Another important question is whether the damage to the brain is due to an infection of the brain by the virus or the overstimulation of the immune system from a corona infection elsewhere.
There is clear evidence that the coronavirus can infect nerve cells. This is evident, among other things research with ‘organoids’, tiny clumps of brain tissue grown in the laboratory from human pluripotent stem cells. The virus was able to infect the nerve cells in the organoids, kill some nerve cells and reduce the formation of synapses, connections between the nerve cells.
Autopsies of deceased COVID-19 patients also showed the presence of the virus in brain tissue with an electron microscope, albeit in small quantities.
Compared to other organs, it is difficult to detect the virus in the brain. As mentioned, it is sometimes found in brain tissue, but infection of the central nervous system appears to be extremely rare. That means that the strong immune system response to the virus infection is likely the cause of the neurological problems.
This is important for the treatment: if it concerns an infection, it is recommended to treat the patients with remdesivir or another antiviral agent, otherwise the patient must be given anti-inflammatory drugs. And while it is useless to give someone anti-virals once the virus is gone, it is dangerous to give anti-inflammatories to someone with a viral infection in their brain.
Therefore, more research is needed to distinguish between the two possible causes of the neurological problems.
The Federal University of Rio de Janeiro will build a tissue bank of cerebrospinal fluid, among other things, and monitor patients who have recovered after admission to intensive care. University College London will also be conducting similar studies, according to reports Nature. The researchers will undoubtedly have years of work on this, but hopefully answers will be given to a number of questions earlier.
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