Doctors seeing more cases of rare brain disorder, stroke linked to COVID-19

LONDON — We know that the most severe cases of COVID-19 can bring about extreme respiratory problems. A new study finds, however, the disease may also have a devastating effect on the brain. Doctors in London are seeing more neurological complications due to the coronavirus, including a rare disorder that causes brain inflammation.

The team from University College London reports that some COVID-19 patients are actually experiencing neurological problems first, before the illness’s typical symptoms develop. These effects on the brain include delirium, nerve damage, and even stroke.

“We 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,” Dr. Michael Zandi says in a media release.

COVID-19 and brain inflammation

The study examined 43 people, between the ages of 16 and 85. All were treated for neurological symptoms after a confirmed or suspected COVID-19 infection. Researchers say 10 cases involve temporary brain dysfunction or delirium. Twelve cases involve brain inflammation, eight have nerve damage, and eight others involve a stroke.

In the patients with brain inflammation, the team says most are suffering from acute disseminated encephalomyelitis (ADEM). According to the Cleveland Clinic, this rare disorder causes severe headaches, confusion, blurred vision, and weakness in the arms and legs.

ADEM typically appears about one to two weeks after the patient suffers an infection. The disorder typically affects children. But anyone can develop ADEM, and severe cases can be fatal.

The team in London says they usually see one ADEM patient a month, but that number is now one per week during the pandemic.

Will coronavirus trigger a new epidemic?

Researchers say it’s too early to know all of COVID-19’s possible complications. As more cases involving brain trauma come in, the study authors warn of a possible spike in patients suffering the yet unknown after-effects of coronavirus.

“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,” says Zandi.

“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,” Dr. Ross Paterson adds.

The immune system attacking itself

The London team reports that SARS-CoV-2, the virus causing COVID-19, is not being found in the cerebrospinal brain fluid of their patients. This leads them to believe the virus is not directly attacking the brain. The study points to a patient’s own immune system causing the brain inflammation as it reacts to coronavirus.

Zandi notes the new research backs up a previous study of 153 patients with neurological complications due to COVID-19. That study notes coronavirus patients tend to have excessively sticky blood. The paper confirms patients with this condition are experiencing strokes at a higher rate than normal.

The study is published in the journal Brain.

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