The long-term effects of COVID-19 on the brain still need to be clarified, despite “interesting” links, says consultant neurologist Malcolm Vella, who urges, against letting down our guard just because the mortality rate is, so far, low in Malta.

Acknowledging links between chronic neurological disorders and infectious agents, Vella has not yet had patients with neurological complications of COVID-19.

But he is aware of three who presented with strokes and tested positive, as well as a case of severe encephalopathy, following a prolonged stay on a ventilator in the Intensive Therapy Unit, in a patient with coronavirus-related lung disease. 

Some scientists suspect COVID-19 causes respiratory failure and death through damage to the brain and not to the lungs. But Vella has no doubt it is primarily an infection of the respiratory system.

“Damage to lungs definitely occurs directly from the injury caused by the virus on these cells,” he states, adding that “we are still learning about the effects of COVID-19 on the nervous system, mostly through observation of neurological complications occurring in infected patients.”

While an autopsy study on 18 patients who died of COVID-19 complications revealed evidence of brain injury, secondary to lack of oxygen, in all of them, it is yet to be determined whether these hypoxic changes in the brains of individuals who survived a severe COVID-19 infection would lead to other clinical manifestations later in life, Vella said.

Meanwhile, a growing number of reports are suggesting increased risk of stroke in patients with COVID-19. Young and otherwise healthy individuals with minor symptoms have been reported to have suffered strokes.

In Malta, the coronavirus has been described as “mild” by the prime minister, who has also said no serious cases were being diagnosed and that there was no need for panic.

Vella believes that with an infection that has reached the level of a pandemic, there will always be an element of scaremongering from non-professionals, which, unfortunately, leads to a lot of anxiety, particularly in susceptible individuals, suffering from mental health disorders.

“However, we must not forget that scientific evidence has proven to the world that COVID-19 is a potentially serious infection, with a morbidity and mortality rate,” he said.

“It has killed not only vulnerable people, but also young, previously healthy, individuals.

“This is a fact that nobody can deny,” he added about downplaying the novel coronavirus.

“We should definitely not let down our guard just because the mortality rate is, so far, low in our country.

“Everyone should be responsible, and everyone should take an active part in controlling the spread of infection.

Over the past months, the Public Health Department has heeded very sound advice regarding measures to control the infection.

“We should, therefore, unite together as a country and follow their advice.”

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