The ever-evolving spectrum of Coronavirus-related research has shown significant promise. While it is widely accepted that SARS-Cov-2 virus can permanently or for a long time cause lung damage, a new study has revealed that the infection is also associated with a neurological and neuropsychiatric illness that can damage the brain.
A team of neurologists conducted research on 43 COVID-19 patients at the National Hospital for Neurology and Neurosurgery in the U.K. with brain inflammation. In the study, published on July 8, they found neurological complications including delirium, nerve damage and stroke which, at times, were a patient's first symptoms instead of respiratory signs.
Inflammation of Brain
They also identified one inflammatory condition, ADEM (Acute disseminated encephalomyelitis), which is fatal in many cases, increasing among COVID-19 patients. The study revealed that during the early days of the pandemic in Britain, ADEM cases increased from one in a month to two-three per week in April. ADEM is a rare condition which is generally observed among children and often caused by viral infections.
"We're seeing things in the way COVID-19 affects the brain that we haven't seen before with other viruses. We identified a higher than expected number of people with neurological conditions such as brain inflammation, which did not always correlate with the severity of respiratory symptoms," said joint senior author of the study which was published in the journal Brain, Dr Michael Zandi, a consultant at the University College London Hospitals NHS Foundation Trust.
The patients, aged between 16 to 85 years, had either confirmed or suspected COVID-19. Out of them, doctors identified 10 cases of temporary brain dysfunction or transient encephalopathies with delirium that also resembled the studies conducted in other places. They also found 12 cases of brain inflammation, 8 cases of nerve damage (mostly Guillain-BarrÃ© syndrome) and as many cases of strokes.
"We should be vigilant and look out for these complications in people who have had COVID-19. Whether we will see an epidemic on a large scale of brain damage linked to the pandemic â perhaps similar to the encephalitis lethargica outbreak in the 1920s and 1930s after the 1918 influenza pandemic â remains to be seen," Zandi told The Guardian.
Long-Term Health Issues
The cases raise concerns about long-term health issues resulting from permanent or long-term brain damage. During the study, a 55-year-old, who recovered from COVID-19 and was discharged from the hospital, began to show signs of psychiatric illness. The woman, who had no history of such illness, began hallucinating and behaving oddly. In one instance, she reported seeing lions and monkeys in her house. In another, she put her coat on and took it off repeatedly.
In one case, a 47-year-old patient was admitted with a headache and numbness in the right hand. She reported the neurological symptoms following a week of cough and fever. When she became unresponsive, emergency surgery had to be conducted to relieve pressure from her swollen brain.
In other studies, some patients have reported breathing trouble and fatigue long after recovery. Zandi said that doctors around the world must stay vigilant to such complications, urging them to be alert of cognitive symptoms. "The message is not to put that all down to the recovery, and the psychological aspects of recovery. The brain does appear to be involved in this illness," he said adding that further study will be required to understand the full scale of implications and brain disorders caused by COVID-19.
The additional problem with such long-term effects is that in future in other illnesses, there could be a delayed response from the brain due to the damage. "It's a concern if some hidden epidemic could occur after COVID where you're going to see delayed effects on the brain because there could be subtle effects on the brain and slowly things happen over the coming years, but it's far too early for us to judge now," he said.