Coronavirus and brain injury – How doctors are beginning to observe a link
According to articles recently produced by the BBC and The New York Times, neurologists are starting to see a small subset of COVID-19 patients developing serious impairments of the brain.
When interviewed by the BBC, Professor Hugh Montgomery, a consultant in critical care at the Whittington Hospital in North London commented that the brain has become a serious cause for concern among doctors who have been noting symptoms of their patients with one another.
They have found that a number of patients are experiencing a significant inflammation of the brain which can result in delirium or confusion.
Professor Montgomery described the symptoms as fitting with diffuse encephalitis. Encephalitis is a serious condition in which the brain becomes swollen and can be caused by viral, bacterial or fungal infections or even a problem with the immune system where the body mistakenly attacks the brain.
Professor Montgomery also noted that more than 25% of patients admitted to hospital with Coronavirus have significant blood clots. These can prevent proper circulation and affect organs such as the heart or brain.
The New York Times has also reported that some patients with Coronavirus are exhibiting an altered mental state or encephalopathy. Encephalopathy means damage or disease that affects the brain and is often used as a general term to refer to a change in the way the brain is working.
It must be remembered that the reports from both these articles are anecdotal and very little is known about the way Coronavirus affects the body. The article does however outline a number of reports from doctors about patients who have presented with unusual symptoms such as seizures or headaches and confusion. When tested, they were positive for Coronavirus and brain scans showed abnormal swelling and inflammation in several areas of the brain.
The article further reports that doctors around the world have been reporting similar observations of strokes, seizures and encephalitis-like symptoms. Dr Alessandro Padovani from the University of Brescia in Italy told the newspaper that they had opened a separate NeuroCovid unit to care for patients with neurological conditions.
Dr John Stevens, a neurologist at the John Hopkins School of Medicine in Baltimore is tracking neurological observations in COVID-19 patients. He emphasised that most people do not show neurological symptoms but in those who do, he suggested that this may be as simple as low oxygen levels from respiratory failure which affects the function of the brain. Dr Stevens commented that specialists have now started to observe patients for neurological symptoms all around the world. Some have even reported cases of patients who were admitted to hospital for their altered mental state and ultimately tested positive for COVID-19 despite showing no other symptoms.
Much more research is needed and is being undertaken but hopefully with doctors around the world sharing their knowledge and insight into how the virus may affect the brain, more can be understood about how to manage and treat these symptoms.
Bolt Burdon Kemp supports the Encephalitis Society. More support and information on encephalitis can be found here.
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