Covid-19 could cause stroke in up to six in 10 inpatients

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One study suggested that coronavirus can cause brain damage in six out of 10 critically ill patients in the hospital.

British researchers examined 125 people hospitalized for the virus at the height of the British crisis in April – but they admitted that the patients had been selected by doctors and were probably among the most seriously ill.

Sixty-two percent suffered from a stroke during their hospital stay, while almost a third developed symptoms of psychosis or dementia.

Scientists at the universities of Liverpool, Southampton, Newcastle and University College London admit that their study is too small to draw definitive conclusions.

But they say it provides a “snapshot” of the lesser-known neurological damage that respiratory infection can trigger.

Up to a third of people who fall seriously ill with a coronavirus develop dangerous blood clots, which can trigger strokes if they migrate to the brain and cut off its blood supply.

Scientists have trouble figuring out exactly why the clots form, but they are believed to be caused by severe inflammation caused by the Covid-19 infection.

This inflammation of the main arteries leading to the brain is thought to be the cause of the psychiatric problems seen in some patients.

Coronavirus can cause brain damage in up to six in 10 people, small study of more than 100 patients found (file)

The latest study, published in The Lancet Psychiatry, found that the most common brain damage was a stroke, which was reported in 77 of 125 patients (62%).

Of these, 57 patients had a stroke caused by a blood clot in the brain, known as an ischemic stroke, and nine patients had a stroke caused by brain bleeding.

One patient had a stroke caused by inflammation of the blood vessels in the brain.

Age data were available for 74 stroke patients and the majority were over 60 years of age (82%).

WHAT CAUSES BLOOD SHELLS IN COVID PATIENTS?

One in three people who become seriously ill with a coronavirus develop dangerous blood clots, which scientists say contribute to their death.

Clots can become fatal if they migrate to major organs, such as the lungs, and cut off their blood supply.

Blockages can trigger heart attacks, strokes, organ failure and pulmonary embolism, if they migrate to the main organs.

While experts don’t know why the virus causes blockages, there are three main theories:

CYTOKINE STORM

The prevailing theory is that it is the result of an excessive immune response known as a “cytokine storm”.

Cytokines are chemical signaling molecules that guide a healthy immune response.

They tell immune cells to attack viral molecules in the body.

But in some people, this resonance goes into the overdrive and the immune cells also begin to attack healthy tissue, known as the cytokine storm.

When the blood vessels are damaged, they can leak, causing a drop in blood pressure and increasing the risk of clots.

INFECTION BY-PRODUCT

Other scientists say the increase in stroke may be a by-product of the way COVID-19 invades the human body.

Professor Ian Jones, virologist at the University of Reading, told MailOnline: “Covid binds to an enzyme called ACE2 which is found on the surface of the cell.

“He just uses it as a means of fixing himself, but in doing so, the enzyme function of ACE2 is reduced.

“The consequence of this is an imbalance of the hormones called angiotensin I and angiotensin II which together regulate blood pressure.

“It could be linked to the increase in reported strokes. “

UNIQUE FORM OF VIRUS

Dr. Robert Bonow, a professor of cardiology at Northwestern University, said it may be the unique form of the coronavirus that causes blood clotting problems.

He said that the tips of the virus, which lock onto cell receptors, can also attach to blood vessels.

Once they are anchored to these cells in the blood vessels, the viral particles can cause damage to them as well as to the heart muscle, says Dr. Bonow.

During this time, 39 patients showed signs of confusion or behavioral changes reflecting an altered mental state.

Nine had unspecified brain dysfunction, known as encephalopathy, and seven patients had brain inflammation, known medically as encephalitis.

The remaining 23 patients with altered mental status were diagnosed with psychiatric disorders.

Only two of these patients were diagnosed with a mental health problem before being hospitalized with Covid-19.

But the researchers say they cannot rule out the possibility that these people previously lived with undiagnosed conditions.

The 23 patients diagnosed in psychiatry included ten patients with new psychosis and six patients with dementia-like syndrome.

Seven patients showed signs of mood disorders, including depression and anxiety. Age information was available for 37 of the 39 patients with altered mental status and of these, about half were under the age of 60 (49%).

Co-author Dr. Benedict Michael of the University of Liverpool said: “While an altered mental state was reported by some clinicians, we were surprised to identify so many cases, especially in younger patients , and by the extent of clinical syndromes ranging from brain inflammation (encephalitis) to psychosis and catatonia.

“Clinicians should be alert to the possibility that patients with Covid-19 develop these complications and, conversely, to the possibility of Covid-19 in patients with acute neurological and psychiatric syndromes. “

But independent scientists say people should not “worry too much” about the results because they are “probably relatively rare” in most Covid-19 patients.

Michael Sharpe, a professor of psychological medicine at the University of Oxford, said: “This report describes often striking cases of neurological and psychiatric illness as sometimes associated with severe Covid-19 in hospital patients.

“It reminds us that Covid-19 is more than a respiratory infection and that we need to consider its connection to a variety of other diseases.

“However, as this is only a series of case reports from patients seen by certain types of hospital specialists, we cannot be certain that these diseases were in fact caused by Covid-19 or were simply concomitant.

“In addition, we cannot estimate the frequency of these diseases in the larger population of people who develop Covid-19. We must do research to remove these uncertainties.

“However, at present, the general population should not worry too much about these possibly associated diseases, as they are probably relatively rare in those infected with this coronavirus. “

Professor Paul Garner, an infectious disease expert at the Liverpool School of Tropical Medicine, said, “I am concerned that it is too early to make a safe psychiatric diagnosis in patients with severe Covid-19 who have symptoms used in long-term diagnosis. long-term psychiatric illnesses.

“My concern is that this [latest study] is a classic case of doctors putting things in boxes.

“People have symptoms and then doctors diagnose them based on a preexisting understanding, but in this case we don’t yet understand what’s going on with patients with Covid-19, nor do we know the natural course of Covid-19 neurological, psychological, or psychiatric symptoms.

“There are still many questions to be answered and studies to be done before we can say with certainty whether Covid-19 causes psychiatric disorders such as psychosis. “

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