Symptoms of Covid-19

How Covid-19 can damage the brain

https://www.bbc.com/future/article/20200622-the-long-term-effects-of-covid-19-infection

Excellent article well worth reading in full. Things get even more complicated over time. Seems like questions are piling up before a single answer can be found.

“They were extremely agitated, and many had neurological problems – mainly confusion and delirium,” she says. “We are used to having some patients in the ICU who are agitated and require sedation, but this was completely abnormal. It has been very scary, especially because many of the people we treated were very young – many in their 30s and 40s, even an 18-year-old.”
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Now, more than 300 studies from around the world have found a prevalence of neurological abnormalities in Covid-19 patients, including mild symptoms like headaches, loss of smell (anosmia) and tingling sensations (arcoparasthesia), up to more severe outcomes such as aphasia (inability to speak), strokes and seizures. This is in addition to recent findings that the virus, which has been largely considered to be a respiratory disease, can also wreak havoc on the kidneys, liver, heart, and just about every organ system in the body.
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Estimates of exact prevalence vary, but it seems that roughly 50% of patients diagnosed with Sars-CoV-2 – the virus responsible for causing the illness Covid-19 – have experienced neurological problems.
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Further complicating matters, many people suffering from the effects of Sars-CoV-2 are never actually tested for the virus, especially if they do not exhibit a cough or fever. It means that if they have neurological symptoms, we may never know if this was linked to Sars-CoV-2.
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*cough* encephalitis lethargica *cough*
“In fact, there is a significant percentage of Covid-19 patients whose only symptom is confusion” – they don't have a cough or fatigue, says Robert Stevens, associate professor of anaesthesiology and critical care medicine at Johns Hopkins Medicine in Baltimore, Maryland.

“We are facing a secondary pandemic of neurological disease.”
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There are other quirks that Stevens has noticed but cannot explain. “Covid-19 patients seem to have a lack of sensitivity to the drugs we normally use – we’ve had to use five to 10 times the amount of drugs for sedation that we would normally use,” he says.
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In fact, some scientists now suspect that the virus causes respiratory failure and death not through damage to the lungs but through damage to the brainstem, the command centre that ensures we continue to breathe even when unconscious.
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If Sars-CoV-2 can cross this barrier, it suggests that not only can the virus get into the core of the central nervous system, but also that it may remain there, with the potential to return years down the line.

Though rare, this Lazarus-like behaviour is not unknown among viruses: the chickenpox virus Herpes zoster, for example, commonly infects the nerve cells in the spine, later reappearing in adulthood as shingles – roughly 30% of people who experienced chickenpox in childhood will develop shingles at some point in their lives.
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Maybe not so much rare as missed.
Other viruses have caused far more devastating long term impacts. One of the most notorious was the influenza virus responsible for the 1918 pandemic, which caused permanent and profound damage to the dopamine neurons of the brain and central nervous system. (While it’s long been assumed that influenza cannot cross the blood-brain barrier, some scientists now think that it can). An estimated five million people worldwide were hobbled by a form of extreme exhaustion known as “sleepy sickness” or “encephalitis lethargica”.
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Nutt plans to enroll 20 Covid-19 patients who developed depression or another neuro-psychiatric condition into a study that will use Imperial’s state-of-the-art PET scanners to look for signs of brain inflammation or abnormalities in neurotransmitter levels.

In Baltimore, Stevens is also planning a long-term study on Covid-19 patients discharged from the ICU, which will also conduct brain scans as well as detailed cognitive tests on functions such as memory capacity.

And in Pittsburgh, through the Global Consortium Study of Neurological Dysfunction in Covid-19, Sherry Chou, a neurologist at the University of Pittsburgh, has coordinated scientists from 17 countries to collectively monitor the neurological symptoms of the pandemic, including through brain scans.
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“Even though neurological symptoms are less common in Covid-19 than lung problems, recovery from neurological injuries is often incomplete and can take much longer compared to other organ systems (for example, lung), and therefore result in much greater overall disability, and possibly more death,” she says.
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lunarainbows said:
thats interesting, because before I had seen that it was determined “rare” to have a runny nose and congestion. (This is in the USA, I wonder if U.K. will update)?
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i ran across that also, but i don't know what country it was attached to.


this reminds me of one thing i found peculiar in medical texts ca. y2k.

for example, "rarely, there will be a runny nose". (or a greek term meaning "runny nose".) what does this mean? i found that it could be confusing.

1) it is rare, but is sometimes the case
2) it is not really worth pointing out, but there you have it
3) it is rare, but it is worth pointing out
 
Wits_End said:
Two-thirds of people with coronavirus have no symptoms, ONS data shows

http://www.msn.com/en-gb/news/coron...data-shows/ar-BB16rGcp?li=BBoPWjQ&ocid=ASUDHP
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Or to put it another way;

77 people, out of 115 tested from a pool of over 60 million candidates, and then found to have covid-19, had no symptoms, at the time of testing.

IMO it's a total non story, the sample size is just far, far, far, too small to allow any extrapolation, let alone meaningful extrapolation.
 
Title : Warning of serious brain disorders in people with mild coronavirus symptoms

Subtitle : UK neurologists publish details of mildly affected or recovering Covid-19 patients with serious or potentially fatal brain conditions

Link : https://www.theguardian.com/world/2...-disorders-in-people-with-mild-covid-symptoms

Doctors may be missing signs of serious and potentially fatal brain disorders triggered by coronavirus, as they emerge in mildly affected or recovering patients, scientists have warned.

Neurologists are on Wednesday publishing details of more than 40 UK Covid-19 patients whose complications ranged from brain inflammation and delirium to nerve damage and stroke. In some cases, the neurological problem was the patient’s first and main symptom.

The cases, published in the journal Brain, revealed a rise in a life-threatening condition called acute disseminated encephalomyelitis (Adem), as the first wave of infections swept through Britain. At UCL’s Institute of Neurology, Adem cases rose from one a month before the pandemic to two or three per week in April and May. One woman, who was 59, died of the complication.


A dozen patients had inflammation of the central nervous system, 10 had brain disease with delirium or psychosis, eight had strokes and a further eight had peripheral nerve problems, mostly diagnosed as Guillain-Barré syndrome, an immune reaction that attacks the nerves and causes paralysis. It is fatal in 5% of cases.

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There appear to be six different groupings of symptoms for Covid-19:

http://www.msn.com/en-gb/health/med...tudy-finds/ar-BB16Rqg5?li=AAnZ9Ug&ocid=ASUDHP

Symptoms of Covid-19 appear to fall into six different groupings, researchers have revealed in work they say could help to predict whether a patient will end up needing a ventilator or other breathing support.

The team say the findings could give healthcare providers several days advanced warning of demand for hospital care and respiratory support.

But it could also help flag patients at risk of becoming seriously ill, meaning home support, such as an oxygen meter or nurse visits, could be provided so that any deterioration is spotted quickly and hospital attendance is prompt.
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Jarred Younger talks about psychological symptoms of COVID-19 in this video. Anxiety, depression, hallucinations, paranoia and cognitive difficulties and dementia caused by the virus could be a result of either a massive immune respons, or the virus having crossed the blood-brain barrier.

 
Anna H said:
Jarred Younger talks about psychological symptoms of COVID-19 in this video. Anxiety, depression, hallucinations, paranoia and cognitive difficulties and dementia caused by the virus could be a result of either a massive immune respons, or the virus having crossed the blood-brain barrier.

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Great video. Watched it yesterday and although I can't say I know much about the physiology, it makes sense in terms of how those effects relate to symptoms.

It also makes sense of my hypothesis that site of infection is largely a major driver of what symptoms occur and their severity, a combination of viral load, site of infection and localized immune resources, along with other chance factors such as prior immunity and simple stochastic randomness. So someone who breathes a small load through their nose may only have some neurological symptoms, through the olfactory bulb, and maybe loss of smell, but if that breath is deep enough it may reach the sinuses, throat trachea all the way down.

If someone breathes it through the mouth it lacks the benefit of nose hair and sinuses catching the virions, may more easily get into the throat, for the hacking cough, trachea and then the lungs. Then from the lungs, or the same with a more direct path through the olfactory bulb, it may get through the nervous system, possibly reaching the vagus nerve and climbing up, causing dysautonomic and cardiac symptoms, maybe reaching the brainstem where breathing reflex gets affected.

Then there are those who either have mostly, only or initially GI symptoms, who probably ingested it from contaminated food. From there it depends what kind of reception it gets from the microbiome and immune system. It may get through the enteric nerves, from then on to various organs.

All consistent with observation that wearing a mask reduces symptom severity even in those infected, likely having to do with the immune system having the ability to control the infection at its site of origin and stamping it down before it goes out of control. Lots depend on chance, viruses have no propulsion, they are simply carried by turbulent flow and everything depends on what immune response is available close-by. And considering that the size difference between a virus and a human is basically the same as a human and the Earth's volume, well, that's a lot of space to hunker down.

There have been several reports of only dementia-like symptoms, from hallucinations to catatonia. Great example to cite Cuomo, he mostly had those at first. I despair at what psychiatry will do with this, I think this is likely to be the model to finally explain most psychiatric diseases, it's basically the first actually coherent explanation ever, but I fear that the field is far too emotionally attached to their psychogenic delusions, too much commitment and future embarrassment to admit it was all a massive failure.

Great CGI, too. The design department outdid themselves :p

He finishes the video saying he will do more, the next likely on long COVID.
 
rvallee said:
I despair at what psychiatry will do with this, I think this is likely to be the model to finally explain most psychiatric diseases, it's basically the first actually coherent explanation ever, but I fear that the field is far too emotionally attached to their psychogenic delusions, too much commitment and future embarrassment to admit it was all a massive failure.
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I agree, and many in the field, people who are actual grown ups and don't revert to magical thinking, are realizing this as well.
The research is building up more and more evidence that many psychiatric illnesses present with inflammation in the brain. Most anti psychotic medication have anti inflammatory effects. It takes a rather impressive degree of denial to ignore this fact.

This is an interesting video by Sam Vaknin, a professor in psychology, about magical thinking and how it's part of conspiracism. It also always involves ignorance.
Also about how gullible humans in general are, we believe 95% of what we're told, even utter nonsense, due to the base rate fallacy
(https://en.m.wikipedia.org/wiki/Base_rate_fallacy)
and how phenomena that have been utterly debunked still leaves residues. This made me think of the BPS people...
(He talks about conspiracism about 30 minutes in)

 
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Davido, B., Seang, S., Tubiana, R., & de Truchis, P. (2020). Post-COVID-19 chronic symptoms: a post-infectious entity?. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, S1198-743X(20)30436-5. Advance online publication. https://doi.org/10.1016/j.cmi.2020.07.028

A report by a team of French infectiologists that suggests that some long COVID symptoms are compatible with dysautonomia (from COVID-damaged blood vessels).
 
Fascinating listening to the BBC Radio 4 science program this afternoon about the different Covid-19 symptoms in adults and children. Based on data from the 4 million people in the UK filling in the daily symptoms and test results tracker, in adults the top 3 symptoms are still fever, persistent cough and loss of smell or taste. In children the symptom pattern is quite different, with the top 5 symptoms being sore throat, headache, fever, fatigue and skipping meals. Rashes were also mentioned as quite common.
 
Trish said:
Fascinating listening to the BBC Radio 4 science program this afternoon about the different Covid-19 symptoms in adults and children. Based on data from the 4 million people in the UK filling in the daily symptoms and test results tracker, in adults the top 3 symptoms are still fever, persistent cough and loss of smell or taste. In children the symptom pattern is quite different, with the top 5 symptoms being sore throat, headache, fever, fatigue and skipping meals. Rashes were also mentioned as quite common.
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I recall adults with SARS also citing extreme fatigue.
 
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