How does COVID-19 damage the brain?

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In the first weeks of the COVID-19 pandemic, doctors focused on maintaining the breathing of patients infected with the SARS-CoV-2 coronavirus and treating damage to the lungs and cardiovascular system. Over time, there has been more and more evidence that the coronavirus also damages the brain and nervous system. Why is this happening?

1. COVID-19, a disease caused by the SARS-CoV-2 coronavirus, affects not only the respiratory system but can also cause complications from the nervous system. Strokes and hemorrhages are among the most common
2. Symptoms such as confusion, confusion, and irritability may also appear in the course of COVID-19
3. Scientists are looking for answers to the question of whether the neurological complications in COVID-19 are related to the infection itself or to the overreaction of the immune system to the infection
4. For more up-to-date information on the coronavirus epidemic, visit the TvoiLokony home page

The coronavirus damages the nervous system

Initial findings showed that the SARS-CoV-2 coronavirus attacks the respiratory system, causes respiratory problems, and damages the lungs. However, closer observation of patients showed that the coronavirus infection affects the entire body, including the nervous system and the brain. Some people hospitalized for COVID-19 have experienced confusion, agitation, and light-headedness.

In April, a group of researchers in Japan published the first report of a patient with COVID-19 who had swollen and inflamed brain tissues as a result of infection. Another report describes a patient suffering from damage to the myelin, the sheath that protects neurons, from COVID-19. Such damage is seen in neurodegenerative diseases such as multiple sclerosis. Neurological symptoms also include ischemic and hemorrhagic strokes, and memory loss.

It is not uncommon for serious diseases to have serious consequences, but the magnitude of the COVID-19 pandemic means that thousands, even tens of thousands of people worldwide may experience these problems. Scientists are still trying to answer the key question: why do people infected with SARS-CoV-2 coronavirus develop symptoms from the nervous system. Viruses can attack and infect the brain, but it’s not clear how the SARS-CoV-2 coronavirus does. Neurological symptoms may arise not from the infection itself, but from an overreaction of the immune system. Understanding how these symptoms develop is crucial as they require different forms of treatment.

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Research on the effects of SARS-CoV-2 on the brain

Neurologist Benedict Michael of the University of Liverpool and colleagues have been compiling data on patients with neurological complications related to COVID-19. A paper came out in June where researchers analyzed the clinical data of 125 UK test positive COVID-19 people who experienced neurological or psychiatric effects.

In 62 percent of the subjects suffered damage to the blood supply to the brain, which resulted in ischemic stroke or hemorrhage. 31 percent showed mental disturbances such as confusion and prolonged loss of consciousness sometimes accompanied by encephalitis and swelling of the brain tissue. Ten people who changed their mental state developed psychosis.

Not all participants in the study were in intensive care units. “We had groups of young people without conventional risk factors who experienced strokes or sharp changes in their psyche that could not be explained,” said Michael.

Another study, this time published in July, which looked at 43 patients with neurological complications from COVID-19, showed that the most common neurological outcomes were stroke and encephalitis. Encephalitis can escalate to severe disease and cause neurons to lose their myelin sheath, leading to MS-like symptoms. Some of the patients most affected by neurological complications had only mild respiratory symptoms.

Less common complications of COVID-19 from the nervous system include peripheral nerve damage typical of Guillain-Barre syndrome, and feelings of anxiety and post-traumatic stress disorder. Similar symptoms have been seen in SARS and MERS outbreaks, but data on neurological complications from these outbreaks are limited.

Read:

1. Coronavirus can cause changes in the nervous system
2. The unusual complications of COVID-19 include: strokes in young people
3. COVID-19 patients often experience severe neurological symptoms

How many people will have a neurological complication?

It is difficult to answer this question. A study published in July in the Lancet magazine estimated the incidence of these complications based on data collected during the epidemics of other coronaviruses – SARS and MERS. Central nervous system symptoms occurred in at least 0,04 percent. people with SARS and 0,2 percent. from MERS. Considering that there are currently almost 30 million confirmed cases of SARS-CoV-2 coronavirus infection worldwide, this may mean that from 12 to 60 thousand. experienced neurological complications, assuming they occur with a similar frequency as with SARS and MERS.

The main problem in determining how many people with COVID-19 may have had neurological complications is that clinical trials focus on patients hospitalized for COVID-19, who often require intensive care. Neurobiologist Fernanda De Felice from the Federal University of Rio De Janeiro says that the incidence of complications from the nervous system in this group of patients may be as high as over 50 percent. There is much less information for people who have a mild COVID-19 history or have no respiratory symptoms.

How does the infection affect the brain?

The answer to the question why and how the coronavirus infection affects the nervous system disorders is very important. De Felice says that while the perturbation pattern is fairly consistent, the underlying mechanisms are not yet clear. Finding the answer to this question will help doctors choose the right treatment options.

“If it is a direct viral infection of the central nervous system, we should give patients remdesivir or another antiviral drug,” says Benedict Michael, adding that if the virus is not present in the central nervous system (perhaps it has already been cleared from the body) then treatment should be based on on anti-inflammatory therapy.

There is already evidence that SARS-CoV-2 can infect neurons by killing some and reducing synaptic formation between them. The question remains, however, how the virus reaches the brain. At first it seemed that this might be related to damage to the olfactory nerve, but the evidence argues against it.

“It seems that viral infection of the central nervous system is extremely rare,” said Michael. This means that many of the neurological problems doctors face are likely the result of the body’s immune system fighting a virus. However, it is not certain that this is the case in all cases – scientists will need to identify biomarkers that can reliably distinguish a viral brain infection from inflammation caused by immune activity. This means more clinical examinations, autopsies, and physiological examinations.

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