Neurologists around the world say that a small subset of patients with COVID-19 are developing serious impairments of the brain.Although fever, cough and difficulty breathing are the typical hallmarks of infection with the new coronavirus, some patients exhibit altered mental status, or encephalopathy, a catchall term for brain disease or dysfunction that can have many underlying causes, as well as other serious conditions.
Much is still unknown about the neurological symptoms, but efforts are underway to study the phenomena, said Dr. Sherry H-Y. Chou, a neurologist at the University of Pittsburgh School of Medicine, who is leading a team of investigators for the Neurocritical Care Society.
“We absolutely need to have an information finding mission, otherwise we’re flying blind,” Chou said. “There’s no ventilator for the brain. If the lungs are broken we can put the patient on a ventilator and hope for recovery. We don’t have that luxury with the brain.”
Experts have emphasized that most COVID-19 patients appear to be normal neurologically.
Neurological specialists also say that it is too early to make definitive statements or identify the specific mechanisms by which the new coronavirus is affecting the neurological system.
In one recent paper, Chinese scientists noted that there was some evidence that other coronaviruses were not confined to the respiratory tract and invaded the central nervous system, and the authors speculated that this may potentially play a role in acute respiratory failure in COVID-19.While it is not unusual for elderly people to experience confusion when they develop other infections, “the striking thing is we have not seen any real respiratory illness in these patients,” Nee said. They have continued to test positive and cannot be discharged, even though they are not really ill, he said.
Another study, published in the British Medical Journal in late March, found that of 113 patients from Wuhan who died of COVID-19, 22% had experienced disorders of consciousness, ranging from somnolence to deep coma, compared with only 1% of another group of patients who recovered from the illness.