Delirium accompanied by fever could be an early symptom of COVID-19

Reviewed by Emily Henderson, B.Sc.November 4, 2020

Delirium accompanied by fever could be an early symptom of COVID-19. This is the main conclusion drawn from a review of scientific research conducted by researchers from the Universitat Oberta de Catalunya (UOC).

The study is published in open access Journal of Clinical Immunology and Immunotherapy, which highlights the fact that, along with the loss of the sense of taste and smell and the headache that occurs in the days leading up to the onset of cough and breathing difficulties, some patients also develop delirium.

As such, the manifestation of this confused state, if accompanied by high fever, should be considered an early marker of the disease, particularly in the case of elderly patients.

“Delirium is a state of confusion in which the person feels out of touch with reality, as if he were dreaming,” explained Javier Correa, a UOC researcher, who conducted this study at the University of Bordeaux (France).

He added that “we must be alert, especially in an epidemiological situation like this, because an individual who shows certain signs of confusion can be an indication of infection”.

Correa, together with UOC Cognitive Neuro Lab researcher Diego Redolar Ripoll, examined the published body of scientific work on the effects of COVID-19 in relation to the central nervous system, i.e. the brain.

The review found that although much of the coronavirus research conducted since the first cases of pneumonia were reported in China (December 31, 2019) has focused on the damage it causes to the lungs and other organs, such as kidneys and heart. , there are growing indications that the coronavirus also affects the central nervous system and produces neurocognitive alterations, such as headaches and delirium, as well as psychotic episodes.

The main hypotheses explaining how the SARS-CoV-2 coronavirus affects the brain point to three possible causes: hypoxia or neuronal oxygen deficiency, inflammation of the brain tissue due to the cytokine storm, and the fact that the virus has the ability to cross the blood – brain barrier to directly invade the brain. “

Javier Correa, researcher, Open University of Catalonia

He pointed out that any of these three factors have the potential to cause delirium and explained that evidence of hypoxia-related brain damage was seen in autopsies performed on patients who died from the infection and that it was possible to isolate the virus from the brain tissue.

According to the researchers, delirium, cognitive deficits and behavioral abnormalities are more likely to be the result of systemic inflammation of the organ and a state of hypoxia, which also causes inflammation of neuronal tissue and damage in areas such as the hippocampus. , which are associated with cognitive dysfunction and behavioral changes presented by patients suffering from delirium.