If patients die as a result of COVID-19 disease, it is mostly due to pneumonia or lung failure. But the corona virus can also lead to heart attack and stroke and cause long-lasting neurological damage.

At the beginning of the corona pandemic, medical doctors had assumed that those who survived COVID-19 disease would be well. But there are increasing signs that COVID-19 can lead to serious and permanent consequential damage. This includes persistent breathing and lung problems, but also serious damage to the blood vessels and the brain. Months later, the risk of thrombosis, pulmonary embolism, heart attack and stroke is apparently increased.

COVID-19 can lead to inflammatory processes in the brain

“The whole thing is probably due to damage to the endothelium that lines the vessels from the virus,” explains Ulrike Protzer from the Technical University of Munich. This then leads to the fact that the platelets accumulate there to repair the damage. If there is an overreaction, thrombosis can occur.

Meanwhile, doctors also suspect that inflammatory processes lead to blockages in the blood vessels. How long they last is not yet clear. Some patients report long-term circulatory problems, others report fatigue that continues for months after the illness. Headaches or a reduced sense of smell or taste are also reported.

Severe neurological complications possible

It is not yet clear how often neurological damage results from COVID-19. According to a study by researchers from the University of Liverpool, a good 900 cases of neurological complications were known worldwide by mid-May – including over a hundred serious diseases such as meningitis or the so-called Guillain-Barré syndrome, in which sufferers suffer from paralysis.

Brain damage even with slight courses?

University College London neurologists also reported in the Brain magazine that coronavirus can cause brain damage in patients with only mild symptoms or those who have recovered. However, these would usually be recognized late or not at all.

Previously, researchers led by Dr. Michael Zandi, lead author of the study, examined more than 40 Covid-19 patients and found acute demyelinating enzyphalomyelitis (ADEM) in some of them. This is an inflammatory disease that leads to the degenerative destruction of the central nervous system.

Consequences similar to multiple sclerosis

“We have never seen the way Covid-19 attacks the brain with other viruses before,” says Zandi. The massive brain damage that occurs even in patients with mild corona symptoms is particularly unusual.

The experts diagnosed inflammation of the central nervous system in a total of twelve of the examined patients, in ten a temporary brain disease with delirium or psychosis. “From a biological point of view, ADEM has some similarities to multiple sclerosis, but it is more severe and usually only occurs once,” explains Zandi. Some patients will have long-term disabilities, while others will recover well, the study author said.

Final evaluation is not yet possible

However, according to experts, it is too early for a final assessment of whether and how strongly brain damage can occur even with slight courses. In order to observe the corresponding courses, the University Hospital Munich in Großhadern has now set up a contact point for patients with mild Covid 19 courses.

“As with any disease that is new and that we have not yet understood enough, you have to look carefully at what will happen in the coming months and years,” explains Professor Matthias Klein from the Department of Neurology in Großhadern. You can currently not estimate that in any way.

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