This is about a story of a 25-year-old Italian radio One day, he lost his sense of smell. Nothing Unusual for someone who had a cold in March. The common cold, whose symptoms lasted barely a day.
The data from Germany made him suspicious: you discovered some mild COVID-19-patients had lost their sense of taste and smell (anosmia and Dysgusie).
He opted for a x-Ray. After all, he would be able to interpret it almost immediately. And found no strange characters no signs of pneumonia bilaterally, characteristic of a new Coronavirus infection. Also in the case of a Fibroskopie a nose sample, nothing Unusual was seen.
But since he had it at Hand, he made a MRI of the brain in 2D and 3D. And as the Surprise leapt. In the olfactory bulb something was going on. A significant change in the cortex it revealed that an infection could happen.
Immediately a PCR, which was positive. With no more symptoms than a loss of Smell, our protagonist had a viral load in the throat and was possibly contagious.
“To the best of our Knowledge this is the first report on the involvement of the human brain in vivo in a COVID-19-patient who shows a change, which is the viral Invasion of the brain in an odor-related cortical Region compatible,” explain the Doctors. Letterio S. Politi, Ettore Salsano and Marco Grimaldi, authors of an article in JAMA Neurology, in which you lied in the case of the radio check.
This opens the way to the hypothesis that the COVID-19 characteristic loss of Smell is not necessarily a blockage in the nasal passages by the mucus, or the destruction of cells in the pituitary gland due. Rather, there is a direct viral involvement in the brain.
Coronavirus-way to the brain
“SARS-CoV-2 could penetrate the Riechweg in the brain and sensorineural dysfunction cause,” point out, although they acknowledge that ” pathology and CSF studies are required to confirm this hypothesis. “
These are the possible points of entry of the Virus, thanks to its Protein S (its “Spikes”), the ACE2-lock some cells M. V., Politi et al can open.
Could it be that in the case of the patient was confused with other pathology in parallel to COVID-19? Alternative diagnosis (epileptic Status, posterior reversible encephalopathy syndrome, encephalitis of a type of Receptor …) are given the clinical context is unlikely to assure the authors of the study.
This does not mean, of course, that this Change in the development of the COVID-19 occurs. They looked into the brains of other patients, and found nothing. It may be that the Resonance too late up to 12 days after onset of symptoms.
The brain of the radiologists was returned normal 28 days later of the first resonance. Just like the sense of smell. “The Disappearance of cortical abnormalities from the MRI in the follow-up study suggests that imaging changes in COVID-19 are always present or in the very early Phase of the infection may be restricted “, believe the Doctors.
Of course, you stress how important it is to consider the loss of Smell as a characteristic feature of this disease, although it is not unusual to lose him even with a cold. Although the physical causes of anosmia are completely different.
A Virus beyond the lung
There is increasing evidence that the SARS-CoV-2-Coronavirus nest can in non-respiratory organs. Although its typical Manifestation is used in the throat and lungs far, it has been found in samples from kidney, heart, brain, and blood vessels.
COVID-19 is a disease that can be as serious as a bilateral pulmonary inflammation, but at times it leads to an Overreaction of the immune system. Less specialized defenses to attack healthy cells and cause the call Cytokine storm, what is in the end worse than the effect of the Virus itself.
However, there have been documented changes in the organs with relative frequency, in which the Virus is propagated, so that the cells are destroyed, just to be able to use his chemical Compounds to multiply.
In the case of neurological manifestations, a group of researchers from the Yale University (USA) has compiled in JAMA, the evidence available:
The viral neuro-invasion can be achieved in various Ways, including the TRANS-synaptic transfer (Connections) of infected neurons, of the entry by the Olfactory, the infection of the vascular endothelium (internal covering), or the Migration of leukocytes through the blood-brain barrier (blood-brain) “, point out.
The most common neurological complaints in COVID-19 anosmia, Ageusia, and headaches. However, it was also reported on other diseases, such as accidents. cerebrovascular, disorders of consciousness, seizures, and encephalopathy.