Autopsies May Explain ‘Brain Fog’ From COVID
Ultimately, the study team found megakaryocytes in the brains of a third of the COVID-19 patients who died.
The results were published online on February 12 inJAMA Neurology.
So, do megakaryocyte brain formations explain COVID-19 brain fog? Nauen stressed that it is premature to characterize the finding as cause and effect evidence.
“Knowing that they are there is the first step. Now we have to understand why they are in the brain, and what tells them to come to the brain by mistake, if this type of inflammation is very different than we ever have. seen before is responsible for brain fog and may also contribute to an increased risk of stroke, ”he noted.
“None of these patients had a stroke. And I speculate. But you can imagine that if you start to clot or block this very complex network of carefully regulated capillaries, then your blood pressure will change. higher, and possibly increase the risk of stroke, ”Nauen said.
Meanwhile, Dr. Larry Goldstein, chair of the University of Kentucky’s department of neurology and co-director of the Kentucky Neuroscience Institute, offered a cautious view of Nauen’s findings.
“’Brain fog’ is not a specific condition and does not have definitive diagnostic criteria,” Goldstein said.
Brain fog is also “not specific to COVID, and can occur in association with a variety of inflammatory conditions, degenerative diseases, drugs – especially some cancer chemotherapy drugs – and intensive care unit hospitalizations, among others. “, he added.
Yet, in the case of COVID-19, could megakaryocytes be the cause? Goldstein acknowledged that the explanation is “plausible”. But the same goes for a wide range of other explanations, including inflammation, reduced oxygen in the blood, stroke, reduced blood flow and / or “general complications of the blood. ‘hospitalization for an acute and potentially fatal illness,’ he said.
So without brain scans or detailed reports on each patient’s “cognitive state”, it’s impossible to know, Goldstein said. This means, for now, all that can be said is that “there are a variety of ways in which brain damage can occur in this setting.”
There’s more on COVID-19 brain fog at NewYork-Presbyterian Hospital.
SOURCES: David Nauen, MD, PhD, assistant professor, department of pathology, Johns Hopkins University, Baltimore; Larry Goldstein, MD, chair, department of neurology, and co-director, Kentucky Neuroscience Institute, University of Kentucky, Lexington; JAMA Neurology, February 12, 2021, online
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