The neurological symptoms associated with the coronavirus are more than known. From severe headaches, to blackouts, even through epileptic seizures. These are just a few of the many examples that have been documented, both as symptoms of infection and as sequelae. However, when three teenagers went to the emergency room Benioff Children’s Hospital San Francisco, affected by symptoms of a psychiatric disorder, discover that it could be related to COVID-19 It was a surprise.
Actually, there was already some very rare case report, but only in adults. And the relationship was not entirely clear either. But this is the first time that this phenomenon has been detected in teenagers.
The three cases have been described in a study, recently published in JAMA Neurology. In it, it is narrated how the diagnosis took place, the immunological markers that caught the attention of the researchers and, of course, the treatment, which had mixed results in each of them.
These three teens came to the hospital with Mild or asymptomatic COVID-19. It was not, therefore, the coronavirus that had led their relatives to look for Medical help. Rather, it was the psychiatric disorder they seemed to be suffering from.
The symptoms were variable. However, in general they could be summarized as suicidal thoughts, delusions, and paranoia. Two of them had psychiatric history, like depression or anxiety, but not the third.
Doctors knew that some psychiatric symptoms had already been diagnosed in adults with mild coronavirus. And they also knew that in many of them the presence of antineural antibodies, which attack the patient’s own brain tissue. Therefore, the three children were subjected to the relevant tests to see if they had this same marker. These consisted of remove cerebrospinal fluid through a lumbar puncture and then analyze it for antibodies.
One of them didn’t have them, but the other two did. And, curiously, they were the two who did have a psychiatric history.
Should the psychiatric or autoimmune disorder be treated?
Severe cases in some young coronavirus patients are known to be due to overwork on their immune system. But what about these three guys is something different. And they are mildly ill or even asymptomatic people, but even so their immune system has turned against some of their cells. In this case, those of the brain tissue. It has been seen with other symptoms, in different parts of the body, and it was also thought that it could be related to neurological symptoms. But this autoimmune reaction that generates psychiatric symptoms is something much rarer to see.
Therefore, it is worth asking to which of the two pillars of the problem it was more important to attack: the psychiatric disorder or the autoantibodies?
The quickest and safest answer is that it is best to attack both. Therefore, the two patients who had antineural antibodies received, in addition to the psychiatric treatment, intravenous immunoglobulin. This is a therapy known as immunomodulatory, which are used to redirect the immune system when it has wrong and it has begun to attack what it should not.
Only five days later, the first of them already had more organized thoughts and better understanding. Besides, the paranoia it had noticeably decreased. The second, on the other hand, improved somewhat, but he still had a clear alteration in his mood, along with some cognitive symptoms. As for the third, who only received psychiatric treatment, was evolving favorably at the time of writing the study.
It should be noted that this patient turned out to be marijuana consumer, so the scientists who have carried out the research believe that this could be the trigger, in addition to the coronavirus.
And now that?
Now, the study authors want to know more about this rare coronavirus symptom. It appears that people with a history of psychiatric disorder are more predisposedBut could it be that those antineural antibodies were already there before the infection and that COVID-19 had only been a red flag?
That is something they cannot respond to at the moment. But at least one thing is clear. Even the asymptomatic coronavirus does not save us from suffering from some of the most unpleasant symptoms. Therefore, prevention is better than cure. Or, in this case, it is better to vaccinate than to regret.