Could COVID-19 cause long-term brain problems?

With each passing day, the world continues to struggle with containing the spread of coronavirus and mitigating its devastating impact on global medical infrastructure. We’re all focused on making sure there are enough ventilators, PPE, and hospital beds to take care of the tens of thousands suffering from severe lung functioning and respiratory symptoms.

Many patients, thankfully, will survive the infection and make a full recovery. It’s impossible to say right now what long-term health implications may develop among survivors, but a new study is suggesting the world may see a major influx of neuropsychiatric and brain-related problems in the months, years, and even decades following the end of this pandemic.

Research on COVID-19 and its association with long-term brain problems

Researchers from the University of California San Diego School of Medicine say that if history is any indicator, many recovered coronavirus patients could experience various brain-related problems ranging from depression and anxiety to full-on seizures or changes in cognitive functioning.

“Past pandemics have demonstrated that diverse types of neuropsychiatric symptoms, such as encephalopathy, mood changes, psychosis, neuromuscular dysfunction or demyelinating processes, may accompany acute viral infection, or may follow infection by weeks, months, or longer in recovered patients,” the study reads.

“Our article seeks to bring the medical community’s attention to the need for monitoring and investigations to mitigate such outcomes, not to cause panic among individuals whose lives are already greatly affected by this pandemic,” the researchers add.

For reference, the word encephalopathy is a fairly broad medical term that describes any type of brain disease, damage, or malfunctioning. Demyelination refers to the loss of protective nerve cells covering the brain and has been linked to any number of neurological problems such as multiple sclerosis, loss of vision, and bladder problems.

There have already been preliminary reports of COVID-19 patients experiencing changes in brain functioning, and since the coronavirus is so new, there’s no way to say what long-term repercussions may linger.

It’s not just coronavirus-positive individuals either. Even for those of us who can avoid contracting the coronavirus, we’re all feeling more psychological pressure right now. It’s unavoidable. In this way, the risk of brain-related problems like depression, anxiety, addiction, and insomnia are higher for everyone, not just COVID-19 patients.

“COVID-19 is a significant psychological stressor, both for individuals and communities,” says senior author Suzi Hong, Ph.D., associate professor in the departments of Psychiatry and Family Medicine and Public Health at UC San Diego School of Medicine, in a university release. “There are fears of illness, death, and uncertainty of the future. This pandemic is a potential source of direct and vicarious traumatization for everyone.”

That being said, we just don’t know enough about how the coronavirus may be impacting infected patients’ central nervous systems (CNS) and its effect on the development of future neuropsychiatric problems. If we look to the past for a sign of what’s to come, patients who survived influenza pandemics in the 18th and 19th centuries did indeed experience a host of brain-related issues including insomnia, depression, mania, suicidal thoughts, and even outright delirium.

“Encephalitis lethargica is an inflammatory disorder of the CNS marked by hypersomnolence (abnormal sleepiness), psychosis, catatonia, and Parkinsonism. Incidence increased around the time of the 1918 pandemic,” the study states.

More recently, following the SARS outbreak in 2003, H1N1 in 2009, and MERS in 2012, recovered patients reported higher than normal rates of seizures, narcolepsy, and brain inflammation, as well as other neurological problems. With all of this historical data in mind, it almost seems unavoidable that the same issues, to some degree, will appear in the global population once this pandemic is brought under control.

“Reports are already surfacing of acute CNS-associated symptoms in individuals affected by COVID-19,” notes professor Hong, citing recent research that found severely infected patients in Wuhan were suffering from both delirium and a higher than normal occurrence of strokes.

So, what can be done today? For now, all the medical community can do is keep an eye out for neuropsychiatric conditions and symptoms among infected patients. For some, these issues could occur while the virus is still active in their bodies, but for others, it could take years.

“We will need to do this at different points in their lives, for years to come, to fully appreciate this pandemic’s effects on neuropsychiatric outcomes for different age groups, and how to better prepare for pandemics to come,” Hong concludes.

The study can be found here, published in Brain, Behavior, and Immunity.