On Wednesday (Jul 8), researchers from the University College London (UCL) published a study which found that COVID-19 could cause severe neurological damage in infected persons.

The study, which was published in the journal Brain, described possible complications that the coronavirus could cause in patients—it could induce strokes, increase delirium, cause nerve damage and lead to brain inflammation, which could be fatal.

In a UCL press release, joint senior author Dr Michael Zandi noted that the researchers had “identified a higher than expected number of people with neurological conditions such as brain inflammation, which did not always correlate with the severity of respiratory symptoms”.

The scientists worked with 43 COVID-19 patients—those who were confirmed to be infected as well as those suspected of having the virus—who were treated at UCL Hospitals from April to May. The participants displayed different symptoms, some mild, and some severe. Their ages ranged from 16 to 85 years old.
The study found 10 cases of “temporary brain dysfunction” and delirium, which corresponds with other studies that found evidence of delirium with agitation; 12 cases of rare brain inflammation; eight cases of nerve damage and eight cases of stroke in the patients.
One woman was reported to have hallucinations—she said she saw monkeys and lions in her home, while others said their limbs or face were numb. Some experienced disorientation and double vision, and in one critically ill patient was almost unconscious and only responded when they felt pain.
The researchers reported that the majority of the patients who showed brain inflammation were diagnosed with quite a rare and sometimes fatal condition called acute disseminated encephalomyelitis (ADEM).
Prior to the COVID-19 outbreak, the research team in London would see about one ADEM patient per month, but this number rose with the pandemic. During the period covered by the study, the saw at least one ADEM patient per week.
According to the scientists, further research is certainly needed to understand the possible long-term neurological consequences of the COVID-19 outbreak.
The reason COVID-19 infected patients are displaying brain complications is still unclear. The coronavirus was not found in their brain fluid, so the virus does not seem to attack the brain directly.
The scientists proposed a theory, which is that the neurological complications could be somehow triggered by an immune response from the patient’s body, not by the virus itself.
According to the press release, this study’s findings correlate to another recent study, which also involved Dr Zandi and co-author Dr Hadi Manji (UCL Queen Square Institute of Neurology). They had identified 153 patients who displayed neurological complications stemming from COVID-19.
This paper also confirms previously reported findings of a higher than expected number of patients who experienced stroke, which is apparently related to the “excessive stickiness of the blood in COVID-19 patients”.

“Given that the disease has only been around for a matter of months, we might not yet know what long-term damage COVID-19 can cause,” noted joint first author Dr. Ross Paterson. “Doctors needs to be aware of possible neurological effects, as early diagnosis can improve patient outcomes.”

Dr. David Strain of the University of Exeter Medical School, who did not take part in the study, noted that the findings were “important but not surprising”, as some previous COVID-19 patients have needed a longer period of rehabilitation for their bodies and brains. Dr. Strain noted that much more understanding is needed about “the impact of this infection on the brain”.

“We should be vigilant and look out for these complications in people who have had Covid-19. Whether we will see an epidemic on a large scale of brain damage linked to the pandemic – perhaps similar to the encephalitis lethargica outbreak in the 1920s and 1930s after the 1918 influenza pandemic – remains to be seen,” said Dr. Zandi.

/TISG

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