- At first, experts believed that Covid-19 only affected the lungs
- As more patients presented with neurological symptoms, researchers investigated
- Now, a new study suggests three stages of Covid-19-related brain damage
As the Covid-19 outbreak is entering its sixth month since the discovery of SARS-CoV-2, experts are discovering different ways it affects the body.
At first, scientists and medical experts thought it was a respiratory disease that attacked only the lungs. In April 2020, Health24 published an article unpacking the neurological effects of Covid-19, causing symptoms such as seizures and confusion.
At first, it was still unclear how and why Covid-19 would attack the neurological system, but medical experts agreed that neurological issues should be incorporated into the Covid-19 treatment paradigm, and doctors and first responders should not dismiss Covid-19 when a patient presents with symptoms like a seizure, stroke or sudden confusion.
Now, the Journal of Alzheimer’s Disease has published a comprehensive review of Covid-19’s effect on the neurological system, classifying Covid-19-related brain damage into three stages, according to a news release.
The importance of understanding Covid-19’s impact on the brain
Dr Majid Fotuhi, the medical director of NeuroGrow Brain Fitness Center in Northern Virginia states that there should be more research on the long-term effects of Covid-19 on the brain and that patients should receive a brain MRI before leaving the hospital.
"We are learning that a significant number of hospitalised Covid-19 patients have various degrees of brain impairment. As a medical community, we need to monitor these patients over time as some of them may develop cognitive decline, attention deficit, brain fog, or Alzheimer's disease in the future. There is a lot we can do to promote brain healing in Covid-19 patients, but first, we must understand the nature and severity of their neurological deficits. At the patient level, getting a baseline MRI before leaving the hospital is imperative so that we have a starting point to evaluate and treat them," he explained in a statement.
Stroke, seizure, dizziness could be symptoms
Previous research covered on Health24 stressed the importance of doctors recognising symptoms such as strokes, sudden confusion, seizures or dizziness as signs of Covid-19 infection as doctors only looked for respiratory symptoms early in the outbreak.
Now, in the new research, Dr Fotuhi further emphasises the importance of being aware of these neurological symptoms in Covid-19 patients as there are already case reports revealing the impact of Covid-19 on patients’ brains.
A study from France also showed that 84% of Covid-19 patients in ICUs had positive abnormalities on neurological examinations, according to the authors.
Three-stage 'NeuroCovid' classification
The paper suggests a three-stage classification scheme for medical research to use in future hypotheses and studies. These include:
- NeuroCovid Stage 1: During this stage, the virus affects the epithelial cells of the nose and mouth. When these cells are affected, patients lose their sense of taste and smell.
- NeuroCovid Stage 2: During Stage 2, the immune system reacts by releasing cytokines that cause inflammation. It starts in the lungs but travels in the blood vessels to all body organs, which can cause blood clots, and may lead to strokes.
- NeuroCovid Stage 3: When the cytokine storm gets worse, it damages the blood-brain barrier, which serves as a protective barrier for the blood vessels in the brain. Now, the virus can invade the brain, which can cause symptoms such as seizures, confusion or a coma.
What happens to the brain after Covid-19 patients recover?
Dr Fotuhi says in the study that Covid-19 patients may not show clear neurological symptoms at first, but that any brain damage can occur later. Therefore, an MRI for patients a few months after hospitalisation may be necessary to rule out brain damage.
"Our experience with previous forms of coronaviruses suggests that in the long-term patients may develop depression, insomnia, Parkinson's disease, memory loss, or accelerated ageing in the brain," Fotuhi said. "For those recovering from Covid-19, I recommend regular exercise, eating a heart-healthy diet, reducing stress, and improving sleep; these are critical ways patients can rejuvenate their brain and minimise having poor outcomes in the future."
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