccine. In this article, we track the progress of these therapeutics and offer a critical yet hopeful perspective.

The antidepressant fluvoxamine appears to prevent COVID-19 infections from worsening and may help keep patients out of the hospital, a trial based on research from the University of Virginia School of Medicine suggests. Original Research: Open access. Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial by Eric J. Lenze, MD; Caline Mattar, MD; Charles F. Zorumski, MD; Angela Stevens, BA; Julie Schweiger; Ginger E. Nicol, MD; J. Philip Miller, AB; Lei Yang, MPH, MSIS; Michael Yingling, MS; Michael S. Avidan, MBBCh; Angela M. Reiersen, MD, MPE. JAMA https://jamanetwork.com/journals/jama/fullarticle/2773108

Clinically, Bell's palsy is primarily characterized by the dysfunction of peripheral seventh cranial nerve (i.e. facial nerve), leading to a complete or partial facial paralysis. The classic sign of the disease is the involvement of only one side of the face with a sudden onset. Both sides of the face are simultaneously affected in less than 1% of cases. Symptoms usually peak in less than 48 hours and pain behind the ear sometimes occurs as a preceding symptom.

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A viral load test measures how much human immunodeficiency virus (HIV) is in the blood. Viral load is first measured when you are diagnosed with HIV infection. This initial measurement serves as the baseline, and future viral load measurements will be compared with the baseline. Since viral load can vary from day to day, the trend over time is used to determine if the infection is getting worse. If your viral load shows a steady increase over several measurements, it means th...e infection is getting worse. If the trend in viral load decreases over several measurements, it means that the infection is being suppressed. The viral load is measured using one of three different types of tests: Reverse-transcriptase polymerase chain reaction (RT-PCR) test Branched DNA (bDNA) test Nucleic acid sequence-based amplification (NASBA) test These tests measure the amount of the genetic material (RNA) of HIV in the blood. But each test reports the results differently, so it is important to use the same test over time.

Pathological studies looking at individuals who have perished from Covid-19 have already started. A small pathological study of 18 patients, published as a letter in the New England Journal of Medicine in June, suggests that most damage occurred due to hypoxia, or a lack of oxygen to the brain. Researchers are also relying organoids, so-called mini-brains, to see how the virus may affect the different cells in these three-dimensional, self-organization tissue culture models. Using this approach, researchers from Johns Hopkins University discovered that Covid-19 can both infect and spread across neural tissuebut they cannot say with any certainty that the virus can pass through the blood brain barrier to get into the brain in the rst place.

Studies of animals and people experiencing isolation have identified several brain structures that appear to be affected by a lack of social interaction. Although these studies can’t identify causal relationshipsand don’t always agree with one anotherthey shine a light on some of the mechanisms by which physical isolation, or feelings of loneliness, could impair brain function and cognition.

Face pareidolia, the phenomenon of seeing face-like structures in inanimate objects, is a perceptual phenomenon that occurs when sensory input is processed by visual mechanisms that have evolved to extract social content from human faces.

Given existing knowledge of other coronaviruses and respiratory viruses, the wide range of CNS and PNS associations with COVID-19 is not surprising, and this is the focus of most current reports. However, neurological disease is also likely to be seen increasingly in patients who are SARS-CoV-2-positive but with few or no typical features of COVID-19, based on knowledge of other epidemic viral infections and cases reported so far.28 Case-control studies will be needed to help... establish whether SARS-CoV-2 is causal or coincidental in such patients. Hypercoagulable states and cerebrovascular disease, which have been seen rarely for some acute viral infections, are an important neurological complication of COVID-19. Overall, the proportion of patients with neurological manifestations is small compared with that with respiratory disease. However, the continuing pandemic, and the expectation that 5080% of the world's population might be infected before herd immunity develops, suggest that the overall number of patients with neurological disease could become large. Neurological complications, particularly encephalitis and stroke, can cause lifelong disability, with associated long-term care needs and potentially large health, social, and economic costs. Health-care planners and policy makers need to be aware of the growing burden. Careful clinical, diagnostic, and epidemiological studies are needed to help define the neurological disease manifestations and burden. This work will involve the collaboration of a range of clinical and research expertise, and harmonised approaches across regions; smaller case series and registries should be combined into meta-analyses such as that of the COVID-19 Neuro Network run through Brain Infections Global, which is also providing standardised case record forms and case definitions. See more

Dr. John F. Connolly is the Senator William McMaster Chair of Cognitive Neuroscience of Language at McMaster University, and co-founder and Chief Science Officer of VoxNeuro. His research has received support from national and international funding agencies including: Natural Science and Engineering Research Council of Canada (NSERC), Canadian Institutes of Health Research (CIHR), Canada Foundation for Innovation, Ontario Brain Institute (OBI), Ontario Centres of Excellence (...OCE), Scottish Rite Charitable Foundation (Canada & USA), March of Dimes Research Foundation (USA), National Institutes of Health (USA), Heart and Stroke Foundation of Canada, The Hospital for Sick Children (Sick Kids), Networks of Centres of Excellence of Canada, Autism Speaks’ High Risk - High Impact Initiatives (USA), Collaborative Health Research Projects (CIHR & NSERC). VoxNeuro has received innovation support funding from the National Research Council of Canada Industrial Research Assistance Program (NRC IRAP). See more

COVID-19, the abbreviation for coronavirus disease 2019, is the name of the disease caused by a virus named SARS-CoV-2, an abbreviation for severe acute respiratory syndrome coronavirus 2. The first report of this virus was in Wuhan, China, in November 2019 and now (Spring 2020) it has spread all over the world, so it is called a pandemic. This viral infection may cause fever, cough, tiredness, shortness of breath, and, in some cases, diarrhea. The infection usually causes mi...ld symptoms in children and teenagers, but it can be lethal to the elderly. This virus can be spread between people very easily, so it is important to understand how to prevent its spread. The most effective ways to do this are by regularly washing hands with soap and water, maintaining a safe distance from other people, covering the mouth when coughing or sneezing, avoiding touching the face, eating a healthy diet, and staying home. See more

Social distancing means keeping physical space between yourself and other people outside your household. It is a vital step in helping to slow the spread of this virus. Here's why: COVID-19 spreads easily through physical contact from person to person. This is why it is important to reduce the ways people come in close contact with one another. An effective way to do this is to stay home as much as possible and avoid crowded, public places where it is difficult to keep a safe... space between people. Many communities have limits on how many people can attend events and gatherings or enter restaurants and bars. And many schools and universities have reduced close contact by providing online learning. When close interaction with others is likely, such as essential trips to the grocery store or gas station, or at a gathering, the CDC recommends wearing a cloth face covering over your mouth and nose and staying at least 6 feet away from others.

Dr. H. Aaron Aronow takes us on a personal journey beginning with The Great Spanish Flu Pandemic of 1918-1920, through the HIV/AIDS Pandemic of 1981, to the current Covid-19 Pandemic, sharing some of the latest updates and how we can continue to protect our personal health, and the public health. Dr. Aronow will also share some insights on the evolving implications for his vision of a Medicare Based Single Payer Universal Healthcare System For All and health policy more broadly, that will help end racial and economic based disparities in addition to taking Q&A from attendees. This webinar will be moderated by Rabbi Denise L. Eger.

A preliminary study of patients hospitalized with COVID-19 has found the disease can damage the brain, causing complications such as stroke, inflammation, psychosis and dementia-like symptoms in some severe cases. The findings are the first detailed look at a range of neurological complications of COVID-19 and underline a need for larger studies to find the mechanisms behind them and assist the search for treatments.

Neuroscience describes the scientific study of the mechanics of the central nervous system such as its structure, function, genetics and physiology as well as how this can be applied to understand diseases of the nervous system. Neurology is a specialized area of medicine that concerns disorders and diseases of the nervous system ranging from Alzheimer's disease through to infection and personality disorders. Neurology involves diagnosing and treating conditions of the central, peripheral and autonomic nervous systems.