- Doctors observed that the onset of neurological symptoms in some patients may be a warning sign of a novel coronavirus infection.
- Some COVID-19 patients have displayed confusion and seizures that can be associated with inflammation of the brain.
- It’s unclear why some coronavirus patients exhibit neurological symptoms, and it’s not solely happening to elderly patients.
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COVID-19 is the kind of medical condition that requires a test to confirm the diagnoses, and that’s because the most common symptoms also appear with other viral infections like the flu or cold. Two types of tests can confirm the infection: one detects the presence of the SARS-CoV-2 virus, which is replicating in the body, and the other finds the antibodies that fight off the disease.
Being able to quickly diagnose COVID-19 clinically could be of massive help to physicians and patients since tests are still in such short supply. Doctors have started observing some early COVID-19 signs caused by the novel coronavirus. Some patients experience the sudden loss of smell and taste, and researchers already proved that the virus can interact with some of the cells in the olfactory tissue. Now, new reports from various countries indicate that some patients may be prone to multiple neurological signs upon being infected, although these symptoms can occur with other neurological diseases.
Impairments of the brain can be severe and can occur for a variety of reasons, as they can be secondary to other medical conditions. But some symptoms, including an altered mental state and seizures, have been observed in patients around the world before a COVID-19 test came back positive. The New York Times chronicled a few examples:
In early March, a 74-year-old man came to the emergency room in Boca Raton, Fla., with a cough and a fever, but an X-ray ruled out pneumonia, and he was sent home. The next day, when his fever spiked, family members brought him back. He was short of breath, and could not tell doctors his name or explain what was wrong — he had lost the ability to speak
But it’s not just older people who have been developing neurological symptoms following infection:
On Tuesday, doctors in Detroit reported another disturbing case involving a female airline worker in her late 50s with COVID-19. She was confused, and complained of a headache; she could tell the physicians her name but little else and became less responsive over time. Brain scans showed abnormal swelling and inflammation in several regions, with smaller areas where some cells had died.
US doctors and doctors in other regions observed abnormal neurological afflictions in patients with COVID-19. Doctors in Austria, China, France, Germany, Italy, and Holland found similar cases, including in patients under 60. One train of thought is that neurological signs may follow lung failure caused by COVID-19. Oxygenation issues in the brain could explain some of these symptoms.
Four elderly patients from Danbury Hospital in Connecticut showed encephalopathy signs before testing positive for COVID-19, and they had no other symptoms. Two of them developed low-grade fevers and needed oxygen, but two did not show any respiratory illness that might have altered their mental state.
The Times notes that studies detailing neurological problems in COVID-19 patients already exist. Doctors from Wuhan published a paper in February detailing neurological symptoms. A study from the same region in March found that 22% of 113 patients who died of COVID-19 in Wuhan “experienced disorders of consciousness, ranging from somnolence to deep coma” compared to just 1% from a group of patients who recovered.
A different study says there’s evidence that other coronaviruses aren’t confined to the respiratory tract and can invade the nervous system as well. The same may be true for SARS-CoV-2, at least for some patients. But more research is required.
The CDC now lists “new confusion or inability to arouse” among the COVID-19 warning signs that should prompt action. You should contact your doctor if you or someone in your care is experiencing abnormal confusion and seizures. “You don’t feel your best when you have a fever, but you should be able to interact normally,” Dr. Frontera told The Times, warning people not to call 911 just because they’re concerned. “You should be able to answer questions and converse in a normal fashion.”
Physicians treating new neurological cases should also take into account the possibility that the symptoms may have been caused by COVID-19 and take measures to protect themselves. As telling as these symptoms may be though, they do not appear in all COVID-19 patients, which means the disease can only be diagnosed correctly with a test.