Long COVID Study On Neuropsychiatric Impairment

Investigating Neuropsychiatric Impairments In Long COVID: A Groundbreaking Study


In a recent YouTube video, Dr. Misha Kogan, an expert in Integrative Medicine, introduced Dr. Alba Azola, Director of Long COVID at Johns Hopkins and an Assistant Professor in the Department of Physical Medicine and Rehabilitation. Dr. Azola shared exciting news about a new study she is leading, focusing on the neuropsychiatric effects of long COVID. The study aims to explore the role of blood-brain barrier disruption and its contribution to inflammatory states in patients experiencing lingering symptoms. Let’s dive into the details of this groundbreaking research.

Long Covid Symptoms Study photo of Dr. Misha Kogan and Dr. Alba.

Understanding the Study

Dr. Azola’s study is a collaborative effort between the Department of Neurology and Infectious Disease. The researchers are leveraging techniques previously employed to examine Neuropsychiatric impairments post-HIV and applying them to long COVID patients. The study focuses on individuals experiencing Neuropsychiatric sequelae, which includes cognitive impairments, depression, and anxiety. The primary hypothesis centers around the disruption of the blood-brain barrier, leading to the migration of immune cells into the brain and subsequent inflammation.

The study involves two visits. During the first visit, participants undergo blood work, including specific tests for cytokines not commercially available. These tests help identify biomarkers associated with blood-brain barrier permeability and inflammatory states. Additionally, a psychologist administers an extensive cognitive assessment to assess cognitive function, depression, and anxiety levels. The second visit involves an MRI study at the Kennedy Krieger Institute (KKI) to quantify the disruption of the blood-brain barrier.

Comparing Patient Groups

The study aims to compare two groups of patients: those with long COVID symptoms and those who have recovered from COVID-19 and do not exhibit lingering Neuropsychiatric impairments. By examining these two groups, researchers can better understand the specific role of blood-brain barrier disruption in long COVID patients.

Inflammatory Marker Testing

To assess blood-brain barrier permeability and inflammation, the study measures various inflammatory markers. These markers include CCL2, CXCL12, VEGF, TNF-Alpha, IL-6, CCL19, Mig, and CXCL9. The extensive list of tests provides a comprehensive understanding of the biomarkers associated with long COVID and its Neuropsychiatric sequelae.

Patient Participation and Sponsorship

Patient participation is crucial for the success of this study. The study is fully sponsored by the National Institutes of Health (NIH), ensuring that patients do not incur any costs associated with the blood work, MRI, or other assessments. By participating, patients contribute to expanding knowledge and understanding of long COVID, ultimately paving the way for targeted treatments and improved patient care.

Study Logistics and Progress

The study visits take place at the Main Campus and KKI. Patients receive comprehensive neuropsychological assessments and MRI scans to evaluate brain health. The research team has already begun recruiting patients and anticipates enrolling three to four patients per week. Although the study was funded in May, the research timeline was delayed, but efforts are underway to accelerate recruitment and progress.


Dr. Alba Azola’s study investigating the neuropsychiatric impairments in long COVID patients marks an important step towards understanding the underlying mechanisms and potential treatments for these lingering symptoms. By exploring the disruption of the blood-brain barrier and its role in inflammatory states, researchers aim to provide insights into the pathophysiology of long COVID. Patient participation is vital to the success of the study, and those involved will contribute to advancing medical knowledge and improving patient outcomes.

If you or your loved one is interested in learning more or joining the study please contact study team at 443-447-5312 or BHP@jhmi.edu.

GW Center for Integrative Medicine offers a Long COVID program which meets Thursdays.  The Long COVID group is composed of supportive peers and led by GWCIM providers.

Find more information on Long COVID from John Hopkins Post Acute COVID resource website: https://www.hopkinsmedicine.org/coronavirus/pact

Lancet Study shows that natural COVID immunity might be better than vaccines

New Lancet Study On Natural COVID Immunity

Dr. Misha Kogan, director of the GW Center for Integrative Medicine (GWCIM), summarized the insight from an article published in The Lancet about the COVID-19 pandemic and boosters. 

This study was a systematic review meaning that researchers synthesized insight from several different studies. It is also a meta-analysis study. This means that the paper looks at prior controlled trials and assesses the quality of data to ensure “you’re comparing apples and apples.” 

Here are the key takeaways.

Lancet Study shows that natural COVID immunity might be better than vaccines

New Lancet Study On Natural COVID Immunity
Scientists reviewed 65 studies from 19 different countries for the article

Scientists reviewed 65 studies from 19 different countries for their article, “SARS-CoV-2 infection protection against re-infection: a systematic review and meta-analysis” (2023). The Bill and Melinda Gates Foundation funded this study and The Lancet is considered to be one of the top medical journals in the world.

People have been wondering how long they will be protected against getting a symptomatic infection of COVID-19. Dr. Kogan expects that this question–and this study–may trigger a few controversies around when people should get boosted. Until more data is available, “young and healthy people who have been infected before with COVID should not get the Pfizer booster,” right now, Dr. Kogan shares. 

Researchers will also need to re-do this data over and over again as new strains appear. 

When Should People Get Boosted for COVID-19?

“It’s highly individualized,” Dr. Kogan explains after reviewing this paper. This can make some people confused about whether they should get boosters and how frequently to get them. “It’s still reasonable to get boosted every 12 months,” Dr. Kogan states, “unless you have a preexisting condition or illness. Everyone over 65 years old should talk to their doctor and likely get boosted.” People may still get reinfected after a booster, but they are more likely to be protected against severe illness. 

“If you’re relatively healthy and have no problems, I’d say no boosters at all, none–until I have more data,” Dr. Kogan reflects toward the end of his review. “This will be critiqued” he adds. Questions may include, “How do we know that you have included all the data?” 

For now, this is a robust study until there is more data to review. It’s also worth noting that many of the studies in the article cited were done in Europe, though there are studies in Africa and Asia in the paper.

When Should People Get Boosted for COVID-19

Schedule an appointment at the GWCIM

Have more questions you want to discuss your health with a functional medicine, integrative medicine, or chronic illness doctor? Receive the care you need and schedule an appointment with us.

GW Center, located in Washington, D.C., hosts an weekly online Long COVID program for members.