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Some patients with severe COVID-19 suffer from brain failure. A new Swedish study indicates that it is the body’s own immune system that is to blame for the drama. Choosing the right treatment is important knowledge.
The new coronavirus sars-cov-2 can cause many different symptoms, including confusion and personality changes. Stock Photography.
Confusion, personality disorder, and memory problems are symptoms that affect approximately 10-15 percent of all severe COVID-19 patients. Until now, it was not clear if this is because the virus managed to cross the blood-brain barrier, which in normal cases should prevent foreign substances from reaching the brain. But now a new Swedish study indicates that the virus rather appears to irritate the body’s immune system, thereby affecting the function of nerve cells in the brain.
– We can not see signs that there is a virus in the brain or that the blood-brain barrier is damaged. However, we see clear signs of severe inflammation, says Arvid Edén, chief physician and researcher at the infection clinic at Sahlgrenska University Hospital.
Together with his colleagues, he has examined cerebrospinal fluid, the fluid that surrounds the brain and spinal cord, in patients with moderate or severe COVID-19 and nervous system symptoms. The results are published in the scientific journal Neurology.
Still how inflammation spreads to the brain is unknown. But the researchers have two possible explanations.
– Most likely, the virus causes irritation to the brain through the mucous membranes of the nose. There are many viruses there, and the olfactory nerves are only millimeters away from those that go directly to the brain, says Arvid Edén.
Another route could be through cells in the walls of the blood vessels that surround the brain. There are the same types of receptors that the virus uses to infect cells in the lungs, for example.
Why is this knowledge interesting?
– For me, as a specialist in infections, it is important to know whether I should start a virus inhibitor treatment or concentrate on helping the body to dampen this overreaction of the immune system. It’s a basic turning point when it comes to choosing the right effort, says Arvid Edén.
Brain failure is not exclusive to covid-19, but it can occur in other types of more serious infectious diseases. But it seems to be more common in covid-19, explains Arvid Edén.
– The nervous system can be affected in many different ways. The most common is loss of smell and taste. But in others it can be aggravated, such as memory disorders and personality disorders; that suddenly you have a different mood than the environment is used to.
In most patients, symptoms disappear after the acute phase of the disease has passed.
To calm a rampant immune system
The most serious symptoms of COVID-19 are often caused by an overreaction of the immune system and begins to attack the body’s own tissue. This exaggerated reaction can be suppressed, for example, with cortisone. One of these drugs is the glucocorticoid dexamethasone, which was recently approved by the European Medicines Agency (EMA) for the treatment of patients with covid-19.
Source: Medical Products Agency
