Be careful out there.
Some Coronavirus Patients Show Signs of Brain Ailments
Doctors have observed neurological symptoms, including confusion, stroke and seizures, in a small subset of Covid-19 patient.
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. These neurological syndromes join other unusual
symptoms, such as diminished sense of smell and taste as well as heart ailments.
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.
The
patient, who had chronic lung disease and Parkinson’s, was flailing his
arms and legs in jerky movements, and appeared to be having a seizure.
Doctors suspected he had Covid-19, and were eventually proven right when
he was finally tested.
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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.
Physicians diagnosed a
dangerous condition called acute necrotizing encephalopathy, a rare
complication of influenza and other viral infections.
“The
pattern of involvement, and the way that it rapidly progressed over
days, is consistent with viral inflammation of the brain,” Dr. Elissa
Fory, a neurologist with Henry Ford Health System, said through an
email. “This may indicate the virus can invade the brain directly in
rare circumstances.” The patient is in critical condition.
These
domestic reports follow similar observations by doctors in Italy and
other parts of the world, of Covid-19 patients having strokes, seizures,
encephalitis-like symptoms and blood clots, as well as tingling or
numbness in the extremities, called acroparesthesia. In some cases,
patients were delirious even before developing fever or respiratory
illness, according to Dr. Alessandro Padovani, whose hospital at
University of Brescia in Italy opened a separate NeuroCovid unit to care
for patients with neurological conditions.
The
patients who come in with encephalopathy are confused and lethargic and
may appear dazed, exhibiting strange behavior or staring off into
space. They may be having seizures that require immediate medical care,
and experts are warning health care providers who treat such patients to
recognize that they may have Covid-19 and to take precautions to
protect themselves from infection.
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