Coronavirus can lead to neurological complications, including delirium, brain inflammation, stroke and nerve damage, a new University College London (UCL) study published Tuesday in the journal Brain finds.
While respiratory symptoms are commonly associated with coronavirus, for some patients in the study, neurological complications were the first and most significant indication that they had contracted the virus.
Of 43 confirmed or suspected Covid-19 patients at the University College London Hospital, researchers identified 10 with delirium, 12 with brain inflammation, eight with cases of stroke and eight with nerve damage.
They include a woman who seemed to recover and was sent home. “She was disoriented and displayed ritualistic behavior such as putting her coat on and off repeatedly. She reported visual hallucinations, seeing lions and monkeys in her house,” the researchers wrote. One patient died of brain-destroying encephalitis.
The researchers called for close surveillance of the rare and sometimes fatal inflammatory disorder called acute disseminated encephalomyelitis (ADEM). They identified nine cases of ADEM, which is prevalent in children, over a five-week period.
“In Greater London… we would expect to see this incidence of cases in five months, which indicates that COVID-19 is associated with an increased incidence of ADEM,” the study states.
The study’s findings suggest that neurological complications were likely a result of immune response to the virus, rather than a result of the virus directly attacking the brain. Researchers say these neurological complications are similar to those related to other coronavirus outbreaks: SARS in 2003 and MERS in 2012.
“Given that the disease has only been around for a matter of months, we might not yet know what long-term damage Covid-19 can cause,” said UCL researcher Ross Paterson. “Doctors need to be aware of possible neurological effects, as early diagnosis can improve patient outcomes.”
He added that people recovering from the virus should seek professional health advice if they experience neurological symptoms.
The researchers said their study was biased toward severe disease. They called for additional research to assess the neurological and neuropsychological consequences of Covid-19.
Outside experts agree that more research is needed on the topic.
“We’ve already seen that some people with COVID-19 may need a long rehabilitation period – both physical rehabilitation such as exercise, and brain rehabilitation,” said David Strain, a senior clinical lecturer at the University of Exeter Medical School. “We need to understand more about the impact of this infection on the brain.”