Being delirious and confused is new warning sign of deadly coronavirus, docs warn

BEING delirious and confused is a new warning sign of deadly coronavirus, doctors have warned.

In most cases, Covid-19 causes a high temperature and dry cough, with those in a more severe condition developing shortness of breath and respiratory distress.

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However, experts are now seeing the disease directly invade the brain in more and more patients - triggering symptoms including delirium, confusion and headaches.

“Many Covid-19 patients have been reported to have neurological symptoms, such as headache, confusion, seizures, and even strokes,” Dr Halim Fadil, a neurologist and movement disorders specialist at Texas Health Arlington Memorial Hospital, told Healthline.

Researchers found that neurological symptoms were present in  of patients with Covid-19 in Wuhan, China - the epicentre of the pandemic.

In particular, doctors say those with severe coronavirus who are admitted to hospital often develop an acute brain condition called “ICU delirium."

Fluctuating consciousness

This is because those with life-threatening symptoms often rely on ventilators to assist with breathing and need to be sedated to minimise the pain and discomfort associated with intubation.

However, these lifesaving measures also come with side effects that include confusion, inability to comprehend what’s happening around you, and inability to focus.

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“Patients with delirium may have auditory hallucinations, visual hallucinations, disorientation of time and space, agitation, aggression, fluctuating level of consciousness, and impairment of sleep-wake cycle,” said Dr Kevin Conner, a neurologist at Texas Health Arlington Memorial Hospital and Texas Health Physicians Group.

According to Dr Conner, patients with delirium can also experience memory difficulties and speech that’s “disorganised, or incoherent.”

Studies suggest that one-third to more than 80 per cent of ICU patients experience delirium during their stay.

People with ICU delirium are also more likely to have long-term cognitive damage and are less likely to survive.

Conner says the majority of patients in the ICU will experience some level of delirium during their treatment, and that “delirium can be brought on by any severe illness, such as sepsis, fever, infection, organ failure, and so forth.”

He adds that while Covid-19 can trigger delirium by damaging the lungs and reducing oxygen to the brain, high fevers caused by the virus are also a risk factor.

Earlier this month, scientists suggested Covid-19 can cause encephalitis (brain inflammation and swelling) and stroke in healthy young people with otherwise mild Covid-19 symptoms.

Researchers from the Henry Ford Health System made the revelation while treating a 58-year-old woman in Detroit, US, who tested positive for Covid-19.

Necrotising encephalitis

As well as presenting the typical Covid-19 symptoms of a cough and a high temperature, the woman, who has not been named, also began feeling confused, fatigued and disorientated.

Medics decided to carry out an MRI scan which identified dark spots in her brain which indicated cell death.

Further scans revealed the woman's brain also had lesions, or brain bleeds, in her temporal lobes, which are involved in consciousness and memory as well as sensation.

This confirmed that the woman had developed acute necrotising encephalitis (ANE) - a central nervous infection.

ANE is a rare disease characterised by brain damage (encephalopathy) that usually follows a viral infection.

It’s previously been linked to infections like the flu, chickenpox and enterovirus - but now doctors believe could also be associated with the new coronavirus.

While this is believed to be one of the only cases of ANE linked to Covid-19, the researchers have urged doctors to be aware of a possible link.

Similarly, several reports have described Covid-19 patients suffering from .

Guillain–Barré syndrome is a neurological disorder where the immune system responds to an infection and ends up mistakenly attacking nerve cells, resulting in muscle weakness and eventually paralysis.

Neurological complications

Other coronaviruses SARS and MERS similarly affected the central nervous system of some patients - triggering life-threatening neurological complications including strokes, seizures, encephalitis and meningitis.

Health experts say the deadly bug may be causing neurological problems as the virus latches onto a receptor in our bodies called ACE-2, which is primarily located in the lungs.

However, according to Igor Koralnik, chief of neuroinfectious diseases and global neurology at Northwestern University’s Feinberg School of Medicine, ACE-2 is also present in other parts of the body, including the nervous system and vessels going to the brain.

The other potential mechanism behind the neurological symptoms is called a secondary infection, which means that a person’s respiratory infection is putting so much strain on the body that it’s triggering a major neurological problem.

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Experts have emphasised that most Covid-19 patients appear to be normal neurologically.

“Most people are showing up awake and alert, and neurologically appear to be normal,” said Dr Robert Stevens, a neurologist at the Johns Hopkins School of Medicine in Baltimore, who is tracking neurological observations.

Neurological specialists also say that it is too early to make definitive statements or identify the specific mechanisms by which the new coronavirus is affecting the brain.