1. Skip to content
  2. Skip to main menu
  3. Skip to more DW sites

Severe brain damage possible after COVID-19

July 9, 2020

According to British neurologists, COVID-19 can cause serious damage to the brain and central nervous system. Such damage can lead to psychosis, paralysis and strokes, which are often detected in their late stages.

Gehirn Präparat
Image: picture-alliance/OKAPIA/A. Grambow

There are numerous signs that the novel coronavirus SARS-CoV-2 not only attacks the lungs and respiratory tract, but also other organs on a massive scale.It can severely affect the heart, vessels, nerves, kidneys, and skin. 

British neurologists have now published shocking details in the journal "Brain," which suggests SARS-CoV-2 can cause severe brain damage — even in patients with mild symptoms or those in recovery. Often this damage is detected very late or not at all.

Neurologists at the University College London (UCL) diagnosed acute demyelinating encephalomyelitis (ADEM) in nine British COVID-19 patients. This inflammatory disease causes a degenerative destruction of the central nervous system, affecting the myelin sheaths of the nerves in the brain and spinal cord.

Different degrees of damage

Of the 43 patients examined, 12 suffered from inflammation of the central nervous system, 10 from a transient encephalopathy (brain disease) with delirium or psychosis, eight from strokes, and a further eight from problems of the peripheral nerves, mostly with the diagnosis of Guillain-Barré syndrome. This is an immune reaction that attacks the nerves and causes paralysis and is fatal in 5% of cases. A 59-year-old woman died of the complication.

Infografik Erkrankungen der Myelinscheide ENG

Scientists have never before seen another virus attack the brain in the same way COVID-19 does, points out Dr. Michael Zandi. He is a lead author of the study, as well as a consultant at UCL Hospitals. What is unusual is the severe brain damage even in patients with mild symptoms.

Damage often goes unrecognized

The cases now published confirm fears that COVID-19 is causing long-term health problems in some patients. Many patients remain breathless and tired long after their recovery. Other recovering patients suffer from numbness, weakness, and memory problems.

Biologically, ADEM has some similarities to multiple sclerosis, but it is more severe and usually occurs only once. Some patients will be left with a long-term disability, while others will recover well, explains Michael Zandi.

The entire spectrum of brain diseases and long lasting side effects caused by SARS-CoV-2 may not yet have been recorded, said Zandi, because many patients in hospitals are too sick to be examined with brain scanners or other methods.

MRI scan of brain
MRI scan of brainImage: Colourbox

Neurological damage or late effects are partly not detected or are detected too late due to overload

"We would like to draw the attention of physicians around the world to these complications of the coronavirus," said Zandi. Physicians and medical staff should always consult a neurologist for patients with cognitive symptoms, memory problems, fatigue, numbness, or weakness.

Shocking case studies

Also published were touching individual stories, for example of a 47-year-old woman who suddenly felt headaches and numbness in her right hand after a week of coughing and fever. In the hospital she became fatigued and unresponsive. During an emergency operation, part of her skull had to be removed to relieve the pressure on her swollen brain.

Another 55-year-old patient without any previous mental illness began to behave strangely the day after being discharged from the hospital. For example, she put on and took off her coat several times in a row. She also began to hallucinate — seeing monkeys and lions in her house. Back at the hospital she was given antipsychotic medication.

People in American hospital during the Spanish Flu outbreak of 1918
The Spanish flu was an influenza pandemic that killed between 20 and 50 million people, according to the WHOImage: picture-alliance/National Museum of Health and Medicine

The Spanish flu was an influenza pandemic that killed between 20 and 50 million people, according to the WHO

Thousands of cases of brain damage, even with Spanish flu

British neurologists fear that COVID-19 could leave subtle brain damage in some patients, which will only become apparent in the coming years. According to the study, there were similar long lasting side effects discovered in those who recovered from the devastating Spanish flu in 1918, in which up to one million people probably suffered brain damage.

"Of course, we hope that this won't happen, but when you have such a large pandemic affecting such a large part of the population, we have to be vigilant," said Dr. Michael Zandi of the UCL Queen Square Institute of Neurology.