COVID-19, the disease caused by the coronavirus, is affecting people in almost every country in the world. While most people are aware of the more common symptoms like fever, cough, and trouble breathing, they probably don’t know that some patients also develop encephalopathy.
In a preliminary paper published in February, scientists from Wuhan, China, reported COVID-19 patients with neurological symptoms. Since then, doctors from countries in Europe and the United States have seen similar symptoms. Even more alarming is that many of these patients who show encephalopathy show no other signs of the disease. In Danbury, Connecticut, four older patients came in with encephalopathy. Two of the four had no other symptoms and two ended up developing a fever and some breathing issues.
Some of the neurological issues that patients display are dizziness, headaches, impaired consciousness, and stroke. Not much is known about the neurological symptoms, the underlying cause, or why some people don’t display any other symptoms but test positive for COVID-19. Doctors in Italy have observed patients with seizures, blood clots, tingling in the extremities, and encephalitis-like symptoms. In a few cases, patients presented as delirious before they got a fever or other symptoms.
Recently, a woman in her late 50s presented with confusion and headache. She knew her name, but not much else, and as time passed, she became less and less responsive. Scans of her brain showed swelling and inflammation in several regions and some areas showed cell death. The doctors in Detroit diagnosed her with something called acute necrotizing encephalopathy (ANE). ANE is rare and is normally diagnosed because of brain damage resulting from an infection.
“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.