KOMPAS.com – As each week passes, it becomes clear that corona virus can trigger a large number of neurological problems, which are diseases caused by abnormalities in the human nervous system.
Some people who have relatively mild illness claim to experience inherent cognitive effects due to corona virus disease, especially problems related to memory, fatigue, and difficulty focusing.
However, the worst cases are the most concerning.
One of them is Paul Mylrea. A 64-year-old man who is director of communications at Cambridge University suffered two strokes due to corona virus infection.
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Paul has a healthy body and is good at giving speeches. Because of the stroke, it appears that the right side of his body is weaker.
Paul showed the extraordinary recovery doctors have seen at the National Hospital for Neurology and Neurosurgery (NHNN) in London.
His first stroke occurred while he was being treated at University College Hospital. A potentially deadly blood clot was also found in his lungs and legs, so he took a strong blood thinning medication (anticoagulant).
A few days later he suffered a second stroke, even bigger and was immediately transferred to NHNN on Queen Square.
At that time, Dr. Arvind Chandratheva as a neurologist had just left the hospital when the ambulance arrived.
“Paul has a blank expression on his face,” Chandratheva said. “He can only see on one side and he doesn’t know how to use his cellphone or remember the passcode.
“I immediately thought that blood thinners had caused bleeding in the brain, but what we saw was very strange and different.”
Paul suffered another acute stroke due to clots, seizing vital areas of the blood supply in the brain.
Tests show that the indicator of blood clotting, known as D-dimers, is very high.
Normally it is less than 300, and in stroke patients it can increase to 1,000. While Paul Mylrea’s level is more than 80,000.
“I have never seen the level of blood clotting before – something about the body’s response to infection has caused its blood to become very sticky,” said Dr. Chandratheva.
Covid-19 patient has a stroke
During lockdown, there is a decrease in the number of admissions to emergency stroke cases in hospitals.
But within two weeks, neurologists at NHNN treated six Covid-19 patients who had major strokes.
This event is not related to the usual risk factors for stroke such as high blood pressure or diabetes. In each case, they see a very high freezing rate.
Part of the trigger for a stroke is an overreaction of the immune system that causes inflammation in the body and brain.
Chandratheva projected an image of Paul’s brain on the wall, highlighting a large area of damage, which is displayed as white blurring, affecting his vision, memory, coordination, and speech.
The stroke was so large that the doctor thought he might not survive, or be left alive but seriously handicapped.
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“After my second stroke, my wife and daughter thought it was the end, they would never see me again,” Paul said.
“The doctors told them that there wasn’t much they could do but wait. Then, somehow, I survived and got stronger.”
One encouraging sign is Paul’s ability in languages - he speaks six languages - and he will switch from English to Portuguese to speak with one of his nurses.
“Unusually, he learned several languages as an adult, and this will create a different cable connection in the brain that survived a stroke,” said Dr Chandratheva.
Paul said he couldn’t read as fast as he could, and was sometimes forgetful, but that was not surprising given the area of damage in his brain.
His physical recovery is also impressive, which doctors have linked to previous high levels of fitness.
“I usually bike for an hour a day, do several sports sessions a week and swim in the river. My biking and diving days are over, but I hope to swim again,” Paul said.
A study published in a journal Lancet Psychiatry found brain complications in 125 seriously ill corona virus patients at a hospital in the UK.
Nearly half suffer strokes due to blood clots, while others experience brain inflammation, psychosis, or symptoms similar to dementia.
One of the report’s authors, Prof. Tom Solomon of the University of Liverpool said, “It’s clear now that this virus does indeed cause problems in the brain, when at first we thought it was all about the lungs. Partly caused by lack of oxygen to the brain.
“But it seems that there are many other factors, such as the problem of blood clots and the hyper-inflammatory response of the immune system. We also have to ask whether the virus itself infects the brain.”
In Canada, neuroscientist Prof. Adrian Owen has launched a global online study of how viruses affect cognition.
Owen said: “We already know that ICU survivors are vulnerable to cognitive impairment. So, as the number of recovered Covid-19 patients continues to increase, it is increasingly clear that being discharged from ICU is not the end for these people. This is only the beginning of their recovery. “
“Sars and Mers, both of which are caused by the corona virus, are associated with several neurological diseases, but we have never seen anything like this before,” said Dr. Michael Zandi, consultant neurologist at NHNN.
“The closest comparison is the 1918 flu pandemic. We see then there are many brain diseases and problems that arise over the next 10-20 years.”
Also read: Experts Begin Understanding Many Health Problems Caused by Corona
A mysterious neurological syndrome known as encephalitis lethargica arose around the end of World War One and continues to affect more than one million people worldwide.
There is no scientific evidence related to this – whether the trigger is influenza or autoimmune disorders after infection.
In addition to drowsiness coma, some patients have a movement disorder that looks like Parkinson’s disease, which affects them for the rest of their lives.
In the book Awakenings, neurologist Oliver Sacks tells the story of a group of patients who have been frozen in sleep for decades, and how he used the drug L-Dopa for a while to free them from their locked state.
We must be careful before reading too many comparisons between Covid-19 and the Spanish flu pandemic of 1918. But with so many Covid patients having neurological symptoms, it is important to see the long-term effects on the brain.