How the coronavirus almost killed a healthy woman without “normal symptoms”

London – Rebecca Wrixon knew that working as a babysitter for a couple of doctors could leave her exposed to the coronavirus, but as a healthy 44-year-old woman with young children, she didn’t care much about getting COVID-19. It was already clear then, in early April, that the disease hit the elderly and those with underlying conditions hard, but it did not seem like a major threat to their healthy family.

Rebecca Wrixon is seen at Southampton University Hospital during treatment of severe inflammation of the brain caused by COVID-19 infection.

Courtesy of Rebecca Wrixon.

Then one morning, just after Easter, Wrixon woke up with a numb arm.

He never had a cough or fever, he never lost his sense of taste or smell, and it would take days for doctors to diagnose even COVID-19, and much longer to figure out how to stop his body’s reaction. The insidious disease silently caused his body to attack itself, inflaming his brain, paralyzing half of his body, rendering him unable to see or speak, and nearly killing him in the process.

Researchers in Britain now believe that COVID-19 can affect many more people with similar neurological symptoms than is commonly thought, including younger patients and those who, like Wrixon, never experience the best-known signs of the disease.

The fear is not only that these symptoms may be dangerous in themselves, but that they may persist and that no one knows for how long.

“No normal symptoms”

Wrixon’s 11-year-old daughter was in bed with a fever for about a day in early April, then Wrixon experienced some chest pain and a mild rash, but never suspected it was the coronavirus.

“I had no normal symptoms like those telling you to be careful. I just didn’t feel well, I just had itching around my chest and a pain in my chest, but I didn’t cough. I didn’t have trouble breathing or anything like that,” and Then everything cleared up, he told CBS News from his home on the south coast of England.

“It wasn’t until Tuesday of Easter break that I woke up and my arm was numb.”

When her husband came down the stairs and found her struggling to operate the television’s remote control, she said that she couldn’t feel her arm or foot. Wrixon and her husband thought the same.

Her husband asked her to declare her daughter’s birthday and other basic information.

“I couldn’t answer. I had no idea,” Wrixon recalled. “That’s when we thought, ‘I’m having a stroke.'”

They called an ambulance and rushed her to the emergency room.

“I thought I was going to die”.

“It looked like he had a stroke,” said Dr. Ashwin Pinto, the consulting neurologist who ended up wrestling with the Wrixon case for nearly three weeks. “Really soon after seeing Rebecca, she was really starting to struggle with her speech.”

The coronavirus, he said, “really wasn’t on radar at all.”

But tests quickly confirmed that there was never a stroke. In the coming days, as Wrixon’s condition deteriorated precipitously and the magnitude of the pandemic began to register across Europe, he was tested for COVID-19 naturally.

“I didn’t think, in particular, that it was going to be positive,” Pinto said.

The result surprised him. However, despite the positive throat swab test, there was nothing in Wrixon’s blood or cerebrospinal fluid to suggest that the virus was directly attacking his central nervous system. But something was. Magnetic resonance imaging showed that more than half of his brain was severely inflamed.

Magnetic resonance imaging shows scanners of Rebecca Wrixon’s brain the day she was admitted to the hospital (A), six days after admission (B), and 17 days after admission (C), with inflammation appearing in a more toned tone. Clear.

American Academy of Neurology / Southampton University Hospital

At this point, Wrixon was unable to move half of his body at all. She could not see clearly and could not communicate with her doctors or her husband.

When the leading neurologists realized what was wrong, Wrixon’s husband had no guarantees. His daughter asked him to promise him that Mom would come home. He told her that the doctors were doing the best they could, but that he couldn’t promise anything.

“I thought I was going to die. I literally thought, ‘no, you are not going out,'” Wrixon told CBS News.

Rebecca Wrixon lies in her bed at Southampton University Hospital in England in early April 2020, just before doctors began administering plasma exchange treatment. At this point, an inflammation in her brain caused by COVID-19 infection had left Wrixon unable to move half of her body, see clearly, or speak.

Courtesy of Rebecca Wrixon.

Dr Pinto was aware of one or two cases outside the UK that seemed similar, at least on paper. He had read a study of a patient in Detroit whose autoimmune response to a COVID-19 infection had caused similar severe brain swelling, so he decided to take a risk and treat Wrixon not for a viral infection, but for a The immune system becomes crazy.

Once the COVID-19 infection had passed and she had tested negative for the virus, Pinto began giving Wrixon high doses of steroids and blood plasma exchange. The exchange is intended to remove enough plasma from a patient, the part of the blood that carries antibodies that fight infection, and replace it with a protein from donors whose immune system doesn’t overreact to anything to stop the body’s response and relieve inflammation

It worked.

“As soon as the plasma exchange started, the next day I woke up and moved my first finger,” said Wrixon. After five days of treatment, she stood up again. “I was moving. Literally, that plasma exchange works a miracle.”

After more than two terrible weeks in the hospital, he went home and has since made a full recovery. Three months later, Wrixon still feels pain and numbness in her hand, and it is sometimes difficult to pronounce her words.

A “worrying increase”

The duration of those effects, along with the overall prevalence of neurological symptoms in patients with COVID-19, continues to worry Dr. Pinto, and he is not alone.

Two recent British studies make it clear that while the new coronavirus is better understood than ever, it still holds secrets.

A study published July 8 in the journal of Neurology. Brain They found that of 43 patients with confirmed or suspected COVID-19 infections, 12 suffered from inflammation of the central nervous system, including the brain. Of those 12, one made a full recovery, 10 made partial recoveries, and one died.

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COVID-19 infection “is associated with a broad spectrum of neurological syndromes,” the study authors concluded. They called it “striking” to note, in particular, the “high incidence of acute disseminated encephalomyelitis” (ADEM is widespread inflammation of the brain and spinal cord) in patients.

The study conducted at the National Hospital for Neurology and Neurosurgery at University College London also noted that, as Wrixon discovered, severe inflammation “was not related to the severity of COVID-19 respiratory disease.”

According to University College London, the neurologists behind the research said they would normally treat one adult patient per month with ADEM, “but that increased to at least one per week during the study period. [which coincided with the height of the COVID-19 outbreak in London], which according to the researchers is a worrying increase “.

A larger study published in The lancet, which includes the UCL research data, further analyzed the prevalence of neurological symptoms in patients with COVID-19. “She identified a large proportion of cases of acute alteration in mental status, including neurological syndromic diagnoses such as encephalopathy and encephalitis, and primary psychiatric syndromic diagnoses, such as psychosis.”

The study found that among 125 coronavirus patients, 62% “had a cerebrovascular event [stroke], of which 57 (74%) had an ischemic stroke, nine (12%) had intracerebral hemorrhage, and one (1%) had CNS vasculitis [inflammation of blood vessels in brain or spine]”

It is understood that COVID-19 patients, young and old, but particularly older people, often experience strokes, but the researchers were surprised by the prevalence of psychiatric symptoms in younger patients who (again, like Wrixon) do not suffer strokes. In the graph below, “cerebrovascular” indicates patients in the study who experienced strokes, while “neuropsychiatric” refers to patients with other cognitive and physical symptoms, showing the clear change as age increases.

A chart from a study published in The Lancet shows the proportion of COVID-19 patients among a study group experiencing strokes (“strokes”) compared to those experiencing other cognitive and physical “neuropsychiatric” symptoms, disaggregated by age group.

The lancet

Any disease that affects the central nervous system can have long-term health implications, as millions of stroke survivors can attest. Viruses, from the common flu to the “Spanish flu” that wreaked global havoc between 1918 and 1920, often leave their mark on survivors by damaging the brain.

Dr. Pinto noted that in the decade after the 1918 pandemic, doctors saw an increase in cases of a neurological disease called lethargic encephalitis, which many suspect is a late response to the virus.

“If you follow movies, that’s the movie ‘Awakenings’, with Robert De Niro, it’s about those patients who recovered from the 1918-1920 pandemic,” he said. “So we know that viruses have been associated with high long-term brain risk.”

Parallels between the Spanish flu and COVID-19

“What we don’t really know with the coronavirus is what it will look like,” Pinto said. “We are going to see this in real time.”

“This is not influenza”

“There are so many people out there who still think it’s the flu, and to be fair, before I got sick, that’s what I was thinking,” Wrixon told CBS News. “But now? Yes, in no way would I want someone to go through what I went through.”

“Having to be in the hospital on your own and not allowing any family member or friend to see you or visit or talk to you, yes, I don’t want anyone to have to go through that.”

“This is not influenza,” emphasized Dr. Pinto. “We have small outbreaks of influenza in all countries of the world, seasonal, in winter … documented we have no given the range of terrible complications we have with this virus. ”

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Wrixon said it was now difficult to see news images of people gathered in large groups, often without wearing masks.

“It’s ridiculous, really, that people aren’t looking at him more seriously.”

Click here to read The complete academic study of the Wrixon case.