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The article states: > In the region of olfactory bulb and olfactory tract, COVID-19 infection was associated with axon pathology and microvasculopathy, parti

The article states: > In the region of *olfactory bulb and olfactory tract*, COVID-19 infection was associated with axon pathology and microvasculopathy, particularly in patients with smell alterations; the olfactory pathology did not result from direct viral injury and may be associated with local inflammation. That is not the same as "nerves and blood vessels in their nose". For those curious here's an image of where the olfactory bulb is [0]. It's pretty clear that any "layman" would define this as "in the brain". I don't think this is alarmist, rather that you are misunderstanding where the region effected is. 0. https://upload.wikimedia.org/wikipedia/commons/3/34/Head_Olfactory_Nerve_Labeled.png https://upload.wikimedia.org/wikipedia/commons/3/34/Head_Olf...

samatman 5y ago
It's true that the olfactory bulb is a region of the brain, but this is a case where the loss of precision is misleading. "damages the body" is just as accurate as "damages the brain", is just as accurate as "damages the olfactory bulb".
- croes 5y ago
  There is a difference if something is in the brain or the rest of the body
  - samatman 5y ago
    There is a difference if something is in the olfactory bulb or the rest of the brain.
swasheck 5y ago
yes and no. it is somewhat alarmist as the olfactory bulb is anatomically part of the brain and is responsible for initial transmission of the olfactory signals for further processing in the amygdala. it essentially completes the circuit between the olfactory neurons and the amygdala. if the research shows that the amygdala has been damaged, then i'd feel much more comfortable with alarmist "brain damage" headline. even so, the damage itself is devastating. my daughter and wife both suffer from covid-related parosmia. my daughter has dealt with it for ~18 months now and has given up hope of ever getting to enjoy tastes she once loved.
- ModernMech 5y ago
  I'm really sorry for your family. This is part of the reason I don't even want to catch Covid. In 2020 my sister lost her sense of smell t Covid, and it seems to have permanently altered her sense of taste. What else but damage to the brain could do that? To this day food she used to love have been corrupted. She can't describe it, but the closest she has articulated to me is that certain things things "taste the way cigarettes smell." As a result, she has had trouble eating and has lost a lot of weight (not in the way you want to lose weight). I get really upset when people dismiss long covid as some sort of hysteria. Even if that were true, the impacts are real, and it's not a joke or something to be minimized and dismissed.
  - timr 5y ago
    > What else but damage to the brain could do that? Damage to the olfactory epithelia. That is what this paper is describing.
    - djmips 5y ago
      I think that was their point. ^
    - shkkmo 5y ago
      This paper describes damage to the axons in the olfactory bulb and tract. While their olfactory neurons have their cell bodies in the epithelial, their axons extend through the tract into the bulb. Thus the damage appears to not be to receptors or support cells in the epithalia / nose but to axons in bulb / brain.
      - timr 5y ago
        > Thus the damage appears to not be to receptors or support cells in the epithalia / nose but to axons in bulb / brain. No. From the paper: > Consistent with findings reported by other groups,16,19 this study also did not find evidence of viral infection in olfactory bulb from most patients with COVID-19. Therefore, the axon and microvascular pathology in olfactory bulb and olfactory tract were most likely not caused by direct viral injury. Moreover: > this study did not find a strong association between olfactory endothelial injury and disease severity, suggesting that local inflammation in the upper respiratory tract may be sufficient to cause endothelial and axonal damage in the olfactory pathway. I'm not an expert in the microanatomy of the olfactory pathway so I'm not going to debate the location of the samples, but the authors are explicit that your interpretation is incorrect. It's not the neurons themselves, it's some inflammatory process external to the neurons that is causing damage. This has clear implications for the level of panic people are bringing to this conversation. A virus that can infect neurons (e.g. rabies, herpes) can cause damage by moving within the nerves themselves. This virus does not appear to do that, and instead causes local inflammation that indirectly influences the neurons. Debating whether or not this is "brain damage" is academic; most people in this conversation are leaping to wild conclusions about the virus "infecting the brain". This is not supported.
deleted 5y ago
[deleted]
timr 5y ago
> That is not the same as "nerves and blood vessels in their nose". The words literally mean "nerves and blood vessels in the nose". The quoted text also tells you that the observed pathology is not from direct viral infection. Saying that "covid leads to brain damage" because the olfactory nerves are connected to the brain is an unsupported leap, and it's why the title of the paper doesn't say this. The title of this article is purposely sensational, and really needs to be changed. A better, more accurate title would be: "covid smell loss due to inflammation in the olfactory epithelia". Or just the title of the paper itself.
- slg 5y ago
  >A better, more accurate title would be: "covid smell loss do to inflammation in the olfactory bulb". I'm a layperson. Like many laypeople, I would have no idea what the "olfactory bulb" was if I saw it in a headline, but the Wikipedia page for it starts with "The olfactory bulb (Latin: bulbus olfactorius) is a neural structure of the vertebrate forebrain...". It certainly sounds like "brain" is a fair and accurate summary.
  - timr 5y ago
    If you're a "layperson" and resorting to reading wikipedia, then you really have no basis to draw any conclusion. But you're extremely willing to jump to scary conclusions, and disregard people who understand the paper and terminology and tell you that your conclusion is wrong.
    - slg 5y ago
      I think there is an implicit assumption that HN titles shouldn't be written in jargon that most people reading it won't understand.
      - timr 5y ago
        It's a medical paper. It isn't written for non-practitioners, and if you don't understand it, the best thing to do is not to speculate, but to reserve judgment.

The article states: > In the region of *olfactory bulb and olfactory tract*, COVID-19 infection was associated with axon pathology and microvasculopathy, parti

samatman 5y ago

It's true that the olfactory bulb is a region of the brain, but this is a case where the loss of precision is misleading. "damages the body" is just as accurate as "damages the brain", is just as accurate as "damages the olfactory bulb".

croes 5y ago
There is a difference if something is in the brain or the rest of the body
- samatman 5y ago
  There is a difference if something is in the olfactory bulb or the rest of the brain.

swasheck 5y ago

yes and no. it is somewhat alarmist as the olfactory bulb is anatomically part of the brain and is responsible for initial transmission of the olfactory signals for further processing in the amygdala. it essentially completes the circuit between the olfactory neurons and the amygdala. if the research shows that the amygdala has been damaged, then i'd feel much more comfortable with alarmist "brain damage" headline. even so, the damage itself is devastating. my daughter and wife both suffer from covid-related parosmia. my daughter has dealt with it for ~18 months now and has given up hope of ever getting to enjoy tastes she once loved.

ModernMech 5y ago
I'm really sorry for your family. This is part of the reason I don't even want to catch Covid. In 2020 my sister lost her sense of smell t Covid, and it seems to have permanently altered her sense of taste. What else but damage to the brain could do that? To this day food she used to love have been corrupted. She can't describe it, but the closest she has articulated to me is that certain things things "taste the way cigarettes smell." As a result, she has had trouble eating and has lost a lot of weight (not in the way you want to lose weight). I get really upset when people dismiss long covid as some sort of hysteria. Even if that were true, the impacts are real, and it's not a joke or something to be minimized and dismissed.
- timr 5y ago
  > What else but damage to the brain could do that? Damage to the olfactory epithelia. That is what this paper is describing.
  - djmips 5y ago
    I think that was their point. ^
  - shkkmo 5y ago
    This paper describes damage to the axons in the olfactory bulb and tract. While their olfactory neurons have their cell bodies in the epithelial, their axons extend through the tract into the bulb. Thus the damage appears to not be to receptors or support cells in the epithalia / nose but to axons in bulb / brain.
    - timr 5y ago
      > Thus the damage appears to not be to receptors or support cells in the epithalia / nose but to axons in bulb / brain. No. From the paper: > Consistent with findings reported by other groups,16,19 this study also did not find evidence of viral infection in olfactory bulb from most patients with COVID-19. Therefore, the axon and microvascular pathology in olfactory bulb and olfactory tract were most likely not caused by direct viral injury. Moreover: > this study did not find a strong association between olfactory endothelial injury and disease severity, suggesting that local inflammation in the upper respiratory tract may be sufficient to cause endothelial and axonal damage in the olfactory pathway. I'm not an expert in the microanatomy of the olfactory pathway so I'm not going to debate the location of the samples, but the authors are explicit that your interpretation is incorrect. It's not the neurons themselves, it's some inflammatory process external to the neurons that is causing damage. This has clear implications for the level of panic people are bringing to this conversation. A virus that can infect neurons (e.g. rabies, herpes) can cause damage by moving within the nerves themselves. This virus does not appear to do that, and instead causes local inflammation that indirectly influences the neurons. Debating whether or not this is "brain damage" is academic; most people in this conversation are leaping to wild conclusions about the virus "infecting the brain". This is not supported.

deleted 5y ago

[deleted]

timr 5y ago

> That is not the same as "nerves and blood vessels in their nose". The words literally mean "nerves and blood vessels in the nose". The quoted text also tells you that the observed pathology is not from direct viral infection. Saying that "covid leads to brain damage" because the olfactory nerves are connected to the brain is an unsupported leap, and it's why the title of the paper doesn't say this. The title of this article is purposely sensational, and really needs to be changed. A better, more accurate title would be: "covid smell loss due to inflammation in the olfactory epithelia". Or just the title of the paper itself.

slg 5y ago
>A better, more accurate title would be: "covid smell loss do to inflammation in the olfactory bulb". I'm a layperson. Like many laypeople, I would have no idea what the "olfactory bulb" was if I saw it in a headline, but the Wikipedia page for it starts with "The olfactory bulb (Latin: bulbus olfactorius) is a neural structure of the vertebrate forebrain...". It certainly sounds like "brain" is a fair and accurate summary.
- timr 5y ago
  If you're a "layperson" and resorting to reading wikipedia, then you really have no basis to draw any conclusion. But you're extremely willing to jump to scary conclusions, and disregard people who understand the paper and terminology and tell you that your conclusion is wrong.
  - slg 5y ago
    I think there is an implicit assumption that HN titles shouldn't be written in jargon that most people reading it won't understand.
    - timr 5y ago
      It's a medical paper. It isn't written for non-practitioners, and if you don't understand it, the best thing to do is not to speculate, but to reserve judgment.