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Effect of SARS-Cov-2 virus on brain

Date: 14 April 2020 Tags: Miscellaneous

Issue

The full spectrum of the symptoms experienced by those infected with the SARS-CoV-2 is not fully known yet. Recently, research has pointed towards the neurological symptoms witnessed in COVID-19 patients.

 

Background

In an investigation of hospitalised COVID-19 patients in Wuhan, researchers have recorded the neurological manifestations of the disease. They conclude that neurological symptoms can be noticed in a notable proportion of the patients and are not uncommon.

 

Details

  • Researchers studied 214 COVID-19 patients between January 16 and February 19 and noted that over 36.4 per cent of them showed neurologic symptoms, more commonly in patients with severe infection.

  • They have categorised the symptoms into three categories — central nervous system manifestations which include dizziness, headache, impaired consciousness, acute cerebrovascular disease, ataxia (loss of full control of body movements) and seizures; peripheral nervous system manifestations which include taste and smell impairment, vision impairment and nerve pain; and skeletal muscular injury manifestations.

  • The SARS-CoV-2 virus binds itself to a receptor in the human cells called ACE2. This is also the receptor for SARS-CoV. ACE2 is present in other human organs as well, including the nervous system and skeletal muscles.

  • Therefore, it is possible that the virus can lead to the person showing neurological symptoms through direct or indirect mechanisms using the ACE2 receptor.

  • Further, the autopsy report of some COVID-19 patients showed that the brain tissue was hyperemic (congestion of blood in an organ), edematous (accumulation of watery fluids in cells or tissues) and some neurons showed degeneration.

  • Even so, such symptoms are not exclusive to the SARS-CoV-2 virus, neurological injury has also been reported in patients of SARS and MERS.

  • Compared to the nonsevere cases, the severe cases were older and had more comorbidities such as hypertension. Such patients also showed fewer typical symptoms of the disease such as fever and cough, while they were more likely to have neurological symptoms such as acute cerebrovascular disease, impaired consciousness and skeletal muscle injury.

  • Some doctors have reported cases of patients who were brought in for treatment because of their altered mental state, and who ultimately tested positive for Covid-19, although they had none of the classic symptoms like fever or cough.

  • Even so, further research needs to be done to understand why certain symptoms such as loss of smell or taste occur, to see if they are clinical manifestations of the disease itself or occur due to an inflammatory response in some patients.