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Inez Jabalpurwala is the global director of the Viral Neuro Exploration (VINEx) initiative. She is the founding CEO of the Brain Canada Foundation.

The immediate focus of the COVID-19 pandemic is, and must be, to make safe and effective vaccines available to every Canadian, and to bring the death rate to zero. But that won’t be the end of the story. A segment of those infected are living with lasting impacts on their brain health, and we need to know why.

As of Feb. 1, more than 103 million people around the world had been infected with SARS-CoV-2 – the virus which causes COVID-19 disease – and more than two million have died. Of those who were hospitalized and survived, an estimated 10 to 35 per cent reported experiencing persistent symptoms weeks or even months after the infection. They are part of a much larger group, informally known as “long-haulers,” many of whom were never hospitalized and are in their middle years – 30s, 40s and 50s – with women disproportionately affected by as much as a 4 to 1 ratio.

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Long COVID-19 is gaining global attention. In Canada and around the world, conferences, workshops and studies on the lasting impacts of COVID-19 have begun. While long-haulers are experiencing a range of symptoms, many are neurological in nature. A NYU Langone study found that COVID-19 leads to potentially damaging neurological impacts in 1 out of 7 people. The symptoms include headaches, brain fog, chronic fatigue and impaired memory and concentration. Another study by researchers at the University of Oxford and NIHR Oxford Health Biomedical Research Centre found that nearly 1 in 5 people who have had COVID-19 were diagnosed with a psychiatric disorder – such as anxiety, depression or insomnia – within three months of testing positive for the virus.

A virus affecting brain health is not unique to COVID-19. The Spanish flu of 1918 to 1920 infected an estimated one third of the global population, and post-pandemic, a number of researchers noted a connection between the Spanish flu and a pronounced increase in a range of neurological diseases and psychiatric disorders. Similar post-pandemic observations were reported of the 1889 Russian flu. Despite these century-old precedents, we are at a loss today to provide answers to patients who present with post-COVID-19 symptoms.

Additionally, research has suggested a possible link between viral infections – including various influenzas, herpes and HIV – and the onset of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, ALS and multiple sclerosis.

What we learn from our study of COVID-19-brain impacts will therefore contribute to our knowledge about how viruses may affect the brain across the lifespan and potentially give line of sight to treatments or interventions. This work has a longer time horizon, and requires expertise in and collaboration among a range of disciplines – key features of Canadian research.

Canada is a country with globally recognized expertise in brain science and machine learning/AI. We value community and scientific collaboration. And we are already providing leadership in interdisciplinary COVID-19 research, including through the McGill Interdisciplinary Initiative in Infection and Immunity (MI4).

In April, Rocket Science Health, a private brain-health focused medical device company, launched VINEx (the Viral Neuro Exploration), with the goal of raising attention to, and investment in, how viruses affect the central nervous system. VINEx brought together an advisory council of world-renowned, emerging and mostly Canadian researchers and clinicians in virology, immunology, neurology, neurosciences and data science to develop a coherent road map, with an initial focus on SARS-CoV-2.

Government and research funders should expand investment in COVID-19 research and make the study of viral impacts on the brain a priority, beginning with COVID-19 survivors. A Canadian-led effort should first invest in a national study of sufficient scale of patients experiencing neurological and psychiatric consequences, including a COVID-19 population that was never hospitalized. Second, collect multi-modal (imaging, genetics, clinical, behavioural) data, using standardized protocols. Third, store the data on an open science platform, which would enable researchers across disciplines, between countries and around the world to share knowledge, foster collaboration and fast-track progress. Fourth, deploy advanced analytic tools, including machine learning/AI, to analyze the data, develop new hypotheses and draw conclusions. And finally, rally other countries to contribute data and/or analytic tools, linking to their own initiatives and enabling Canada in turn to link to other global efforts.

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Canada has an opportunity to make an outsized contribution to the world. We can ensure our response to this pandemic includes survivors whose quality of life has been compromised, and accelerate our understanding of how viruses and future pandemics may affect brain health.

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