Study sees mysterious COVID-related inflammation leading to hallucinations, confusion

Those patients were about twice as likely as those without neurological symptoms to need ventilators because they were “very unwell with systemic shock as part of their hyperinflammatory state,” said an author of the study, Dr. Omar Abdel-Mannan, a clinical research fellow at University College London’s Institute of Neurology. The new findings strengthen the theory that the syndrome is related to a surge of inflammation triggered by an immune response to the virus, Abdel-Mannan said. For the children in the report, the neurological symptoms mostly resolved as the physical symptoms were treated.

The new report, presented as preliminary research Tuesday as part of an annual conference of the American Academy of Neurology, evaluated children under 18 who were admitted to Great Ormond Street Hospital (GOSH) between April and September of last year with the syndrome (it has a different name and acronym, PIMS-TS, in Britain). The data is also included in a preprint of a larger study that has not yet been peer-reviewed. As was the case with other studies of the syndrome, including in the United States, the researchers said a majority of those afflicted were “nonwhite,” a pattern that public health experts believe reflects the disproportionate way the pandemic has affected communities of colour.

All 24 of the patients with neurological symptoms had headaches and 14 had encephalopathy, a general term that can involve confusion, problems with memory or attention and other types of altered mental function. Six of the children were experiencing hallucinations, including “describing people in the room that were not there or seeing cartoons or animals moving on the walls,” Abdel-Mannan said. He said some experienced auditory hallucinations involving “hearing voices of people not present.”

Some of the patients underwent brain scans, nerve conduction tests or electroencephalograms (EEGs), including 14 who showed slower electrical activity in their brains, the study reported. Abdel-Mannan said a team led by the study’s senior author, Dr. Yael Hacohen, will be following patients who had the syndrome — both those who had neurological symptoms and those who did not. They will conduct brain scans and cognitive assessments to see if the children experience any long-term cognitive or psychological effects.