From loss of smell to stroke, people with covid-19 are reporting strange neurological issues that challenge our understanding of the disease – and how to treat it
JENNIFER FRONTERA has been treating people in intensive care for years. But she has never experienced anything like covid-19 before. “These patients are absolutely among the sickest any of us have ever encountered,” says the New York-based doctor. But the strange thing is, Frontera isn’t a lung disease specialist or a virologist, she is a neurologist. And it is the possible impact of the coronavirus on our brains that is worrying her.
It was early in the outbreak in New York that Frontera and her colleagues began to notice neurological symptoms in those with covid-19. People were passing out before they were hospitalised. Once in hospital, some of them started having unusual movements. Some had seizures and others had strokes.
Similar reports are coming in from hospitals around the world. Some neurological symptoms appear to be mild, such as the loss of smell and taste. At the other end of the spectrum, a few people have developed encephalitis – a potentially fatal inflammation of the brain.
It is a surprising discovery in a disease that was generally considered to attack the airways, and one of pressing concern. One big question is how the new coronavirus is causing these kinds of symptoms. Growing evidence suggests that the virus may work its way into the brain, directly attacking neurons. If that is the case, we may need to reconsider some of the treatments being developed for covid-19. And we must also prepare for potential long-term and chronic neurological conditions in some survivors.