What causes brain damage

Severe brain damage possible even with mild COVID-19 symptoms

There are now numerous indications that the novel coronavirus SARS-CoV-2 not only massively attacks the lungs and airways, but also other organs. It can also be difficult for the heart, blood vessels, nerves, kidneys and skin.

British neurologists have now published shocking details in the journal "Brain" that SARS-CoV-2 can cause serious brain damage even in patients with mild symptoms or in those who have already recovered. Often this damage is recognized only very late or not at all.

University College London (UCL) neurologists diagnosed nine of the 43 UK COVID-19 patients with acute demyelinating encephalomyelitis (ADEM). This inflammatory disease causes degenerative destruction of the central nervous system, which affects the myelin sheaths of the nerves in the brain and spinal cord.

Different consequential damages

Of the patients examined, 12 suffered from inflammation of the central nervous system, ten from transient encephalopathy (brain disease) with delirium or psychosis, eight from strokes and another eight from problems of the peripheral nerves, mostly diagnosed with Guillain-Barré syndrome. This is an immune reaction that attacks the nerves, causes paralysis and is fatal in 5 percent of cases. A 59 year old woman died of the complication.

"We have never seen the way COVID-19 attacks the brain in any other virus," said Dr. Michael Zandi, senior study author and advisor at University College London Hospitals. Above all, the severe brain damage, even in patients with mild symptoms, is unusual.

Damage is often not recognized

The cases now published confirm fears that COVID-19 is causing long-term health problems in some patients. Many patients remain breathless and tired long after their recovery. Others who have recovered suffer from numbness, weakness, and impaired memory.

"Biologically, ADEM has some similarities with multiple sclerosis, but it is more severe and usually occurs only once. Some patients will have long-term disability, others will recover well," said Michael Zandi.

The entire spectrum of brain diseases and long-term effects caused by SARS-CoV-2 may not have been recorded at all, according to Zandi, since many patients in hospitals are too sick to examine them with brain scanners or other methods.

"We want to make medical professionals around the world aware of these complications of the coronavirus," said Zandi. Doctors and health care professionals should definitely consult a neurologist for any patient with cognitive symptoms, memory problems, fatigue, deafness, or weakness.

Shocking case studies

Touching individual fates were also published, for example of a 47-year-old woman who suddenly felt a headache and numbness in her right hand after a week with a cough and fever. In the hospital, she became sleepy and unresponsive. During an emergency operation, part of her skull had to be removed to relieve the pressure on her swollen brain.

Another 55-year-old patient with no previous mental illness began acting strangely the day after she was discharged from the hospital. Again and again she put her coat on and off and began to hallucinate, seeing monkeys and lions in her house. Back in the hospital, she was given antipsychotic medication.

The Spanish flu was a pandemic influenza in which, according to the WHO, between 20 and 50 million people died

Thousands of brain damage also with Spanish flu

UK neurologists fear that COVID-19 disease could leave subtle brain damage in some patients that will only become noticeable in the years to come. According to the study, there were similar long-term effects after the devastating Spanish flu in 1918, which probably caused brain damage to up to a million people.

"We hope, of course, that this doesn't happen, but when you have such a large pandemic that affects a large part of the population, we have to be vigilant," emphasizes Michael Zandi of the UCL Queen Square Institute of Neurology.

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    Author: Brigitte Osterath