COVID and the Brain

July 17, 2020 1:54 p.m.

You have likely seen the growing clinical evidence that COVID is not only a respiratory disease but frequently strikes at the brain and nervous system. A group of new studies out of Spain provide more detailed evidence. Our Spanish correspondent TPM Reader SH sent me this article in El Pais (English language version). The headline is that over half of COVID patients in Spain developed neurological problems of one sort of another.

The headline is possibly misleading because the main study in question is of 841 hospitalized patients at two hospitals in the Spanish region of Castilla-La Mancha. As far as I can tell that percentage is perhaps more aptly described as symptoms since the study itself seems to be talking about manifestations of illness during hospitalization rather than neurological problems which have persisted or appear to be permanent post-recovery. You can see the actual study here in the journal Neurology.

Here’s the results text from the abstract …

Results: Of 841 patients hospitalized with COVID-19 (mean age 66.4 years, 56.2% men) 57.4% developed some form of neurological symptom. Nonspecific symptoms such as myalgias (17.2%), headache (14.1%), and dizziness (6.1%) were present mostly in the early stages of infection. Anosmia (4.9%) and dysgeusia (6.2%) tended to occur early (60% as the first clinical manifestation) and were more frequent in less severe cases. Disorders of consciousness occurred commonly (19.6%), mostly in older patients and in severe and advanced COVID-19 stages. Myopathy (3.1%), dysautonomia (2.5%), cerebrovascular diseases (1.7%), seizures (0.7%), movement disorders (0.7%), encephalitis (n=1), Guillain-Barré syndrome (n=1), and optic neuritis (n=1) were also reported, but less frequent. Neurological complications were the main cause of death in 4.1% of all deceased study subjects.

Another study in the journal Brain looked at strokes and other cerebrovascular incidents. In an interview with El Pais, one of the researchers on both studies suggested that the evidence suggests that COVID may be able to pierce the blood-brain barrier which keeps the brain walled off from many infections.

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