A man’s encounter with covid-19 likely led to him experiencing life-threatening catatonia that erased days of his memory, according to doctors in Sweden. Though the man was able to recover without serious brain damage thanks to prompt treatment, the doctors warn that the man’s case may highlight a never-before-seen form of neurological complication connected to the coronavirus.
The 40-year-old man’s gruelling case was detailed in a report released this week on the preprint website medrxiv.
According to the report, the previously healthy man arrived at the hospital agitated, grimacing, and with fever, exhibiting repetitive speech and movements. Because of his bizarre, disorganised, and uncooperative behaviour, he was involuntarily admitted for care. A few hours into admission, he became mute, while his body temperature spiked to over 38.8 degrees Celsius. He also began having involuntary muscle contractions that left his body and arms rigid, as well as heart and circulation problems. Soon, doctors decided to constantly sedate and intubate him.
Though the doctors weren’t sure exactly what was going on, they suspected that the man’s immune system was overreacting and attacking his brain, likely because of his recent infection from the coronavirus that causes covid-19. Twenty-two days before his hospitalisation, he began experiencing the classic respiratory symptoms associated with covid-19, though apparently his illness wasn’t serious, and a week after that, he tested positive for the virus.
On the basis of that diagnosis, they decided to treat him with steroids and the filtering out of his blood plasma, which contains immune cells and antibodies — a treatment plan intended to calm down his immune system. Six days into hospitalisation, the man began to show dramatic improvement and was able to stay aware and communicative. But he had completely lost any memory of the past few days. Over the next several weeks, he slowly recovered, though he still experienced visual hallucinations and other cognitive problems during that time.
The symptoms that landed him in the hospital, according to doctors, were the manifestation of malignant or lethal catatonia, a rare form of the condition that’s associated with being immobile and unresponsive to external stimuli. This form of catatonia can be life-threatening, because it can lead to the shutdown of the body’s automatic functions, like breathing and pumping blood.
Without the early treatment the man received, it’s possible he might have died or suffered severe neurological damage. Fortunately, later tests showed that he had no signs of lingering brain damage.
This case isn’t the first to connect the novel coronavirus, SARS-CoV-2, to neurological problems indirectly caused by infection, nor is it the first to show this happening in people who only had mild-to-moderate initial symptoms. Many infections can trigger this type of overreaction by the immune system against the brain, which is called autoimmune encephalitis and is fortunately rare.
But according to the doctors, there’s never been a case of autoimmune encephalitis known to cause the exact set of strange symptoms seen here. That raises the possibility, they wrote, “that this may be a novel form of autoimmune encephalitis induced by infection with SARS-CoV-2.”
The frightening case is yet another reminder that we’ve just scratched the surface of understanding covid-19’s range of effects in people.