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Coronavirus: Neurologists warn of serious brain disorders in patients with mild symptoms

AFP / F. Tanneau

British scientists have warned about serious to potentially fatal brain disorders that can occur after infection with the Covid-19 virus. The brain disorders appear to occur in convalescent or mildly affected patients.

British neurologists have one article published in the journal Brain describing more than 40 British Covid-19 cases of severe brain disease from the virus. In some patients, the neurological problem was their first and only symptom of corona infection. The scientists are concerned that the doctor will not notice the symptoms of brain disorders in corona patients and call for alertness. “We see things in the way Covid-19 affects the brain that we have never seen before with other viruses,” said Michael Zandi, lead author of the study, in The Guardian.

Life threatening

Of the cases described, a dozen patients had inflammation of the central nervous system, ten experienced acute confusion (delirium) or psychosis, and eight had strokes. The study thus describes the case of a 55-year-old woman without any psychological history who started hallucinating the day after her discharge from the hospital and saw monkeys and lions in her house.

“In such cases, it is important that we do not attribute everything to the (psychological effects of) the recovery process, because something is definitely happening in the brain,” says Zandi. Another woman needed emergency surgery to relieve the pressure on her swollen brain a week after developing a fever and a cough.

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AFP / Getty / G. Nakamura

Another eight patients had peripheral nerve problems, usually diagnosed as Guillain-Barré syndrome – an immune response that affects the nerves and causes paralysis. The syndrome is fatal in 5% of cases. The most troubling observation is probably the increase in cases of Acute Disseminated Encephalomyelitis (ADEM), a condition that can lead to life-long disability or death in severe cases. At the University College of London (UCL) Neurological Institute, the number of cases increased from one month before the corona pandemic to two or three a week in April and May. A 59-year-old woman died of the condition.

Mild symptoms

All the more alarming is the fact that these are often patients who otherwise have few typical Covid-19 symptoms. “What we see in some patients with ADEM and in other patients is that they are very neurologically ill, but actually have only mild lung disease,” says Zandi. The news comes in addition to the list of health effects that Covid-19 patients will continue to experience in the long term, such as fatigue and shortness of breath, weakness, numbness and memory problems.

The problem may be even bigger than expected, because many Covid patients who stay in the hospital are too ill to lie under the brain scanner, for example. Zandi argues that better research is needed to discover what happens in the brain because of the virus. One concern is that the virus causes brain damage in a minority of patients that only shows up after a few years, as it probably did in nearly a million people during the 1918 Spanish flu pandemic.

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