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Brain damage link investigation after coronavirus survivors suffer from delirium

New research into Covid effects

21 July, 2020 — By Tom Foot

A WOMAN began hallucinating about monkeys and lions in her house with the kind of delusions experts are now suggesting may be a long term side effect of Covid-19.

The 55-year-old University College London Hospitals patient, who had no psychiatric history, experienced “persisting delusions” after being discharged from hospital following treatment for the virus.

Her experience is similar to several other coronavirus patients, according to a new study which warns of a pattern in survivors developing brain damage, delirium and other “severe neurological complications”.

Dr Michael Zandi, one of the authors of the study published in the journal Brain, said: “We should be vigilant and look out for these complications in people who have had Covid-19. Whether we will see an epidemic on a large scale of brain damage linked to the pandemic – perhaps similar to the encephalitis lethargica outbreak in the 1920s and 1930s after the 1918 influenza pandemic – remains to be seen.”

An epidemic of encephalitis lethargica – also known as “sleeping sickness” – spread around the world following the Spanish Flu pandemic in 1918, affecting millions of people.

Dr Zandi added that the “higher than expected number of people with neurological conditions” in the study was not related to the severity of the symptoms experienced.

The study provides a detailed account of neurological symptoms of 43 Covid patients, aged 16-85, who were treated at the National Hospital for Neurology and Neurosurgery, which is part of the UCLH NHS trust.

Researchers identified 10 cases of “brain dysfunction with delirium” and 12 cases of brain inflammation, eight cases of strokes, and eight others with nerve damage, mainly Guillain-Barré syndrome.

The scientific report said the patient who saw lions in her home had only required “minimal oxygen treatment” for the virus, and had been “well on discharge three days later”.

It added: “But the following day, her husband reported that she was confused and behaving oddly.

She was disorientated and displayed ritualistic behaviour such as putting her coat on and off repeatedly.

She reported visual hallucinations, seeing lions and monkeys in her house. “She developed ongoing auditory hallucinations, persecutory delusions …. and her psychotic symptoms persisted after disorientation improved.”

Another patient found they “had difficulty speaking and became disorientated and confused, complaining of well-formed visual hallucinations of people inside her house and objects flying around the room.”

Other patient experiences included hallucinating about being in other countries not visited before and a “reversal of the sleep wake cycle”.

The findings by Dr Zandi follow another report identifying “higher than expected” strokes and also “excessive stickiness of the blood in Covid-19 patients”.

Dr Ross Paterson, from UCL’s Institute of Neurology in Queen Square, said: “Given that the disease has only been around for a matter of months, we might not yet know what long-term damage Covid-19 can cause. Doctors needs to be aware of possible neurological effects, as early diagnosis can improve patient outcomes.”

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