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WHAT DOES COVID-19 DO TO THE BRAIN? NEUROSCIENTISTS SPLIT FACT FROM FICTION

The Coronavirus can cause strange, disorienting effects on the brain from the moment of infection to months after one’s last positive test.

“The sheer variety of symptoms that people are experiencing is mind-boggling,” Andrew Levine, a neuropsychologist and clinical professor at the University of California, Los Angeles, tells Inverse. “So the question is: How can this be?”

Levine has chased the answer to that question for months, striving to pin down the prevalence and symptomatology of what he calls “neuro-Covid.”

While initially considered a primarily respiratory illness, burgeoning case reports and scientific studies make one thing clear: Covid-19 can affect the brain in mysterious and devastating ways.

When people become sick with Covid-19, most experience the hallmark symptoms: fever, fatigue, shortness of breath, or dry cough. Others can experience less common symptoms that link back to the brain: smell and taste loss, headaches, memory loss, dizziness, and confusion.

In severe cases, people suffer from encephalopathy or global brain dysfunction, brain inflammation, post-traumatic stress disorder, seizures, stroke, or even death.

The specifics of how likely a person sick with coronavirus is to develop neurological symptoms range per study, but robust analysis of 4,491patients published in the journal Neurology in October found that 13.5 percent developed a neurological disorder in a median of 2 days from Covid-19 symptom onset. This equates to about one in seven people infected with coronavirus developing brain issues.

Meanwhile, a study published in April in Jama Neurology found that 36.4 percent of 214 hospitalized patients had neurological symptoms; a study published in October in the Annals of Clinical and Translational Neurology found 82.3 percent of 419 hospitalized patients experienced the same.

Crucially, the neurological effects of coronavirus are something most people infected with the disease will not experience. Instead, it is a concern for those who have to be hospitalized post-infection. The patients most likely to show brain-related symptoms are those with severe Covid-19, Levine says.

“The vast majority of people that become infected with SARS-CoV-2 are not going to experience any sort of neurological symptoms,” Levine says.

Eric Liotta is a neurologist at Northwestern who has treated Covid-19 patients like these first hand. Liotta is involved with the Neuro Covid-19 Clinic at Northwestern Memorial Hospital.

“Covid-19 isn’t just a pulmonary disease,” Liotta tells Inverse. “The whole body can suffer as a result of complications.”

Liotta is a co-author of the study published in the Annals of Clinical and Translational Neurology. His team analyzed the neurologic manifestations in a group of 509 Covid-19 positive patients admitted to the hospital in Chicago.

The team found that 42 percent of patients had neurologic manifestations at the onset of Covid-19, 63 percent had brain symptoms when patients were hospitalized, and 82 percent had neurological complications at any time during their illness.

The most common neurological complications were:

  • Muscle aches (45 percent)
  • Headaches (38 percent)
  • Encephalopathy or global brain dysfunction (32 percent)
  • Dizziness (30 percent)
  • Altered sense of taste (16 percent)
  • Anosmia or lack of smell (11 percent).

 

Most of these symptoms are relatively mild and would inconvenience but probably not majorly limit functional ability, Liotta explains.

Meanwhile, the side effect that keeps him up at night is encephalopathy, which can change behavior, mood, and cognitive ability. It’s a broad term for any brain disease that alters brain function or structure.

“Encephalopathy is probably the most important of the neurologic manifestations because it impacts mortality and outcomes, and it was very common,” Liotta says.

In contrast, strokes, movement disorders, motor and sensory deficits, ataxia (loss of full control of body movements), and seizures were uncommon (0.2 to 1.4 percent of patients).

“People can certainly have a very poor outcome if they have a big stroke as a chance event from Covid,” Liotta says. “But it was so much less common, that its impact on the community we suspect is likely to be less than this global brain dysfunction, which, unfortunately, isn’t that well-understood.”

Liotta’s study jibes with a study published in October in the journal Neurology. Those authors analyzed 4,491 hospitalized Covid-19 patients and found that 13.5 percent of patients received a neurologic diagnosis, most commonly encephalopathy, stroke, seizure, or brain injury due to lack of oxygen or blood supply.

These disorders put patients at a 38 percent increased risk of dying in the hospital, and a 28 percent reduced likelihood of being discharged to go home.

Although there are currently over 200 case reports and studies exploring how Covid-19 impacts the brain, health experts have far more questions than answers.

 

Source: https://www.inverse.com/mind-body/coronavirus-brain-damage-neurologists-explain

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