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Young, Healthy US Woman Develops Brain Inflammation After Mild Covid

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A team of US physicians has presented the first known case of a young, healthy adult who, after being infected with Covid-19, developed brain inflammation, offering new insights into potential neurological effects post the infectious disease.

Although Covid-19 is primarily treated as a respiratory disease, patients often experience neurological problems, such as headaches, anxiety, depression, and cognitive issues, which can persist long after other symptoms have resolved.

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Some research has shown blood vessel damage and inflammation, referred to as vasculitis in Covid-19 patients’ brains and central nervous system (CNS). Most cases of CNS vasculitis have been associated with elderly patients with severe Covid-19.

In the journal Neurology: Neuroimmunology and Neuroinflammation, a multidisciplinary team of physicians at the University of California San Diego School of Medicine reported the case of a 26-year-old woman who was diagnosed with Covid-19 four days after an airplane flight in mid-March 2020.

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Her symptoms were mild but progressed two to three weeks later to difficulty moving her left foot and weakness on the left side of her body. She had no headaches and had experienced no change in her mental status or cognition.

Magnetic resonance imaging revealed multiple lesions in the right frontoparietal region of the brain, which is involved in motor control and sensation of the left side of the body. A biopsy revealed CNS lymphocytic vasculitis — inflammation or swelling of blood vessels in the brain and spine.

“This patient was the first confirmed case of Covid-19 CNS vasculitis, confirmed by biopsy, in a young healthy patient with otherwise mild Covid-19 infection,” said Jennifer Graves, a UC San Diego Health neurologist.

“Her case tells researchers and clinicians to consider these serious potential brain complications even in young patients and those with minor initial Covid-19 infections,” she added.

The woman underwent a series of corticosteroid-based treatments, began a long-term immunosuppressive medication, and, after six months, the lesions had substantially decreased and no new lesions had formed. She is still under treatment with immunosuppressive medications, the researchers said.

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