Making Sense of Medical Science (MSMS)

Yesterday, I posted the sad story about an ER doc who caught COVID-19 and wasn't quite right after she recovered. After recovery from the disease she spent time in a psych unit only to tragically commit suicide after she was released. Noting that the virus also causes many people to lose their sense of smell, I wondered whether there was some neurological involvement with the virus that might have contributed to the Doctor's suicide.

Recently, New York City doctors have reported disturbing cases of strokes in younger patients infected with the CoV-2 virus. Over a two-week period, Mount Sinai doctors reported five younger patients who suffered large vessel strokes according to a recent letter they published in the New England Journal of Medicine. All five patients tested positive for COVID-19 but had very mild to no symptoms. Similar reports of this phenomenon first came from Wuhan, where approximately 5% of patients who were hospitalized with the coronavirus also suffered a stroke.

Strokes occur when blood supply to the brain is interrupted causing brain cells to die. One way this can happen is by blood clots that occlude critical vessels preventing blood to oxygenate downstream tissues. Several anecdotal reports from physicians around the world have claimed that the coronavirus seems to cause blood clots in many organs such as the heart, lungs and kidneys. And now the brain.  A study from the Netherlands published in early April looked at 184 patients who were checked into intensive care for COVID-19 pneumonia. Nearly a third of those patients suffered from thrombotic complications, or abnormal blood clotting.

The virus binds to a molecule called ACE-2 (angiotensin converting enzyme type 2) that is expressed in lung cells, the heart, the testes (very high levels), and in vascular endothelium that permeates all organs. That means it can possibly infect cells in the vessels found throughout the body.

I don't know if we will ever find out, but I wonder if the ER doctor who shot herself might have suffered a  cerebrovascular  clot or other pathology that could have affected her emotions, but without the usual signs of a larger stroke.

In a short video I posted earlier today, an ER doctor talks about his experience with the disease this virus causes. He emphasized that this was unlike anything he had ever seen. It is a whole new disease he said.

You don't want to mess with novel viruses.