New coronavirus may cause brain damage in patients with mild symptoms [study]

Potentially fatal neurological disorders can be a symptom of COVID-19, even in people with a mild form of the disease, a new study has shown.

New coronavirus may cause brain damage in patients with mild symptoms [study]
Potentially fatal neurological disorders can be a symptom of COVID-19, even in people with a mild form of the disease, a new study has shown.

Although complications of the respiratory system in COVID-19 disease have been most common in affected and life-threatening individuals, there are growing reports of involvement of the central and peripheral nervous system in this disease.

These neurological complications of the disease include encephalopathy, meningoencephalitis, ischemic stroke, acute necrotizing encephalopathy, and Guillain-Barré syndrome (GBS). Also, radiological evidence showed heart attacks, microhemorrhages, features of reversible posterior encephalopathy syndrome. In addition, a research team described a case of post-COVID-19 demyelination.

Detailed neurological assessment and investigation are difficult for critically ill patients with COVID-19, limiting the possibility of separating the basics of pathophysiology and therefore finding treatment options.

The mechanisms of different neurological syndromes include, either individually or in combination, direct viral neuronal damage, secondary hyperinflammatory syndrome, inflammatory or mediated para- and post-infectious immune disorders, or the effects of severe systemic disorder with neurological consequences of sepsis, hyperpyrexia, hypoxia, or hypercoagulability.

Delirium and psychosis associated with COVID-19 disease
The new research, the results of which were published in the scientific journal Brain, looked at adult patients with COVID-19 in the UK, finding that they had symptoms of a wide range of serious neurological diseases. Many of the patients had only mild symptoms typical of COVID-19, such as fever or respiratory problems, and for some, the neurological symptoms were the only sign that they were ill.

The patients analyzed included 24 men and 19 women, aged between 16 and 85 years. The severity of COVID-19 symptoms ranged from mild to severe. Patients presented with a wide range of features of neurological disorders, including neuroinflammatory diseases and stroke from 6 days before and up to 27 days after the onset of COVID-19 symptoms. Patients were divided into five categories based on clinical, neuro-radiological, neurophysiological and laboratory characteristics.

A 55-year-old woman with no current mental illness or a known history of mental illness was hospitalized with symptoms of COVID-19, including fever, cough and muscle aches. She was discharged two weeks after undergoing oxygen therapy, but four days later, her husband reported that she was confused and behaving strangely. The woman experienced hallucinations, saying she saw lions and monkeys in her house and became aggressive with her family and medical staff. She was then treated with anti-psychotic drugs, and the symptoms subsided over three weeks, although the study does not confirm whether she has fully recovered.

Other neurological problems experienced by patients with COVID-19 included several cases of delirium or psychosis, stroke, and problems with peripheral nerves (found in the extremities, such as the hands and feet).

Ten of the patients included in the study had transient encephalopathies with delirium and psychosis, problems that have been described in other studies. Although the patients analyzed had transient syndromes, detailed neuropsychological tests and their follow-up are needed to determine the extent of cognitive dysfunction during recovery and to examine psychological factors.

Two of the cases analyzed in the present study showed probable autoimmune encephalitis, one with typical clinical features of opsoclonus (irregular eye movement) and myoclonus (involuntary twisting of muscles) and the other with typical radiological images as seen in encephalitis. ” Languages ​​”. These patients did not have autoantibodies (NMDAR, LGI1) associated with autoimmune forms of encephalitis.

It will become clearer over time, scientists say, whether SARS-CoV-2 infection triggers a significant number of cases of autoimmune encephalitis, with likely antibody-mediated mechanisms.

Patients with COVID-19 diagnosed with acute disseminated encephalomyelitis
Nine patients were diagnosed with a form of acute disseminated encephalomyelitis, in which the immune system attacks myelin, which isolates nerves from the central nervous system. If myelin is absent or not thick enough, the nerves lose the ability to transmit information effectively and can result in a wide range of symptoms, including paralysis and cognitive problems. Acute demyelinating encephalomyelitis is rare, but when diagnosed

It is almost always found in children after viral infections, not in adults, as seen in this study.

Hemorrhagic changes, including micro-bleeding, were observed in four patients undergoing imaging procedures, and necrosis was observed in one patient. Two patients had myelitis. One patient with acute hemorrhagic leukoencephalitis did not respond to corticosteroid treatment and needed decompressive craniectomy. A brain biopsy at the time of surgery showed perivenular inflammation associated with acute acute demyelinating encephalomyelitis.

The cases of Guillain-Barré syndrome were not unexpected, say the researchers. The temporal relationship between COVID 19 respiratory disease and the onset of symptoms is consistent with a post-infectious immune-mediated mechanism. Up to two-thirds of patients with GBS have a history of respiratory or gastroenterological disease. The most common pathogens included Campylobacter jejuni, cytomegalovirus, Mycoplasma pneumoniae, HIV and Zika virus.

Further research is needed to investigate the neurological consequences of COVID-19
Although this is not the first time neurological symptoms have been described in patients with COVID-19, this new study provides unique vital information on the broad spectrum of various brain diseases that can be caused by SARS-CoV-2 infection.

In conclusion, infection with the new coronavirus is associated with a wide range of neurological syndromes that affect the cerebral vasculature. The high incidence of acute disseminated encephalomyelitis, especially with hemorrhagic changes, is striking. This complication has not been linked to the severity of COVID-19 disease.

Recognition, investigation and early management of COVID-19-associated neurological disease raise difficulties. Further clinical, neuro-radiological and neuropathological studies are still essential to determine the basic pathobiological mechanisms to guide the treatment of patients. Longitudinal follow-up studies will also be needed to establish the long-term neurological and neuropsychological consequences of COVID-19 disease.

Leave a Reply

Your email address will not be published. Required fields are marked *