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One of the things that makes COVID-19 such a dangerous virus is its ability to evolve, and our limited knowledge of the long-term effects of infection.

Scientists are slowly gathering data as the months roll on, and unfortunately, much of it paints a grim picture.

We know that the virus can cause inflammation throughout the body. This is why dexamethasone, an anti-inflammatory agent, has shown great promise in treating it.

It also causes inflammation of the central nervous system, which scientists have found can lead to neurological disorders that outlast the infection.

The Guardian reports that a study conducted by UCL’s Institute of Neurology found a rise in acute disseminated encephalomyelitis (Adem).

Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned.

That’s rather worrying, and in some cases, the neurological complications were actually the patient’s first symptom.

A dozen patients had inflammation of the central nervous system, 10 had brain disease with delirium or psychosis, eight had strokes and a further eight had peripheral nerve problems, mostly diagnosed as Guillain-Barré syndrome, an immune reaction that attacks the nerves and causes paralysis. It is fatal in 5% of cases.

“We’re seeing things in the way Covid-19 affects the brain that we haven’t seen before with other viruses,” said Michael Zandi, a senior author on the study and a consultant at the institute and University College London Hospitals NHS foundation trust.

Biologically, says Zandi, Adem shares some similarities with multiple sclerosis, but is more severe and at times only manifests as a ‘once-off’.

The cases add to concerns over the long-term health effects of Covid-19, which have left some patients breathless and fatigued long after they have cleared the virus, and others with numbness, weakness and memory problems.

One coronavirus patient described in the paper, a 55-year-old woman with no history of psychiatric illness, began to behave oddly the day after she was discharged from hospital.

She repeatedly put on and then took off her coat and started hallucinating about monkeys and lions in her house. She went back to the hospital and was treated with antipsychotic medication.

According to The Scientist, these concerns have precedent in the 1918 influenza pandemic that infected one-third of the world’s population.

In the decades after, up to 1 million people developed a brain disorder called encephalitis lethargica, known more commonly as “sleepy sickness.” Some scholars have linked the two events together, although the evidence remains inconclusive.

“Whether we will see an epidemic on a large scale of brain damage linked to the pandemic—perhaps similar to the encephalitis lethargica outbreak in the 1920s and 1930s after the 1918 influenza pandemic—remains to be seen,” Zandi tells Reuters.

The scientists who published the paper are now calling for larger, possible global efforts to track and record neurological symptoms by including cognitive function in their patient assessments.

Read more, here.

[source:guardian&scientist]