COVID-19 Symptoms: French and Spanish Researchers Say That Manifestations Of Delirium Accompanied By Fever Are Early Symptoms Of COVID-19
: A new research by French and Spanish Researchers from University Of Bordeaux-France and Universitat Oberta De Catalunya, Barcelona-Spain indicates that delirium accompanied by fever could be an early symptom of COVID-19.
The research findings were published in the Journal of Clinical Immunology and Immunotherapy
The research findings highlight the fact that, together 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.
Hence the manifestation of this state of confusion, when accompanied by high fever, should be considered an early marker of the disease, particularly in the case of elderly patients.
Delirium, a serious disturbance in mental abilities, encompasses an organic-based decline from a preceding baseline mental status, develops over a short period of time, and includes disturbances in cognition, attention, consciousness, and perceptual disturbances (such as delusions and/or hallucinations). As a confusional state, delirium is caused by an acute biological process at the structural, functional, and/or chemical level in the brain and, importantly, it may arise from an existing disease process outside the brain (e.g. SARS-CoV-2 infection)or any acute predisposing factor that, organically, affect the brain at the neurotransmitter, neuroendocrine, and/or neuroinflammatory level in an already vulnerable brain.
Co-researcher Dr Javier Correa from Universitat Oberta De Catalunya-Spain who carried out this study at the University of Bordeaux –France explained to Thailand Medical News, "Delirium is a state of confusion in which the person feels out of touch with reality, as if they are dreaming."
Dr Correa added, "We need to be on the alert, particularly in an epidemiological situation like this, because an individual presenting certain signs of confusion may be an indication of infection".
Dr Correa, together with Universitat Oberta De Catalunya Cognitive Neuro Lab researcher Dr Diego Redolar Ripoll, has reviewed the body of scientific work published on the effects of COVID-19 in relation to the central nervous system, i.e. the brain.
The detailed meta-analysis found that, although to date much of the coronavirus research conducted since the first cases of pneumonia were reported in China (on 31 December 2019) have focused on the damage it causes to the lungs and other organs, such as the kidneys and heart, there are growing indications that the coronavirus also affects the central nervous system and produces neurocognitive alterations, such as headaches and delirium, as well as psychotic episodes.
Dr Correa added, “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 br
ain 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
Dr Correa stressed that any one of these three factors has the potential to result in delirium and explained that evidence of hypoxia-related brain damage has been observed in autopsies carried out on patients who have died from the infection and that it has been possible to isolate the virus from the cerebral tissue.
The study team said that delirium, cognitive deficits and behavioral 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, which are associated with the cognitive dysfunctions and behavioral alterations presented by patients suffering delirium.
The study team concluded, “Here, we presented our point of view on the direct effects of the SARS-CoV-2 infection on the human CNS and its related cognitive and neuropsychiatric complications, aiming that the reviewed data will have guiding importance for the prevention and treatment of COVID-19. In this context, this work constitutes a renewed point of view for the study of the delirium-based COVID-19 physiopathology and could help to establish new and emerging causal links between SARS-CoV-2 infection, delirium, and its resulting neurocognitive alterations.”
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