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According to recent studies, people may be experiencing neurological complications resulting from contracting COVID-19. Scientists are struggling to understand why.
The journal Nature published the story of a woman in her mid-50s who had coronavirus and was experiencing symptoms of psychosis, like seeing lions and monkeys in her house, becoming disoriented and aggressive towards others, and being convinced that her husband was an impostor. All of this despite the fact that she had no psychiatric history and decades older than the age at which psychosis typically develops.
In the early months of the coronavirus pandemic, reports of patients struggling with breathing, as well damage to the lungs and circulatory system were widespread. But in addition to those symptoms, evidence for neurological effects was accumulating. Some hospitalized COVID-19 patients were experiencing delirium, being confused, disorientated, and agitated for prolonged periods.
In April, a team in Japan published the first report of a COVID-19 patient experiencing swelling and inflammation in their brain tissues. Another report from Italy described a patient with deterioration in the fatty coating that protects neurons, called myelin, and is irreversibly damaged in neurodegenerative diseases such as multiple sclerosis.
A neuroscientist at the University of California, San Diego, reportedly told Nature about this development: “The neurological symptoms are only becoming more and more scary.”
The list now includes memory loss, brain haemorrhage, and strokes. It’s not uncommon for serious diseases to cause the aforementioned effects, but given the scale of the COVID-19, this means tens of thousands of people are at risk, if not already presenting these symptoms, which could lead to lifelong problems as a result.
Although viruses can invade and infect the brain, COVID-19 is still largely a novelty for researchers, so they’re struggling to pinpoint exactly who’s at risk, or even if the virus does so in a significant way. The neurological symptoms might instead be a result of overstimulation of the immune system. The importance of finding out exactly lies in the fact that both scenarios require entirely different treatments.
A June paper by the University of Liverpool analysed clinical details for 125 people in the United Kingdom with COVID-19 who had neurological or psychiatric effects. Of these, 62% had experienced damage to the brain’s blood supply, including strokes and haemorrhages, while 31% had altered mental states, like confusion or prolonged unconsciousness. These last cases were sometimes accompanied by encephalitis, the swelling of brain tissue. Ten people who had altered mental states developed psychosis.
A similar studypublished in July confirmed that the most common neurological effects are stroke and encephalitis. The latter can escalate to acute disseminated encephalomyelitis, in which both the brain and spinal cord become inflamed and neurons lose their myelin coatings, which can then lead to symptoms resembling those of multiple sclerosis. Some of the worst-affected patients had only mild respiratory symptoms.
As aforementioned, clinicians still don’t know how common these neurological effects are. A major problem in quantifying cases is that clinical studies have typically focused on people with COVID-19 who were hospitalized, often those who required intensive care. Neurobiologist Fernanda De Felice at the Federal University of Rio de Janeiro in Brazil told Nature that the prevalence of neurological symptoms in this group could be more than 50%. But there is much less information about those who had mild illness or no respiratory symptoms.