What does it mean for COVID-19 to impact the brain?
What does it mean for COVID-19 to impact the brain?
This explainer is more than 90 days old. Some of the information might be out of date or no longer relevant. Browse our homepage for up to date content or request information about a specific topic from our team of scientists.
This article has been translated from its original language. Please reach out if you have any feedback on the translation.
Physicians and scientists are learning more about how COVID-19 impacts organs outside of the respiratory system, such as the brain. The emerging evidence has revealed that some COVID-19 patients experience neurological symptoms in the brain, spinal cord, nerves, and ganglia (cell bodies that relay nerve signals). In early March 2020, observational data from 58 patients in France indicated the presence of neurological symptoms such as agitation, confusion, disorientation, and encephalopathy (brain damage). In April 2020, a study was published on 214 COVID-19 patients in China with "severe infection," where over a third were reported to experience neurological symptoms, including acute cerebrovascular diseases and impaired consciousness. In July 2020, another study on over 40 British patients provided additional evidence about neurological symptoms, ranging from brain inflammation and delirium to nerve damage and stroke. Some of these patients reported severe symptoms, such as strokes and paralysis resulting from nerve damage, while others experienced more minor symptoms like breathlessness and fatigue. Most of the cases with brain inflammation were diagnosed with acute disseminated encephalomyelitis (ADEM), which is a rare illness involving inflammation of the brain and spinal cord that results from viral infections. Data from London indicated an increase in ADEM cases for this study period during the pandemic, as the number of reported cases would typically have been expected over a 5-month period rather than a 5-week period in the city. SARS-CoV-2, the virus that causes COVID-19, was not detected in the cerebrospinal brain fluid of any of the British patients tested, which may suggest that the virus did not directly attack the brain and that the symptoms could have occurred post-infection. Vanderbilt University Medical Center launched a study in July 2020 that will study delirium, post-traumatic stress disorder (PTSD), and depression in patients who have been hospitalized with COVID-19. These disabling impacts are also known as post-intensive care syndrome (PICS), and previous studies of intensive care patients similar to COVID-19 patients suggest that 33-50% experience dementia, 10-20% experience PTSD, and 33% experience major depression. Researchers are also studying whether COVID-19 patients with brain inflammation are at higher risk of autoimmune disorders like demyelination, where the protective coating of nerve cells is attacked by the immune system and may lead to weakness, numbness and difficulty with daily activities. With the increasing evidence of neurological symptoms, which have not been found to occur as commonly as respiratory symptoms, researchers and health care practitioners are continuing to observe patients around the world to learn more about how COVID-19 impacts on the brain. The long-term implications are still unclear, since COVID-19 is a new disease and there has not been enough time to observe the development of symptoms in patients over long periods of time.
Physicians and scientists are learning more about how COVID-19 impacts organs outside of the respiratory system, such as the brain. The emerging evidence has revealed that some COVID-19 patients experience neurological symptoms in the brain, spinal cord, nerves, and ganglia (cell bodies that relay nerve signals). In early March 2020, observational data from 58 patients in France indicated the presence of neurological symptoms such as agitation, confusion, disorientation, and encephalopathy (brain damage). In April 2020, a study was published on 214 COVID-19 patients in China with "severe infection," where over a third were reported to experience neurological symptoms, including acute cerebrovascular diseases and impaired consciousness. In July 2020, another study on over 40 British patients provided additional evidence about neurological symptoms, ranging from brain inflammation and delirium to nerve damage and stroke. Some of these patients reported severe symptoms, such as strokes and paralysis resulting from nerve damage, while others experienced more minor symptoms like breathlessness and fatigue. Most of the cases with brain inflammation were diagnosed with acute disseminated encephalomyelitis (ADEM), which is a rare illness involving inflammation of the brain and spinal cord that results from viral infections. Data from London indicated an increase in ADEM cases for this study period during the pandemic, as the number of reported cases would typically have been expected over a 5-month period rather than a 5-week period in the city. SARS-CoV-2, the virus that causes COVID-19, was not detected in the cerebrospinal brain fluid of any of the British patients tested, which may suggest that the virus did not directly attack the brain and that the symptoms could have occurred post-infection. Vanderbilt University Medical Center launched a study in July 2020 that will study delirium, post-traumatic stress disorder (PTSD), and depression in patients who have been hospitalized with COVID-19. These disabling impacts are also known as post-intensive care syndrome (PICS), and previous studies of intensive care patients similar to COVID-19 patients suggest that 33-50% experience dementia, 10-20% experience PTSD, and 33% experience major depression. Researchers are also studying whether COVID-19 patients with brain inflammation are at higher risk of autoimmune disorders like demyelination, where the protective coating of nerve cells is attacked by the immune system and may lead to weakness, numbness and difficulty with daily activities. With the increasing evidence of neurological symptoms, which have not been found to occur as commonly as respiratory symptoms, researchers and health care practitioners are continuing to observe patients around the world to learn more about how COVID-19 impacts on the brain. The long-term implications are still unclear, since COVID-19 is a new disease and there has not been enough time to observe the development of symptoms in patients over long periods of time.
Publication
What our experts say
Physicians and scientists are learning more about how COVID-19 impacts organs outside of the respiratory system, such as the brain. The emerging evidence has revealed that some COVID-19 patients experience neurological symptoms in the brain, spinal cord, nerves, and ganglia (cell bodies that relay nerve signals). In early March 2020, observational data from 58 patients in France indicated the presence of neurological symptoms such as agitation, confusion, disorientation, and encephalopathy (brain damage). In April 2020, a study was published on 214 COVID-19 patients in China with "severe infection," where over a third were reported to experience neurological symptoms, including acute cerebrovascular diseases and impaired consciousness. In July 2020, another study on over 40 British patients provided additional evidence about neurological symptoms, ranging from brain inflammation and delirium to nerve damage and stroke. Some of these patients reported severe symptoms, such as strokes and paralysis resulting from nerve damage, while others experienced more minor symptoms like breathlessness and fatigue. Most of the cases with brain inflammation were diagnosed with acute disseminated encephalomyelitis (ADEM), which is a rare illness involving inflammation of the brain and spinal cord that results from viral infections. Data from London indicated an increase in ADEM cases for this study period during the pandemic, as the number of reported cases would typically have been expected over a 5-month period rather than a 5-week period in the city. SARS-CoV-2, the virus that causes COVID-19, was not detected in the cerebrospinal brain fluid of any of the British patients tested, which may suggest that the virus did not directly attack the brain and that the symptoms could have occurred post-infection. Vanderbilt University Medical Center launched a study in July 2020 that will study delirium, post-traumatic stress disorder (PTSD), and depression in patients who have been hospitalized with COVID-19. These disabling impacts are also known as post-intensive care syndrome (PICS), and previous studies of intensive care patients similar to COVID-19 patients suggest that 33-50% experience dementia, 10-20% experience PTSD, and 33% experience major depression. Researchers are also studying whether COVID-19 patients with brain inflammation are at higher risk of autoimmune disorders like demyelination, where the protective coating of nerve cells is attacked by the immune system and may lead to weakness, numbness and difficulty with daily activities. With the increasing evidence of neurological symptoms, which have not been found to occur as commonly as respiratory symptoms, researchers and health care practitioners are continuing to observe patients around the world to learn more about how COVID-19 impacts on the brain. The long-term implications are still unclear, since COVID-19 is a new disease and there has not been enough time to observe the development of symptoms in patients over long periods of time.
Physicians and scientists are learning more about how COVID-19 impacts organs outside of the respiratory system, such as the brain. The emerging evidence has revealed that some COVID-19 patients experience neurological symptoms in the brain, spinal cord, nerves, and ganglia (cell bodies that relay nerve signals). In early March 2020, observational data from 58 patients in France indicated the presence of neurological symptoms such as agitation, confusion, disorientation, and encephalopathy (brain damage). In April 2020, a study was published on 214 COVID-19 patients in China with "severe infection," where over a third were reported to experience neurological symptoms, including acute cerebrovascular diseases and impaired consciousness. In July 2020, another study on over 40 British patients provided additional evidence about neurological symptoms, ranging from brain inflammation and delirium to nerve damage and stroke. Some of these patients reported severe symptoms, such as strokes and paralysis resulting from nerve damage, while others experienced more minor symptoms like breathlessness and fatigue. Most of the cases with brain inflammation were diagnosed with acute disseminated encephalomyelitis (ADEM), which is a rare illness involving inflammation of the brain and spinal cord that results from viral infections. Data from London indicated an increase in ADEM cases for this study period during the pandemic, as the number of reported cases would typically have been expected over a 5-month period rather than a 5-week period in the city. SARS-CoV-2, the virus that causes COVID-19, was not detected in the cerebrospinal brain fluid of any of the British patients tested, which may suggest that the virus did not directly attack the brain and that the symptoms could have occurred post-infection. Vanderbilt University Medical Center launched a study in July 2020 that will study delirium, post-traumatic stress disorder (PTSD), and depression in patients who have been hospitalized with COVID-19. These disabling impacts are also known as post-intensive care syndrome (PICS), and previous studies of intensive care patients similar to COVID-19 patients suggest that 33-50% experience dementia, 10-20% experience PTSD, and 33% experience major depression. Researchers are also studying whether COVID-19 patients with brain inflammation are at higher risk of autoimmune disorders like demyelination, where the protective coating of nerve cells is attacked by the immune system and may lead to weakness, numbness and difficulty with daily activities. With the increasing evidence of neurological symptoms, which have not been found to occur as commonly as respiratory symptoms, researchers and health care practitioners are continuing to observe patients around the world to learn more about how COVID-19 impacts on the brain. The long-term implications are still unclear, since COVID-19 is a new disease and there has not been enough time to observe the development of symptoms in patients over long periods of time.
Context and background
COVID-19 has been linked to a series of health complications beyond respiratory failure, including neurological complications that can potentially damage the brain. Recently, news has been circulating about how SARS-CoV-2, the virus that causes COVID-19, has been associated with many different neurological syndromes, including nerve damage, delirium, and stroke. While the condition is not very common, doctors are currently looking at data from individual patients from around the world to assess how it has impacted patients. These neurological complications have also been reported during previous epidemics, such as the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003 and the Middle East Respiratory Syndrome (MERS) outbreak more recently in 2012.
COVID-19 has been linked to a series of health complications beyond respiratory failure, including neurological complications that can potentially damage the brain. Recently, news has been circulating about how SARS-CoV-2, the virus that causes COVID-19, has been associated with many different neurological syndromes, including nerve damage, delirium, and stroke. While the condition is not very common, doctors are currently looking at data from individual patients from around the world to assess how it has impacted patients. These neurological complications have also been reported during previous epidemics, such as the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003 and the Middle East Respiratory Syndrome (MERS) outbreak more recently in 2012.
Resources
- Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China (JAMA)
- Neurologic Features in Severe SARS-CoV-2 Infection (NEJM)
- The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings (Brain)
- How Covid-19 can damage the brain (BBC)
- Warning of serious brain disorders in people with mild coronavirus symptoms (The Guardian)
- Long after the fire of a Covid-19 infection, mental and neurological effects can still smolder (STAT News)
- Delirium, PTSD, brain fog: The aftermath of surviving COVID-19 (American Psychological Association)
- Study to explore how COVID affects cognition over time (Vanderbilt University Medical Center)
- Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China (JAMA)
- Neurologic Features in Severe SARS-CoV-2 Infection (NEJM)
- The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings (Brain)
- How Covid-19 can damage the brain (BBC)
- Warning of serious brain disorders in people with mild coronavirus symptoms (The Guardian)
- Long after the fire of a Covid-19 infection, mental and neurological effects can still smolder (STAT News)
- Delirium, PTSD, brain fog: The aftermath of surviving COVID-19 (American Psychological Association)
- Study to explore how COVID affects cognition over time (Vanderbilt University Medical Center)
