There is new knowledge about the coronavirus: an infection can also affect the nervous system. An interview with Prof. Dr. Julian Bösel, the director of the Clinic for Neurology at the Kassel Clinic.
- The Corona virus spreads further in the region kassel out
- Now there is new knowledge about the effects of a corona-Infection
- Interview with Prof. Dr. Julian Bösel, Director of the Clinic for Neurology at the Kassel Clinic
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Kassel – an infection with corona can also affect the nervous system. We spoke to Prof. Dr. Julian Bösel, the director of the clinic for neurology at the clinic kassel.
Prof. Bösel, so far Covid-19 is primarily known as a respiratory disease. To what extent is the coronavirus also a case for neurology?
Several reports from China, Japan, Italy, France and recently also from the USA have shown that the coronavirus can also affect the nervous system – both the peripheral and the brain, as is evident from the neurological symptoms.
What are the symptoms?
Smell and taste disorders are relatively common, which probably reflect the involvement of certain mucosal cells, but can also be an indication that the nerves and brain are affected. Headaches and muscle aches, dizziness, nausea and vomiting, hallucinations, impaired consciousness, epileptic seizures, neck stiffness and even neurological deficits can be symptoms.
Corona in Kassel: New symptoms in severe courses
Do these symptoms appear before patients test positive or are they added to common symptoms such as cough and fever?
Both have been described. These can actually be early symptoms and can therefore be an indication of one corona-Have infection tested. It is also possible that other typical symptoms are missing. If the course is mild, the neurological side effects appear to disappear after a few days.
How does the entry of the coronavirus into the brain work?
The most common route is probably via the blood and is referred to as hematogenous spread: the virus can dock onto vascular wall cells via the so-called ACE2 as a receptor and work its way to the brain cells that also carry ACE2. The other route apparently leads through nerves connected to the brain and spinal cord.
In the olfactory mucosa, for example, nerve cells could be affected and the virus could be introduced into the brain via the olfactory bulb. The virus can also reach the brain stem via other cranial nerves, for example from the throat or respiratory organs.
Corona in Kassel: New findings on the virus
Are these findings new?
Scientists have also discovered this behavior in other corona viruses, for example those in the MERS and SARS disease waves. A Japanese patient recently provided evidence that Sars-CoV-2, as part of Covid-19, can also affect the nervous system.
In his brain and meningitis with epileptic seizures, the virus was first detected in the nerve water. Another patient in the United States died after neurological symptoms and was autopsied. The virus was found in his brain’s nerve and vascular wall cells – as an indication of spreading through the blood.
Know your enemy: New important findings in corona research via @srfnews https://t.co/k1OZmvlm19
– Michelle Renaud (@ MichelleRenaud1) April 23, 2020
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What effects can nervous system involvement have?
Direct effects include encephalitis (meningitis), meningitis (meningitis) or their combination, meningoencephalitis. But there are also indirect effects such as strokes: the coronavirus leads to changes in the blood and to its clotting. Covid-19 patients have an increased tendency to thrombi. This explains why some of the Covid-19 patients suffer from pulmonary embolism. There are currently reports from the USA, where young corona patients also suffer strokes that were otherwise not at increased risk.
Corona in Kassel: Study at a hospital on corona patients with severe courses
What experience have you had at the clinic so far?
We neurologists are only just beginning to recognize the problem. Our clinic is coordinating a study with the Ludwig Maximilians University in Munich, which will record patients with intensive care courses and nervous system involvement throughout Germany in order to identify patterns and therapeutic opportunities.
Specifically, we have expanded our screening to include the neurological symptoms mentioned in our regular emergency room and also in the separate emergency room (Covid Care Unit, CCU) specially set up for Covid 19 patients.
Incidentally, neurological deficiency symptoms are always warning signs with which patients should always come to the hospital. Despite all the attention that Covid-19 is currently receiving, this must not lead to patients with symptoms of this type avoiding being presented in the clinic out of fear of being infected with the virus, this applies particularly to patients with suspected stroke.
By Anja Berens
The corona pandemic continues to spread in Kassel. Three chief physicians talk about the first experiences and the preparations that are going on in the clinic.
In the Corona crisis, several closed clinics in the Kassel region are to be reactivated.
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