(Washington) New York doctors treating patients with COVID 19 are increasingly observing more symptoms than fever, cough and shortness of breath: Some were confused until they didn’t know where they were or what the current year was .
Posted on April 17, 2020 at 7 h 52
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Issam AHMED
Agence France-Presse
This loss of storage is sometimes associated with a lack of oxygen in the blood, but in some patients the level of confusion seems disproportionate to the level of lung disease.
For Jennifer Frontera, neurologist at Langone University Hospital in Brooklyn, the question arises as to the effects of the new coronavirus on the brain and nervous system.
Studies are beginning to describe the phenomenon. In the Journal of the American Medicine Association (Jama) last week, doctors reported that 36% of 214 Chinese patients had neurological symptoms ranging from loss of smell to nerve pain to seizures and strokes (stroke).
in the New England Journal of Medicine , the top-rated American medical journal, French doctors in Strasbourg described that more than half of the 58 intensive care patients were confused or upset. Brain scanners showed possible inflammation.
“Everyone says it’s a breathing problem, but it also affects something that is very valuable to us, the brain,” said S. Andrew Josephson, director of the Neurology Department at AFP. University of California San Francisco.
“If you feel confused and have trouble thinking, these are good reasons to consult a doctor,” he adds. “The old idea that you should only come when you are out of breath is probably no longer valid.
Viruses and the brain
Virologists are not entirely surprised that the new SARS-CoV-2 coronavirus can affect the brain and nervous system, as this relationship has been observed with other viruses, especially the AIDS virus. HIV.
Viruses can affect the brain in two ways, explains Michel Toledano, a neurologist at the Mayo Clinic in Minnesota.
The first is to trigger an abnormal immune response called a “cytokine storm” that causes inflammation of the brain. This is called autoimmune encephalitis.
The second is a direct brain infection: this is called viral encephalitis. The brain is protected by the so-called blood-brain barrier: it has the task of blocking intruders, but can be broken through.
Some hypotheses suggest that the nose could be the gateway to the brain because odor loss is common in many COVID patients – 17. However, this has not been verified and many patients who lose their sense of smell do not have serious neurological problems.
The main route is indeed that of the overheated immune response. To find out, the virus should be detected in the cerebrospinal fluid. This was done once in a Japanese 17 year, its case in the International Journal of Infectious Disease.
He suffered from confusion and cramps, and the images of his brain showed inflammation. However, the test has not yet been validated and scientists remain cautious.
sequel follows
To solve these puzzles, Jennifer Frontera, who teaches at New York University’s medical school, is working on an international research project to standardize data collection.
His own team recorded cases of seizures in COVID patients – 19 who had never done so before I got sick. The researchers also observed tiny brain hemorrhages that were described as “unprecedented”.
You also want to take cerebrospinal fluid from a 50-year-old whose white matter in the brain is seriously affected. But these samples, like MRIs, are difficult to perform on artificial respiratory patients. And since the majority are dying, there have been few studies on neurological damage.
However, those who survive end up consulting neurologists.
“We see a lot of patients in confused conditions,” Rohan Arora, a neurologist at the Jewish Forest Hills Hospital in Long Island, told AFP. He claims that 39% of coronavirus survivors are affected.
It is not known whether these disorders are permanent. The transition to resuscitation is in itself a source of confusion, especially due to medication.
However, the neurologist notes that the return to normal in Covid patients appears to take longer than in patients who have survived a heart attack or stroke.
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