Listen to this article
A new study has revealed that the neurological complications of covid-19 can
include delirium—abrupt change in the brain that causes mental confusion and
emotional disruption, brain inflammation, stroke and nerve damage.
The research team at University College London (UCL) and University College
London Hospitals (UCLH) published the study in the journal Brain. And
according to the study, the cases of ADEM (an inflammatory disease) seem to
be increasing due to the pandemic, and can prove to be fatal.
Yup, covid-19 can also reach the brain. Image courtesy: Shutterstock
In the study, some patients seemed to be asymptomatic with the neurological
disorder being the first and main indicator of covid-19.
Joint senior author Dr Michael Zandi (UCL Queen Square Institute of Neurology
and University College London Hospitals NHS Foundation Trust) said:
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.
“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–perhaps similar to the encephalitis lethargica
outbreak in the 1920s and 1930s after the 1918 influenza pandemic–remains
to be seen.”
The also gives a detailed account of the neurological symptoms of 43 people
(aged 16-85), who had either confirmed or suspected covid-19 and were being
treated at the National Hospital for Neurology and Neurosurgery, UCLH.
The researchers identified 10 cases of transient encephalopathies (temporary
brain dysfunction) with delirium, which corresponds with other studies finding
evidence of delirium with agitation.
There were also 12 cases of brain inflammation, eight cases of strokes, and eight others with nerve damage, mainly Guillain-Barre syndrome (which usually occurs after a respiratory or gastrointestinal infection).
Nine out of 12 cases with brain inflammation conditions were diagnosed with
acute disseminated encephalomyelitis (ADEM). ADEM is rare and typically seen
in children. Viral infections can aggravate the condition. The team in London
encounters at least about one adult patient with ADEM per month.
During the study period that has increased to at least one per week, which the
researchers believe is a concerning increase.
SARS-CoV-2—the virus causing covid-19, was not detected in the cerebrospinal
brain fluid of any of the patients tested, suggesting the virus did not directly
attack the brain to cause the neurological illness. Further research needs to be
done to understand why patients were developing these complications.
Researchers have found evidence that in some patients the brain inflammation
was likely caused by an immune response to the disease. This suggests that
some neurological complications of covid-19 might actually come from the
immune response and not the virus itself.
Another study involving Dr Zandi and co-author Dr Hadi Manji (UCL Queen
Square Institute of Neurology) identified 153 people with neurological
complications from covid-19. This paper also confirmed the previously
reported findings of a higher than expected number of patients with a stroke.
This was said to result from the excessive stickiness of the blood in COVID-19
Joint first author Dr Ross Paterson (UCL Queen Square Institute of Neurology)
says: “Given that the disease has only been around for a matter of months, we
might not yet know what long-term damage covid-19 can cause.”
“Doctors needs to be aware of possible neurological effects, as early diagnosis
can improve patient outcomes. People recovering from the virus should seek
professional health advice if they experience neurological symptoms,” he
Joint senior author Dr Hadi Manji says: “Our study amalgamates, for the first
time, the clinical presentations of patients with Covid-19 neurological disease
with MRI and laboratory features including, in one case, a brain biopsy.
“This now sets up a template for other researchers around the world,
facilitating coordinated research to optimise the diagnosis and treatments of
these complications, which to date, has proved difficult. In addition, patients
are going to require long term follow up.”
(With inputs from ANI)