COVID-19’s Neurological Impact: Study Finds Link to Strokes, Rare Brain Inflammation

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July 15, 2020

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There is still much that is unknown about the impact of the coronavirus on the body’s neurological system. But a new study from experts at the University College London found that COVID-19 has been linked to stroke, delirium, nerve damage and potentially fatal brain inflammation in some patients.

Published this month in the journal Brain, the researchers identified a rare and sometimes fatal inflammatory condition, known as ADEM, which seems to be increasingly appearing in COVID-19 patients. Acute disseminated encephalomyelitis (ADEM) is a rare type of inflammation that affects the brain and spinal cord, damaging nerve fibers. Symptoms caused by ADEM, from headaches and nausea to vision problems and seizures, can be treated and many ADEM patients recover.

Guilherme Dabus, M.D., an interventional neuroradiologist at the Miami Neuroscience Institute

The new study is concerning because of the range of neurological problems researchers found, said Guilherme Dabus, M.D., an interventional neuroradiologist at the Miami Neuroscience Institute, part of Baptist Health South Florida.

“The biggest breakthrough of this study is the demonstration of the wide spectrum of neurological manifestations that patients with COVID-19 infection may present,” said Dr. Dabus. “The study tells us that we still don’t have a good understanding why some patients may develop neurological syndromes and, amongst the ones that do develop neurological manifestations, why there are so many different types of manifestations.”

Researchers focused on 43 patients, aged 16 to 85, who were treated at University College London hospitals for either confirmed or suspected COVID-19. They experienced a range of symptoms from April to May. They determined that 10 of the coronavirus patients developed “temporary brain dysfunction” with delirium.

They also found 12 cases of brain inflammation, eight cases of strokes, and eight others with nerve damage, mainly Guillain-Barré syndrome (a rare disorder in which your body’s immune system attacks your nerves).” Nine of the 12 patients found to have brain inflammation were also diagnosed with ADEM.

“It is important that the medical community is aware of the possible neurological syndromes that may affect patients with Covid-19 infection so they are attentive to the signs and symptoms,” said Dr. Dabus. “Some of these neurological manifestations such as stroke are time-sensitive and a prompt suspicion and diagnosis may be the difference between life and death.”

Here is more insight from Dr. Dabus regarding this study and its implications:

What characteristics did the patients studied have in common, such as age, gender, ethnicity, underlying conditions? In other words, are some people infected by COVID more likely to encounter neurological challenges?
Dr. Dabus: “There were no specific common features in the studied population: 24 were men and 19 women. Their ages ranged from 16 to 85, and approximately half were white and the other half described as non-white. Therefore, you can see that pretty much everyone is at risk for neurological manifestations. Although, considering the high number of people infected with Covid-19, it is still a small chance in its most serious forms.”

What are some limitations of this study?
Dr. Dabus: “The study limitations include the retrospective nature of the data analysis and the relative small number of cases; also it should be considered the fact that out of the 43 patients included only 29 had definitive diagnosis of COVID-19 while 8 were considered probable and 6 possible for the diagnosis.”

What should future studies about the link between the Coronavirus and neurological challenges focus on?”
Dr Dabus: “Future studies should focus on understanding the mechanisms of this association, as well as which patient population may be at risk for each specific neurological manifestation. Finally, with that information we will be able to counteract those mechanisms in specific populations, preventing the neurological manifestations to occur.”

Anything else you would like to add regarding COVID-19?
“As a new disease, a lot of the information is fluid and there is still a lot of uncertainty. As time goes by, better information and data becomes available. And that’s when the breakthrough really happens. With better information and data, we can formulate better strategies to fight the virus and the infection — from improved, more effective preventive measures to more effective treatment algorithms.”

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