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Infectious Diseases

Updated 20 July 2020

Brain disorders found in Covid-19 patients with mild symptoms

It has become evident to doctors and researchers that Covid-19 might be triggering neurological complications in patients – even in those with mild symptoms.

  • A UK study details over 40 cases where coronavirus patients presented with neurological disorders
  • Even those with mild Covid-19 symptoms were affected
  • The neurological impact of the virus could have long-term consequences for those who recover

It has become evident to doctors and researchers that Covid-19 might be triggering neurological complications in patients – even in those with mild symptoms.

One study on a mini lab-grown brain showed that the virus can directly attack brain cells.

Some of the brain disorders that have been identified in coronavirus patients include encephalopathy, ischaemic stroke and Guillain-Barré Syndrome, which can cause haemorrhaging and inflammation.

But it isn't easy diagnosing these conditions, especially if the patient is impaired due to a ventilator. 

READ | Delirium: The forgotten, preventable symptom of Covid-19 

New detailed cases

"Early recognition, investigation and management of Covid-19-related neurological disease are challenging," writes a group of neurologists that analysed just over 40 Covid-19 patients in the UK that presented with neurological complications. They published their studies in Oxford's journal Brain.

The group of patients ranged in age from 16 to 85, and their Covid-19 symptoms varied from mild to critical. The aim of the study was to detail their symptoms, treatments and recovery process to help doctors better spot the signs of a brain disorder. 

The most common disorder was neuroinflammatory syndromes and encephalopathy, which affected those over the age of 50 and presented with confusion and disorientation, psychosis in one, and seizures in another. 

Seeing monkeys and lions

One patient – a 55-year-old woman – had mild symptoms and was ready to be discharged after day three. However, she then started showing signs of a brain disorder, despite not having a history of any mental disease. 

Her behaviour included repeatedly putting on and taking off her coat, seeing lions and monkeys and later becoming aggressive. After being put on treatment, she started improving after three weeks.

One patient, however, died from severe necrotising encephalitis – an inflammation that causes lesions and tissue death in the brain.

"Collectively, these cases presented a considerable challenge to diagnose with MRI, neurophysiology, including [electroencephalogram], being difficult to obtain in an intensive care setting in addition to the demands of safe nursing and infection control," say the authors.

There's also some debate over treatment options, like the use of high dose corticosteroids, which could put Covid-19 patients at greater risk.

READ MORE | Stroke, confusion: Covid-19 often impacts the brain

Future studies important

"Further clinical, neuroradiological, biomarker and neuropathological studies are essential to determine the underlying pathobiological mechanisms, which will guide treatment."

We also don't know yet what the long-term effects of Covid-19 would be for those who recover from the virus. 

Image credit: iStock