New symptoms are common in Covid-19 patients in New York: in addition to fever, cough and shortness of breath, some are so disoriented that they do not know where they are, what year they are now.
In some cases, this disorientation is due to decreased oxygen in the blood, but some patients are disoriented beyond the level that anemia can cause.
Jennifer Frontera, a neurologist at NYU Langone Hospital in Brooklyn, has examined some of these patients, and said she is concerned about the effects of corona virus on the brain and nervous system.
So far, most people have known about the respiratory symptoms of Covid-19 disease that has infected more than 2.2 million people worldwide. But other strange signs are appearing in many patients, noted by the frontline doctors.
A study published in the Journal of the American Medical Association (JAMA) last week found that 36.4% of the 214 Chinese patients surveyed showed signs of neurosis, from loss of sense of smell to neuralgia. seizures and strokes.
Another study in the New England Journal of Medicine this week on 58 patients in Strasbourg, France, showed that more than half were confused or agitated, and brain scans showed signs of inflammation.
“You still hear it is a disease that makes it hard to breathe, but it also affects the part we care about most, the brain,” S Andrew Josephson, Dean of the Department of Neurology at the University of California, San Francisco, told AFP.
“If you’re confused, if you can’t think normally, that’s why you should seek medical help,” he added.
How does the virus ‘attack’ the brain?
The effects of SARS-CoV-2 on the brain and nervous system are not surprising, as this has been reported in other viruses, including HIV. HIV can cause a decrease in consciousness if not treated, according to AFP.
The virus affects the brain in two ways, according to Michel Toledano, a neurologist at the Mayo Clinic in Minnesota, USA.
One is causing an overactive immune response, called a “cytokine storm,” which causes inflammation in the brain – autoimmune encephalitis.
The second is directly causing encephalitis encephalitis. How does that happen? The brain is protected by a “brainook barrier” (blook-brain barrier), which prevents foreign substances. But this membrane can be compromised.
In addition, because olfactory loss is a common symptom of the corona virus, some ideas suggest that the nose may be the path to the brain. This hypothesis has not been verified, but has become somewhat unconvincing when many patients lose their sense of smell afterwards with no severe neurological symptoms.
For corona virus, doctors believe that the neurological effect is the result of an overactive immune response, rather than penetrating the blood-brain barrier, based on available epidemiological evidence.
To prove invasive phenomena, it is necessary to detect viruses in the cerebrospinal fluid.
The virus in the brain has been recorded in one case, as a young 24-year-old Japanese male, according to an article in the International Journal of Infectious Diseases, according to AFP.
The young man had mixed expressions and convulsions, while the photo showed his brain being inflamed. But that is the only case to date.
Moreover, virus testing in spinal fluid has not been verified, so scientists remain cautious.
More research is needed
All of the above signals indicate that more research is needed.
Frontera, a professor at New York University School of Medicine, is part of an international collaborative research project to standardize data collection. Her group is reporting unusual cases of Covid-19, although no such history, accompanied by signs of small brain haemorrhages.
A surprising record is that in men in their 50s, the white matter – which connects brain cells to each other – is affected to the extent of brain damage.
Doctors were surprised and wanted to take a sample by probing a spine (a needle was put into the spinal canal, to get a CSF fluid).
Brain scans and spinal probes are difficult medical procedures for patients on mechanical ventilation. And since the majority of these patients later die, the full extent of nerve damage is unclear.
Neurologists are currently being called to examine a small number of patients who survived mechanical ventilation.
“We are examining patients who have confused symptoms,” Rohan Arora, a neuroscientist at Long Island Jewish Forest Hills Hospital, told AFP, and said 40 percent of Covid-19 patients recover with signs. such effect.
It’s not clear whether the injury will last long, and the need for intensive care (ICU) itself is also a confusing, disorienting experience, due to many factors, including strong drugs.
Getting back to normal seems to be longer for someone who has had a heart attack or stroke, says Dr. Arora.