Neurological ailments in some coronavirus patients – what could this mean?

As Covid-19 causes complications and death in patients globally, experts are attempting to find out exactly how the virus attacks the body.

While medical experts reported acute respiratory distress syndrome (ARDS) as one of the main symptoms of Covid-19, it has been shown that it can also affect the heart. But now, according to an article in New York Times, and reports by clinicians, neurological symptoms such as confusion, seizures and an altered mental state have also been observed.

But what does this mean?

Virus doesn’t only attack the lungs

In an earlier Health24 article, we discussed the Covid-19 virus’s ability to adhere to several kinds of human cells, not only those of the lungs. This means that patients may present with atypical symptoms such as diarrhoea, apart from the textbook fever, cough and shortness of breath.

Now there are reports of patients who show no signs of pneumonia or respiratory distress, but instead confusion, strange behaviour and sometimes seizures.

There are a couple of hypotheses that might explain why the Covid-19 virus has a neurological effect on some patients. A paper published in the Journal of Medical Virology showed that the virus is not only confined to the respiratory system and therefore affect the neurological system, which explains symptoms such as headaches and vomiting.

Too early to tell

Dr Robert Stevens, a neurologist at the John Hopkins School of Medicine states that all observations in this regard should be handled as hypotheses for now, as it’s too early to define the specific mechanics of how exactly the virus affects the neurological system.

He says that the explanation could be as simple as low levels of oxygen in the blood, resulting from respiratory failure and a sudden increase in carbon monoxide, which can impact the brain’s normal function, hence the lethargy and confusion.

Some experts also believe that the brain can be damaged by a viral infection when the immune system causes an overproduction of cytokines as a reaction to the virus. This may have occurred after a woman who tested positive for Covid-19 developed a rare brain disease known as acute necrotising encephalopathy, a condition that can also be triggered by influenza.

A journal article published in The Lancet explains how cytokines are overproduced in the case of Covid-19, causing severe complications.

This case study of the patient who suffered this rare brain condition while testing positive for Covid-19 was published in Radiology on 31 March 2020.

What this means for those who treat Covid-19

According to Dr Elissa Fory, a neurologist from Henry Ford, clinicians need to consider how those with severe neurological disease will be incorporated into the treatment paradigm as these complications can be just as devastating and deadly as lung complications.

Medical professionals should also not dismiss atypical symptoms such as mental confusion, sudden, severe lethargy and seizures. This, however, doesn't mean that the slightest headache or bout of fatigue should be an immediate alarm bell for Covid-19, but that the spectrum of symptoms caused by the virus may be broader than initially realised. 

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Image credit: iStock

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