The doctors in New York city treating patients from Covid-19 observe more than with fever, cough and shortness of breath, another symptom appeared: some people experience confusion, to the point of not knowing where they are, or what is the current year.
This loss of reference points is sometimes related to the lack of oxygen in the blood, but in some patients the level of confusion seems to be out of proportion compared to the level of affection of their lungs.
For Jennifer Frontera, a neurologist at the university hospital Langone Brooklyn, the question arises as to the impact of the new coronavirus on the brain and the nervous system.
Studies are beginning to describe the phenomenon. In the journal of the Association of american medicine (Jama) last week, doctors reported that 36% of 214 chinese patients had neurological symptoms, ranging from loss of sense of smell with nerve pain, and even seizures and accident vascular cerebral (AVC).
In the New England Journal of Medicine, the american medical journal with the highest rating, of French physicians in Strasbourg have described that more than half of 58 patients in the icu were confused or agitated. The brain scan showed possible inflammation.
“Everyone says that this is a problem breathing, but it also affects something that is extremely valuable, the brain “, told AFP S. Andrew Josephson, head of the department of neurology at the university of California, San Francisco.
“If you feel confused, if you have problems to think, these are good reasons to see a doctor,” he adds. “The old idea according to which it is necessary to come only if one is out of breath is probably more valid. “
Viruses and the brain
Virologists are not totally surprised that the new coronavirus, SARS-CoV-2, can affect the brain and the nervous system, because this link has been observed with other viruses, including the aids virus, HIV.
The virus can affect the brain in two main ways, ” explains Michel Toledano, a neurologist at the Mayo Clinic in Minnesota.
The first is by the triggering of an immune response abnormal called ” storm of cytokine “, which causes inflammation of the brain: this is called autoimmune encephalitis.
The second is by a direct infection of the brain: this is called a viral encephalitis. The brain is protected by what is called the blood-brain barrier: its role is to block the substances up, but it can be pierced.
Some people are speculating that the nose could be the way to access the brain, since the loss of smell is common in many patients Covid-19. But this is not checked, and many patients losing the sense of smell do not have neurological problems serious.
The main track is in fact one of the immune response in overheating. To have the heart net, it would be necessary to detect the virus in the spinal fluid. This has been done once, in a Japanese 24 years of age, whose case has been described in theInternational Journal of Infectious Disease.
It has suffered from confusion and seizures, and imaging of his brain showed inflammation. But the test is not yet validated, and the scientists remain cautious.
To clarify these mysteries, Jennifer Frontera, who teaches at the school of medicine of New York university, is collaborating on an international research project aiming to standardize the collection of data.
His own team has recorded cases of seizures in patients Covid-19 that had never been before falling sick. The researchers also found tiny brain hemorrhages are known as” unpublished “.
They also want to collect the spinal fluid of a middle aged man in which the white matter of the brain is severely affected. But these levies, like the MRI, are difficult to do on patients on an artificial respirator. And as the majority dies, it looks bad neurological damage.
Those that survive end up on the other hand by consulting neurologists.
“We see a lot of patients in states of confusion “, told AFP Rohan Arora, a neurologist at the hospital-Long Island Jewish Forest Hills. He says that 40% of the survivors of the coronavirus are concerned.
It is not known if these disorders are long-lasting. The passage in the icu is, in itself, a creator of confusion, in particular because of the medication.
But the neurologist finds that the return to normal, for patients Covid, seems to take longer than for those who have survived a heart attack or a STROKE.