While right now we don’t know too much about it, some researchers seem to believe that there are serious brain disorders being triggered by COVID-19 itself. Sure, that might sound a bit out there but it does seem to be possibly happening as one paper seems to go over. 

This paper published recently in the journal Brain goes over how this virus could be associated with neurological and neuropsychiatric illness. I know, not everyone is going to be having these issues as a result of the disease but those who do are facing extreme issues. 

The abstract for this study goes as follows:

Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness. Responding to this, a weekly virtual coronavirus disease 19 (COVID-19) neurology multi-disciplinary meeting was established at the National Hospital, Queen Square, in early March 2020 in order to discuss and begin to understand neurological presentations in patients with suspected COVID-19-related neurological disorders. Detailed clinical and paraclinical data were collected from cases where the diagnosis of COVID-19 was confirmed through RNA PCR, or where the diagnosis was probable/possible according to World Health Organization criteria. Of 43 patients, 29 were SARS-CoV-2 PCR positive and definite, eight probable and six possible. Five major categories emerged: (i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalities, and with 9/10 making a full or partial recovery with supportive care only; (ii) inflammatory CNS syndromes (n = 12) including encephalitis (n = 2, para- or post-infectious), acute disseminated encephalomyelitis (n = 9), with haemorrhage in five, necrosis in one, and myelitis in two, and isolated myelitis (n = 1). Of these, 10 were treated with corticosteroids, and three of these patients also received intravenous immunoglobulin; one made a full recovery, 10 of 12 made a partial recovery, and one patient died; (iii) ischaemic strokes (n = 8) associated with a pro-thrombotic state (four with pulmonary thromboembolism), one of whom died; (iv) peripheral neurological disorders (n = 8), seven with Guillain-Barré syndrome, one with brachial plexopathy, six of eight making a partial and ongoing recovery; and (v) five patients with miscellaneous central disorders who did not fit these categories. SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature and, in some cases, responding to immunotherapies. The high incidence of acute disseminated encephalomyelitis, particularly with haemorrhagic change, is striking. This complication was not related to the severity of the respiratory COVID-19 disease. Early recognition, investigation and management of COVID-19-related neurological disease is challenging. Further clinical, neuroradiological, biomarker and neuropathological studies are essential to determine the underlying pathobiological mechanisms, which will guide treatment. Longitudinal follow-up studies will be necessary to ascertain the long-term neurological and neuropsychological consequences of this pandemic.

Basically, those who worked on this paper believe that COVID-19 could be contributing to strokes and things of the sort. This as they noted eight patients who experience strokes and eight more who had peripheral nerve damage. While we know COVID-19 is dangerous this really highlights how much is unknown about this virus. Sure, we know it can kill and that it can also go undetected but who would have thought it would be causing strokes and things of the sort?

We’ve already known that COVID-19 could affect the brain but this in itself is much further than expected. You see, the BBC wrote an article covering the confusion and neurological issues that were noted thus far back in June going over March, and well, those issues were nothing like this but still are also things we need to be aware of. This virus isn’t just one that targets one specific place within our bodies and I don’t think the public realizes how intense it truly can be. 

While concerns of this link have been present for quite some time the study noted above really sets things in place more properly. I know, it’s scary enough already but the more aware we are the better. We all need to know what we’re facing even if so many places are deciding to open back up as of late. 

The Guardian reported as follows on this study and these findings overall:

The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication.

A dozen patients had inflammation of the central nervous system, 10 had brain disease with delirium or psychosis, eight had strokes and a further eight had peripheral nerve problems, mostly diagnosed as Guillain-Barré syndrome, an immune reaction that attacks the nerves and causes paralysis. It is fatal in 5% of cases.

“We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust.

“What we’ve seen with some of these Adem patients, and in other patients, is you can have severe neurology, you can be quite sick, but actually have trivial lung disease,” he added.

“Biologically, Adem has some similarities with multiple sclerosis, but it is more severe and usually happens as a one-off. Some patients are left with long-term disability, others can make a good recovery.”

The cases add to concerns over the long-term health effects of Covid-19, which have left some patients breathless and fatigued long after they have cleared the virus, and others with numbness, weakness and memory problems.

What do you think about all of this? I for one was not expecting it. That being said, I am glad we now know more about this virus and hope that in the future we can truly begin wrapping our heads around it.

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