- A 74-year-old man and a 58-year-old woman are among the US coronavirus patients to suffer neurological problems as a result of the virus
- Scans of the woman's brain taken at a Henry Ford Health System hospital in Detroit showed lost density and brain bleeds
- She came to the hospital lethargic, confused and disoriented
- Doctors discovered cell death and lesions in parts of her brain responsible for sensation, memory, consciousness and for transmitting sensory information
- It was a result of swelling called encephalitis, which is also seen in some severely ill flu and chicken pox patients
- Similar cases have been documented in China and Italy, where one hospital created a ward just for COVID-19 patients with neurological symptoms
PUBLISHED: 21:41 BST, 2 April 2020 | UPDATED: 05:07 BST, 3 April 2020
Some coronavirus patients may suffer brain damage as a result of the devastating infection, doctors around the world are warning. Brain scans of a woman in her 50s taken in Detroit revealed that some of her brain cells had died as a result of a rare complication of the infection.
And similar attacks on the central nervous system have been seen in Italy and China. While neurological complications so far seem to strike a small subset of the more than 700,000 people who have the virus around the world, the reports paint a worrying picture of its potential for long-term effects.
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Dark spots in brain scans (show by arrows) indicate cell death in patients with encephalitis, the brain swelling condition a 58-year-old woman treated in Detroit developed from COVID-19 (file)
'We need to be thinking of how we’re going to incorporate patients with severe neurological disease into our treatment paradigm,' Dr Elissa Fory, a Henry Ford neurologist who was part of the team that diagnosed the woman in Detroit.
'This complication is as devastating as severe lung disease.
By the time the woman, a 58-year-old airline worker, checked into a Henry Ford Health System in Detroit, she already had not only the typical cough and fever seen in coronavirus patients, but was confused, disoriented and lethargic.
Doctors there ran a sweeping panel of diagnostic tests on the woman, including screens for the chickenpox virus and West Nile virus.
They drew a sample of her cerebrospinal fluid too, to check for signs that a bacterial infection was attacking her central nervous system.
Everything came back negative.
But her tell-tale signs of fever and cough had pointed to the correct diagnosis. The woman tested positive for COVID-19.
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More than 200,000 Americans have coronavirus, and now doctors warn health care workers need to be on the lookout for neurological symptoms of the infection (file)
Neurological symptoms are not considered typical of coronavirus, so the doctors also performed a CT scan of her brain.
Dark spots on the resulting can indicate that parts of her brain are less dense than they should appear in a healthy brain.
That told the woman's doctors that either fluid had built up in these regions, or chunks of her brain cells had died off.
In particular, the woman's thalamus showed damage. The thalamus sends sensory information from the far reaches of the body to the cerebral cortex, which processes those signals.
Further scans revealed the woman's brain also had lesions, or brain bleeds, in her temporal lobes, which are involved consciousness and memory as well as sensation.
Taken together, the scans confirmed the doctors' suspicions.
'The team had suspected encephalitis at the outset, but then back-to-back CCT and MRI scans made the diagnosis,' said Dr Fory.
Encephalitis is a dangerous brain swelling condition that can come on as a result of any number of kinds of trauma, as well as severe infections.
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Reports of brain swelling and neurological symptoms have so far been sporadic in US coronavirus patients, but doctors that have seen them warn to watch for confusion (file)
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It is periodically seen in - and may be the cause of death for - flu, chickenpox or enterovirus.
Brain swelling may trigger seizures in these patients too, as was seen in the 74-year-old man with coronavirus in Boca Raton, Florida. He also suffered from chronic lung disease and Parkinson's, but his loss of speech combined with the other symptoms tipped the man's doctors off to the possibility of encephalitis.
Reports of this complication have only been sporadic in the US thus far, but Italy has seen enough cases for one hospital at the University of Brescia to create an entire 'NeuroCovid' unit to administer to patients who had pre-existing or developed neurological conditions.
And Chinese researchers were the first to report the brain complication in some coronavirus patients there.
Now, the Detroit team is warning that US doctors should be on the look out for neurological symptoms in the more exploding number of coronavirus patients across the US.
