A review of studies suggests delirium or mental confusion along with fever could be an early symptom of COVID-19, particularly in elderly patients.
The research published in the Journal of Clinical Immunology and Immunotherapy, showed that along with the loss of the senses of taste and smell, and headaches that occur in the days prior to the manifestation of coughing and breathing difficulties, some patients also develop delirium.
Particularly, in the case of elderly patients, the manifestation of this state of confusion are accompanied by high fever. Thus, it should be considered an early marker of the disease.
Javier Correa from the Universitat Oberta de Catalunya (UOC) in Spain explained, “Delirium is a state of confusion in which the person feels out of touch with reality, as if they are dreaming.”
Correa, who carried out this study at the University of Bordeaux in France said, “We need to be on the alert, particularly in an epidemiological situation like this. An individual presenting certain signs of confusion may be an indication of infection.”
Correa, along with UOC researcher Diego Redolar Ripoll, reviewed the scientific work that was published on the effects of COVID-19 in relation to the central nervous system, i.e. the brain.
There are growing indications that coronavirus affects the central nervous system, and manufactures neurocognitive alterations, such as headaches and delirium, as well as psychotic episodes, the research found.
“The main hypotheses which explain how the coronavirus SARS-CoV-2 affects the brain point to three possible causes: hypoxia or neuronal oxygen deficiency, inflammation of brain tissue due to cytokine storm and the fact that the virus has the ability to cross the blood-brain barrier to directly invade the brain,” said Correa.
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He mentioned that any one of these three factors has the potential to result in delirium.
The evidence of hypoxia-related brain damage has been observed in autopsies carried out on patients who have died from the infection.
“It has been possible to cut off the virus from the cerebral tissue”, Correa said.
Delirium, cognitive deficits and behavioural anomalies are most likely to be the result of systemic inflammation of the organ and a state of hypoxia, which also causes the neuronal tissue to become inflamed and cause damage in areas such as the hippocampus, according to the researchers.
This is associated with the cognitive dysfunctions and behavioural alterations presented by patients suffering delirium, they said.