COVID-19 and Your Brain: An Ongoing Investigation
Brain autopsy findings show oxygen deprivation may play an important role.
Posted Jul 06, 2020
The effects of COVID-19 on the brain are both undeniable and puzzling. The more we learn, the broader the implications appear.
In mid-May, I published a post where I explored the first published research showing a connection between COVID-19 and neurological symptoms. Those symptoms ranged from dizziness and headache to impaired consciousness, slurred speech, and seizures. Since then, more research has connected the novel coronavirus to neurological issues. In early June, a research team in France reported that 84 percent (49/58) of patients (median age 63 years) in intensive care for SARS-CoV-2 infection showed wide-ranging neurological symptoms that included increased agitation and confusion, poorly organized movement in response to commands, and corticospinal tract signs that included increased reflexes (think uncontrolled knee-jerk response), and flexion—particularly in patients' feet. At the end of last month, findings from a UK-wide surveillance study were also released and, although symptoms ran the gamut, stroke (reported in 77 of 125 patients studied) was the most common neurological complication.
Now, a team of researchers in Boston has looked at the brains of deceased COVID-19 patients to try to pinpoint what regions may have been most affected by the disease. They performed autopsies on the brains of 18 patients in total (median age 62 years), all of whom died within 32 days of symptom onset. Ten standard brain areas were studied. While hospitalized, three of the 18 patients had shown muscle pain, two had reported a headache, and one had reported decreased taste. Many of the patients also showed coexisting conditions, including diabetes, hypertension, cardiovascular disease, hyperlipidemia, chronic kidney disease, prior stroke, and dementia.
One of the team’s most striking findings was oxygen-deprivation-related injury throughout the brain of every patient autopsied. They observed neuronal death in the hippocampus (a brain region involved in learning and memory), cerebral cortex (layer of the brain covering the cerebrum, essential for neural integration that allows complex processes like language), and cerebellar Purkinje cell layer (important for motor movement regulation) in each of the patients, regardless of coexisting conditions.
These findings imply that keeping COVID-19 patients’ brains supplied with oxygen while they fight the virus could be important for preventing brain damage; something as simple as giving a patient oxygen earlier in the treatment process might be a game-changer (further researcher is still needed). They also might make you wonder about the brains of those who have fought off COVID-19. Have they, too, experienced some degree of oxygen-deprivation-related brain injury, and, if so, how could it manifest itself both short- and long-term? Working to answer those questions will hopefully lead to treatments for the already hundreds of thousands of COVID-19 survivors.
On a slightly more uplifting note, the team found little to no SARS-CoV-2 in any of the brain regions autopsied. What could that mean? According to lead researcher Isaac H. Solomon, M.D., Ph.D., in a statement for The Washington Post, the fact that SARS-CoV-2 does not seem to concentrate in the brain means it could be easier to treat. Part of what makes other viruses, like HIV and West Nile, harder to treat is that they do spread throughout the brain.
We still have much to learn. In the meantime, protect yourself and those around you by following CDC guidelines.