Coronavirus isn’t just a respiratory disease. The list of coronavirus symptoms goes on, fatigue, confusion, anxiety, delirium and stroke are just a few of the presenting symptoms. In addition, it has become increasingly clear that coronavirus triggers a huge range of neurological problems. According to a recent study, A 58-year-old airline worker recently became the first known case of developing acute necrotizing encephalitis (ANE) because of COVID-19.
Patients with comparatively mild illness often complain of problems with staying focused, tiredness, problems with memory and lingering cognitive impact of disease. However, more severe cases are of more concern.
64-year-old patient, Paul Mylrea had two massive strokes, both caused by coronavirus infection. Mylrea is a director of communications at Cambridge University. He is eloquent and able-bodied despite lingering weakness on his right side. He has made the most remarkable of recoveries as seen by the doctors at National Hospital for Neurology and Neurosurgery (NHNN) in London.
Mylrea experienced his first stroke in intensive care at University College Hospital. Potentially fatal blood clots formed in his lungs and legs, so he had to be put on powerful anticoagulant drugs. What’s more, a few days later, he suffered an even bigger, second stroke. He was immediately transferred to NHNN in Queen Square.
“What we saw was so strange and different”
According to consultant neurologist Dr Arvind Chandratheva, “Paul had a blank expression on his face. He could only see on one side and he couldn’t figure out how to use his phone or remember his passcode.
“I immediately thought that the blood thinners had caused a bleed in the brain, but what we saw was so strange and different,” he said.
Paul suffered from another acute stroke because of a clot that deprived the vital areas of the brain of blood supply. Test results showed astonishingly high levels of D-dimer, marker for clotting factor. The levels of D-dimer are normally 300 and can rise to 1,000 in stroke patients. However, the levels were over 80,000 for Paul Mylrea.
“I’ve never seen that level of clotting before – something about his body’s response to the infection had caused his blood to become incredibly sticky,” says Dr Chandratheva.
“His body’s response to the infection caused his blood to become incredibly sticky”
Strokes in COVID-19 patients are triggered because of a massive overreaction of the immune system which causes inflammation in the body and brain. Neurologists at NHNN treated six COVID patients who had major strokes in a span of two weeks. The cases were not linked with usual causes of stroke, for example, diabetes or high blood pressure.
Paul Mylrea’s stroke was so massive that doctors thought he would likely not survive or be left hugely disabled, if he did. Images of his brain showed large areas of damage affecting his speech, coordination, memory and vision.
“After my second stroke, my wife and daughters thought that was it, they would never see me again,” Paul says. “The doctors told them there was not much they could do except wait. Then I somehow survived and have been getting progressively stronger.”
An encouraging sign for Paul’s recovery was his ability with languages. He could speak six languages and would alternate from English to Portuguese when speaking to nurses.
“Unusually he learned several of his languages as an adult, and this will have created different wiring connections in the brain which have survived his stroke,” says Dr Chandratheva.
His physical recovery has been impressive, although, he cannot read as fast as he used to. He is also sometimes forgetful but that is hardly surprising considering the areas of damage in his brain.
Paul says he cannot read as fast as he used to, and is sometimes forgetful, but that’s hardly surprising given the areas of damage in his brain. Doctors attribute his physical recovery to his previous high level of fitness. He would do a couple of sessions of gym, cycling for an hour everyday and swimming in the river.
References
Coronavirus: What does Covid-19 do to the brain? https://www.bbc.com/news/health-53081022?fbclid=IwAR2WhspyhGqZ9Yaf-hbIOsIt67jrSp9MG56AQLRawZxuPr_qbKWKLmFSXuY
