London — Rebecca Wrixon knew that working as a nanny for a pair of doctors might leave her exposed to coronavirus, but as a healthy 44-year-old with young children, she was not much worried about catching COVID-19. It was already clear then, at the beginning of April, that the disease struck the elderly and those with underlying disabilities hard, but it did not seem to affect her stable family much.
Wrixon then woke up one morning just after Easter with a numb head. She never had a cough or fever, never lost any sense of taste or smell, and even diagnosing COVID-19 would take days for doctors — and even longer to find out how to avoid her body’s reaction to it. The infectious disease secretly caused her body to attack itself, inflamed her brain, paralyzed half of her body, left her incapable of seeing or hearing, and nearly killed her in the process.
British researchers also conclude that COVID-19 will reach far more individuals with severe neurological symptoms than previously thought — including younger patients and others who, like Wrixon, have never encountered the disease’s most well-known signs. The fear is not only that these symptoms in themselves can be harmful, but that they can persist, and nobody knows for how long.
Wrixon’s 11-year-old daughter was around a day in early April in bed with a fever, then Wrixon herself felt some chest pain and a mild rash but she never thought it was the coronavirus.
As her husband came downstairs to see her struggling to control the remote television, she told him that she couldn’t feel her arm or foot. Both Wrixon and her husband believed the same.
Her husband asked her to state the birthday of their daughter and a few other fundamental facts.
“I couldn’t comment. Didn’t have a idea,” remembered Wrixon. “And we were like, ‘I’m having a stroke.'”
They called an ambulance, and the emergency department was rushed into her.
“And I thought I might die.”
“She looked like she had a stroke,” said Dr. Ashwin Pinto, the consultant neurologist who ended up wresting nearly three weeks with Wrixon’s case. “Shortly after I saw Rebecca she really began to struggle with her vocabulary.”
Coronavirus, he said, “was simply totally not on the radar.”
Yet fast tests verified that there was never a stroke. As Wrixon’s condition deteriorated precipitously over the next few days, and the magnitude of the pandemic began to register around Europe, she was naturally tested for COVID-19.
“I didn’t think, particularly, that it was going to be positive,” Pinto said.
The result surprised him. Despite the positive throat swab test, however, there was nothing in Wrixon’s blood or spinal fluid to suggest the virus was directly attacking her central nervous system. But something was. MRI scans showed more than half of her brain severely inflamed.
MRI images show scans of Rebecca Wrixon’s brain on the day she was admitted to hospital (A), six days after admission (B), and 17 days after admission (C), with inflammation appearing in a lighter shade. / Credit: American Academy of Neurology/University Hospital Southampton
At this point, Wrixon couldn’t move half of her body at all. She couldn’t see clearly and she couldn’t communicate with her doctors or her husband.
As leading neurologists grasped to understand what was wrong, Wrixon’s husband got no guarantees. His daughter asked him to promise that mom was going to come back home. He told her the doctors were doing their best, but he couldn’t promise anything.
“I thought I was going to die. I literally thought, ‘No, you’re not coming out,'” Wrixon told CBS News.
Rebecca Wrixon lays in her bed at Southampton University Hospital in England, in early April 2020, just before doctors began giving her plasma exchange treatment. At this point, an inflammation in her brain caused by COVID-19 infection had left Wrixon unable to move half of her body, see clearly or speak. / Credit: Courtesy of Rebecca Wrixon
Dr. Pinto was aware of just one or two cases outside the U.K. that looked similar, at least on paper. He’d read a study about a patient in Detroit whose autoimmune response to a COVID-19 infection had caused a similar, serious inflammation of the brain, so he decided to take a gamble and treat Wrixon not for a viral infection, but for an immune system run amok.
Once the COVID-19 infection had passed and she had tested negative for the virus, Pinto started giving Wrixon high dose steroids and blood plasma exchange. The exchange is meant to remove enough of a patient’s plasma — the part of the blood that carries antibodies tasked with fighting an infection — and replace it with a protein from donors whose immune systems aren’t overreacting to anything, to stop the body’s response and ease the inflammation.
“As soon as the plasma exchange started, the next day I woke up and I moved my first finger,” Wrixon said. After five days of the treatment, she stood up again. “I was moving around. Literally, that plasma exchange works a miracle.”
After more than two harrowing weeks in the hospital, she went home and has since made a full recovery, almost. Three months later, Wrixon still gets pain and numbness in her hand, and sometimes she struggles to get her words out.
A “concerning increase”
How long those effects might linger, along with the overall prevalence of neurological symptoms in COVID-19 patients, continues to worry Dr. Pinto, and he’s not alone.
Two recent British studies make it clear that while it’s better understood than ever, the new coronavirus is still guarding secrets.
A study published on July 8 in the neurology journal Brain found that of 43 patients with confirmed or suspected COVID-19 infections, 12 suffered inflammation of the central nervous system, including the brain. Of those 12, one made a full recovery, 10 made partial recoveries, and one died.
COVID-19 infection, “is associated with a wide spectrum of neurological syndromes,” the study authors concluded. They called it “striking” to note, in particular, the “high incidence of acute disseminated encephalomyelitis” (ADEM is widespread inflammation in the brain and spinal cord) in the patients.
The study conducted at University College London’s National Hospital for Neurology and Neurosurgery noted also that, as Wrixon discovered, the severe inflammation, “was not related to the severity of the respiratory COVID-19 disease.”
According to University College London, the neurologists behind the research said they would typically treat about one adult patient per month with ADEM, “but that increased to at least one per week during the study period (which coincided with the height of the COVID-19 outbreak in London), which the researchers say is a concerning increase.”
A larger study published in The Lancet, which includes the data from the UCL research, looked more broadly at the prevalence of neurological symptoms in COVID-19 patients. It “identified a large proportion of cases of acute alteration in mental status, comprising neurological syndromic diagnoses such as encephalopathy and encephalitis and primary psychiatric syndromic diagnoses, such as psychosis.”
The study found that among 125 coronavirus patients, 62% “presented with a cerebrovascular event [stroke], of whom 57 (74%) had an ischaemic stroke, nine (12%) an intracerebral hemorrhage, and one (1%) CNS vasculitis [inflammation of blood vessels in brain or spine].”
It’s understood that COVID-19 patients, young and old but particularly older people, often experience strokes, but the researchers were surprised by the prevalence of psychiatric symptoms in younger patients who (again, like Wrixon) do not suffer strokes. In the graph below, “cerebrovascular” indicates patients in the study who experienced strokes, whereas “neuropsychiatric” refers to patients with other cognitive and physical symptoms, and it shows the clear shift as age increases.
A graph from a study published in The Lancet shows the proportion of COVID-19 patients among a study group who experienced strokes (
Any illness affecting the central nervous system can have long-term health implications, as millions of stroke survivors can attest. Viruses, from the common flu to the “Spanish Flu” that wreaked global havoc between 1918 and 1920, often leave their mark on survivors by damaging the brain.
Dr. Pinto pointed out that in the decade or so after the 1918 pandemic, doctors saw a surge in cases of a neurological illness called encephalitis lethargica, suspected by many to be a delayed response to the virus.
“If you follow movies, that’s the movie, ‘Awakenings,’ with Robert DeNeiro — it’s all about those patients who recovered from the 1918-1920 pandemic,” he said. “So we know that viruses have been associated with a lot of long-term brain risk.”
“What we really, really don’t know with coronavirus is what that will look like,” said Pinto. “We’re going to see this played out in real-time.”
“This is not influenza”
“There are so many people out there that are still thinking it’s the flu, and in fairness, before I got ill, that’s what I was thinking,” Wrixon told CBS News. “But now? Yeah, no way would I want anybody to go through what I went through.”
“Having to be in the hospital on your own and not having any family or friends allowed to see you or visit you or speak to you, yeah, I wouldn’t want anybody to have to go through that at all.”
“This is not influenza,” stressed Dr. Pinto. “We have small influenza outbreaks in every country in the world, seasonal, in winter… We have not seen the range of terrible complications we get with this virus.”
Wrixon said it was hard now to see images on the news of people gathering in big groups, often without wearing masks.
“It’s ridiculous, really, that people aren’t looking at it more seriously.”
Click here to read the full academic study on Wrixon’s case.
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