There is so much we don’t yet know about the Wuhan coronavirus (COVID-19), and a lot we’ve already learned.
But because the virus has not been around for very long, despite the fact that the Chinese Communist government hid the outbreak for weeks and probably months, we know almost nothing about COVID’s long-term effects on those who have contracted the disease.
That said, a new paper explores the aftermath of the virus and contains some very interesting findings, as Agence France Presse reports:
A pattern is emerging among COVID-19 patients arriving at hospitals in New York: Beyond fever, cough and shortness of breath, some are deeply disoriented to the point of not knowing where they are or what year it is.
At times this is linked to low oxygen levels in their blood, but in certain patients the confusion appears disproportionate to how their lungs are faring.
According to Dr. Jennifer Frontera, a neurologist at NYU Langone Brooklyn hospital who has been seeing these patients, the findings raised alarms among doctors regarding the long-term impact symptomatic coronavirus infections would have on the brain and the nervous system.
Most people are aware that the coronavirus mostly affects the respiratory system, and older or obese patients with preexisting conditions such as heart disease.
But new and unusual signs of the infection are becoming known.
According to a study published last week in the Journal of the American Medical Association, 36.4 percent of 214 Chinese patients had developed neurological symptoms that ranged from a loss of smell to nerve pain, seizures and even strokes.
Meanwhile, a separate paper published in the New England Journal of Medicine last week analyzed 58 patients in Strasbourg, France, finding that more than half of them had become agitated or confused. Brain images suggested there was inflammation. (Related: Rheumatoid arthritis drug combined with vitamin C saved ER doctor from coronavirus death.)
“You’ve been hearing that this is a breathing problem, but it also affects what we most care about, the brain,” Andrew Josephson, chair of the neurology department at the University of California, San Francisco told AFP.
“If you become confused, if you’re having problems thinking, those are reasons to seek medical attention,” he continued. “The mantra of ‘don’t come unless you’re short of breath’ probably doesn’t apply anymore.”
More research is needed — and is coming
Scientists and doctors are not completely surprised that COVID-19 may have long-term negative neurological effects because this has also been documented in other viral infections including HIV — which, if not treated, could cause significant decline in cognitive abilities.
Michel Toledano, a neurologist at the Mayo Clinic, said viruses can affect the brain in a couple of main ways. One, by triggering “an abnormal immune response known as a cytokine storm that causes inflammation of the brain — called autoimmune encephalitis,” AFP reported.
And two, a direct infection of the brain which causes a condition known as viral encephalitis.
These conditions can happen if the protective blood-brain barrier becomes compromised, but since some patients have developed a loss of smell, there is a hypothesis that the nose can provide direct access to the brain.
But that hasn’t been proven yet, and the theory becomes less likely to be true since some patients who lose their sense of smell do not otherwise go on to develop neurological symptoms or problems.
In the case of coronavirus, researchers have come to suspect that, based on current evidence, neurological problems are more likely due to an overactive immune response rather than invasion of the brain.
To prove that, coronavirus must be present in the spinal fluid; this has been documented once — in a 24-year-old Japanese man whose case was presented in the International Journal of Infectious Disease.
He would later develop confusion and seizures, while imaging showed that his brain was inflamed. Yet, his is the only case thus far.
More studies will have to be done to be certain, but that seems likely because the virus isn’t going anywhere anytime soon, it appears.