COVID-19: BRAIN DISORDERS

Brain disorders were some of the symptoms noted in the Office for National Statistics (ONS) survey on Long Covid in the UK.

Disorders can arise for four reasons:

• If the virus causing COVID-19 gets into the blood stream, it can attack any organ that has cells with ACE2 receptors, as in the lungs.  Organs include the brain and heart
• The virus can also cause microclots in the blood stream.  Microclots can damage organs such as the brain, and can cause strokes
• Inflammation arising from the body's own immunological response
  
• The trauma of enduring the illness, initially and any longer affects
  

Now a study by Oxford University has been published in the Lancet, covering nearly a quarter of a million people who had survived COVID-19.  This study reviewed neurological and psychiatric disorders occurring within six months of infection.  Electronic patient records were reviewed, mainly in the USA, for patients believed to have had medium or severe COVID-19 symptoms. Some of these people had been hospitalised.

The key findings were:

• Brain disorders are more common after COVID-19 than after influenza and other respiratory disorders. That suggests COVID-19 as the cause, due as explained above
  
• 34% of people infected with COVID-19 were diagnosed with some form of brain disorder, overall
  
• 13% for the first time
• Therefore 87% exacerbating an existing condition
  
• This rose to 38% admitted to hospital and 46% then in intensive care
  
• Disorders were primarily psychiatric, notably:
• 17% anxiety disorders 
• 14% mood disorders
• 7% substance abuse
  
• Neurological disorders included
  
• 2.1% for ischaemic stroke
• 0.7% for dementia
• 0.6% for brain haemorrhage
  

Clearly bad news for patients, especially those with severe infection.  Also bad news for their families and employers.  Worth avoiding the disease.

The report adds "...the effect across the whole population may be substantial for health and social care systems due to the scale of the pandemic and that many of these conditions are chronic. As a result, health care systems need to be resourced to deal with the anticipated need, both within primary and secondary care services."

This report underlines the conclusion from the review of the ONS survey that we should be concerned as much about Long Covid as the death and hospitalisation figures.