Q&A: COVID-19 May Cause Memory Loss And Confusion For Some Patients

Coronavirus cases continue to rise across the country and in the Cleveland area. As doctors and researchers learn more about the virus, it’s becoming clear COVID-19 is much more than a respiratory disease. 

Experts say as the virus enters the body it can also cause serious neurological complications in some patients – which can lead to stroke, confusion, and even lingering dementia-like symptoms.

ideastream’s Health Team Managing Producer Marlene Harris-Taylor spoke with All Things Considered Host Tony Ganzer about the coronavirus and brain issues. 

So often we hear the coronavirus is a respiratory disorder, and when you go out to places like a doctor’s office, people are screened for fevers, coughs, and shortness of breath, so when did this change to include things like strokes?

As doctors are seeing COVID-19 patients present all kinds of new symptoms, their knowledge is expanding at a very rapid pace about the virus.

Neurocritical care physician at Cleveland Clinic Dr. Pravin George, said the virus does enter the body through the respiratory system, but then it can move on to other organs, including the brain. He said they’re seeing this in the small number of COVID patients who are seriously ill in the intensive care department.

“All of a sudden we started seeing that a subset of these patients were actually having strokes while they were in the ICU. And we started seeing that some of these patients were showing some signs of brain shrinking. Then we started seeing some signs of people having seizures in the ICU,” George said.

Many patients who were heavily sedated while on ventilators are having a hard time waking up and when they do wake up, some are not themselves.

What does that mean? Are patients being affected by the medication they are being given or by the virus or something else?

That is what they are trying to uncover now. These very sick patients are heavily sedated so that they can relax when they’re on the ventilators and let the ventilators breathe for them. But it’s when they are weaned off the medication, that's when they’re seeing some difference in their behavior, George said.

“Some of these patients that are starting to come out of this, they're looking at depression, some of whom are having like an OCD or obsessive-compulsive disorder type of thing. Some are having hallucinations,” said George. “There's some early-onset movement disorders like Parkinson's-like movement. And there's also a lot of patients that are having this issue with memory. And so they're kind of contributing to almost like an Alzheimer's type of picture.”

I understand there is a doctor in Northern Virginia who is so concerned about these neurological complications in some COVID patients that he is advocating for patients to receive a brain scan before leaving the hospital.

Yes, in a recently published paper in the Journal of Alzheimer’s Disease, Dr. Majid Fotuhi, who is affiliated with Johns Hopkins, called for more research on COVID's long-term effects on the brain and for MRIs for patients.

I spoke to the director of the Neurocritical Care Center at University Hospitals, Dr. Michael DeGeorgia, about the journal paper. He agrees this is something all doctors should be aware of, but he is not sure there is enough data to support widespread MRIs.

“I think it is possible that many patients who are sick with COVID are having small, little strokes or damage to their brain that they're not aware of,” DeGeorgia said “But I don't think the data is there yet to say we should just be screening every single patient who has the disease because most of the patients have relatively minor symptoms of mild disease. They're awake, they're talking, they're interactive. And so I don't think that it warrants widespread screening.”

DeGeorgia said one interesting thing is they’re seeing some relatively young people, in their 20s and 30s having strokes. But it’s hard to know if the person already had an underlying condition that predisposed them and or maybe COVID just pushed them over the edge.

So it seems, Marlene, even among doctors there is still a lot of debate [about this disease].

Yes. Dr. DeGeorgia said that’s the way science operates but we in the public don’t often get to see it.

“As we struggle with the science – and again, this is a normal thing that we deal with all the time, it’s just that usually this is dealt with over periods of years. And now we're going through the same process, kind of a rapid-fire in matters of weeks with these different studies,” he said.

COVID has pulled back the curtain on so many things in our society right now, including how medical science works through these issues.