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COVID-19 Affects the Brain

COVID-19 Affects the Brain

    COVID-19 is mostly known for the damage it can cause to the lungs and respiratory systems. However, there is evidence that COVID-19 not only affects the lungs but also many organs throughout the entire body. (See COVID-19 Effects on the Entire Body). More recently, COVID-19 has shown to cause damage to the brain and many neurological symptoms including stroke, brain hemorrhage, and memory loss. A collection of published studies and data from this past summer looks closely at how and why COVID-19 affects the brain. 

Evidence of COVID-19 Affecting the Brain

    Back in April, a report from the journal Critical Care, discovered that many ICU patients with COVID-19 had increased risk of delirium, or confusion. Additionally, a study published in The Lancet Psychiatry this past June analyzed the clinical data of 125 COVID-19 patients from the United Kingdom. The results found that out of 125 patients from the United Kingdom, 62% suffered from strokes and hemorrhages and 31% presented with altered mental states including confusion and memory loss, with evidence of encephalitis or inflammation of the brain. Similarly, another study published in the Oxford Academic Journal of Neurology, found that out of 43 COVID-19 patients, 23% showed signs of delirium/psychosis, 28% had inflammatory symptoms in the brain. All these studies provide evidence that COVID-19 affects the brain, mostly causing patients to suffer from delirium or symptoms of brain inflammation. Scientists are still unclear how long these effects will last.

How Does COVID-19 Affect the Brain

    While scientists are not clear why the brain is affected, they do know that the coronavirus can infect neurons. A study preprint in bioRxiv found that COVID-19 infects neurons in tiny clumps of brain tissue. The virus kills these clumps of brain tissue and reduces the formation of synapses between them. The results from this study were confirmed by another preprint posted on September 8, 2020, investigating human and mouse brains. 
    But how does the virus reach the brain? This question is still being investigated by many researchers. Compared to other organs, the coronavirus is hard to detect in the brain. Scientists believe this could be due to the expression level of the ACE2 receptor, which is an entry receptor that the coronavirus binds to to enter the host cell (See COVID-19 Effects on the Entire Body for more details). ACE2 receptor levels are lower in brain cells, making it difficult to detect COVID-19 in the brain. In order to answer the question about how the coronavirus reaches the brain, scientists need to conduct further research and investigations.
       It's important to understand how the virus reaches brain so patients will be given the right treatments. Benedict Michael, neurologist and lead of author of the UK study published in Lancet Psychiatry, says "If this is direct viral infection of the central nervous system, these are the patients we should be targeting for remdesivir or another antiviral". Meanwhile, "if the virus is not in the central nervous system, maybe the virus is clear of the body, then we need to treat with anti-inflammatory therapies." Giving antivirals to a patient who no longer has the virus is pointless and giving anti-inflammatories to patients who have the virus in their brain is dangerous and risky. 

Summary

    In conclusion, evidence from multiple studies show that COVID-19 does affect the brain, usually causing symptoms of delusion or brain inflammation. It's known that the coronavirus infects neurons in the brain and reduces the formation of synapses between them, preventing impulses to travel in certain parts of the brain. How the virus reaches the brain is not clear but this is important information needed to determine how patients should be treated. The studies cited in this post provide scientists with a great start on where to start looking for answers to learn more about how COVID-19 affects the brain.

Sources

1. Marshall, Michael. “How COVID-19 Can Damage the Brain.” Nature News, Nature Publishing Group, 15 Sept. 2020, www.nature.com/articles/d41586-020-02599-5. 

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