Many months into the COVID-19 pandemic, researchers are still scrambling to understand exactly how it attacks and ravages both the body and the mind. While the incredibly infectious and potentially deadly virus primarily wreaks havoc on the lungs, startling statistics and studies, as well as first-hand doctor testimonials, support that it also invades the brain, resulting in a slew of scary symptoms all pointing to one thing: delirium.
Some researchers have dubbed the ICU a “delirium factory” as a result of the “life-threatening brain injuries” patients have suffered as a result of coronavirus. These include six symptoms—mental confusion, hallucinations, seizures, coma, stroke, and paralysis—and medical experts aren’t exactly sure how to treat them.
COVID-19 May Cause Brain Damage
A recent study from London’s National Hospital for Neurology and Neurosurgery, has linked the coronavirus to a number of neurological conditions, including delirium, stroke and brain inflammation. Other scientific studies also support claims that coronavirus may cause brain damage. One study from Wuhan, China, published in JAMA, found that 36 percent of patients suffered neurological symptoms—including headaches, changes in consciousness, strokes, and lack of muscle coordination. A smaller case study, published in the New England Journal of Medicine, noted that 84 percent of patients admitted to the hospital with COVID-19 induced acute respiratory distress syndrome (ARDS) suffered similar symptoms—one-third of who suffered from “dysexecutive syndrome”—inattention, disorientation or poorly organized movements in response to commands—even after leaving the hospital.
Another recent study published in JAMA found that coronavirus invades the brain, after an MRI of a coronavirus patient who lost sense of smell detected abnormalities. The majority of coronavirus-related brain damage is limited to severe cases, as most of those involved in the published research were on ventilators.
No Treatment Yet
While they have established a connection between brain damage and the virus, researchers are still unsure exactly how exactly it is occurring. “Right now, we actually don’t know enough to say definitely how COVID-19 affects the brain and nervous system,” Sherry Chou, MD, an associate professor of critical care medicine, neurology and neurosurgery at the University of Pittsburgh School of Medicine, who is leading an international study of neurological effects of the virus, told Kaiser Health News. “Until we can answer some of the most fundamental questions, it would be too early to speculate on treatments.”
In the paper that coined the “delirium factory” term, published in the medical journal Critical Care, the authors hypothesized a number of possibilities. “In patients with COVID-19, delirium may be a manifestation of direct central nervous system (CNS) invasion, induction of CNS inflammatory mediators, a secondary effect of other organ system failure, an effect of sedative strategies, prolonged mechanical ventilation time, or environmental factors, including social isolation,” they wrote.
While doctors would normally make neurological complications a priority, the virus complicates everything from initial diagnosis to treatment options. For example, some patients are too sick to travel across the hospital for an MRI and doctors are concerned about contaminating equipment or infecting other healthcare workers. “Our hands are much more tied right now than before the pandemic,” said Dr. Chou. Kevin Sheth, MD, a professor of neurology and neurosurgery at the Yale School of Medicine, added that strokes can also go unnoticed, especially when patients are heavily sedated.
Other Elements Contribute to Mental Decline
In the Critical Care paper, researchers point out that it isn’t the virus alone responsible for potential brain damage of coronavirus patients. “The further elements of human isolation, extended time away from family and other loved ones, and other elements of care all form what could be construed as a delirium factory that medical teams must address,” they write. In addition to continuing to research the brain-coronavirus connection and improving treatment options, they urge the importance of “whole person care” in order to minimize the overall damage.