COVID-19: Persistent Brain Changes / Automated Symptom Monitoring / Decline in ED Visits

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Check out some of today's developments in COVID-19:

Brain changes: COVID-19 patients may show cerebral changes on magnetic resonance imaging months after recovery, according to a study in EClinicalMedicine. Some 60 recovered patients and 39 controls underwent brain MRI. The COVID-19 cohort showed a wide range of differences relative to controls, including significantly higher bilateral gray matter volumes in olfactory cortices and hippocampi. Some of these differences were associated with persistent symptoms like loss of memory and smell. The researchers say the findings indicate "neuro-invasion potential of SARS-CoV-2. ... [E]ven if the patients recover well from the pneumonia condition, the neurological changes may cause a great burden."

Automated symptom monitoring: Daily monitoring for COVID-19 symptoms via text or email helped identify new cases in Maine, researchers report in MMWR. Roughly 1600 contacts of 640 COVID-19 patients were monitored during their 14-day quarantine period. Participants received daily symptom questionnaires using their preferred method: text message, weblink via text or email, or phone call. Those who reported symptoms underwent further investigation and, ultimately, 12% of all contacts met the COVID-19 case definition. The researchers note that roughly 10% of Maine's COVID-19 patients identified between May 10 and July 14 were identified using this system.

Decline in ED visits: Daily rates of emergency department visits declined markedly in the U.S. as the COVID-19 pandemic took hold, according to an analysis of 24 EDs in five states. From January through April, declines were highest in New York (64%) and Massachusetts (57%). In JAMA Internal Medicine, the researchers write, "These findings suggest that practitioners and public health officials should emphasize the importance of visiting the ED during the COVID-19 pandemic for serious symptoms, illnesses, and injuries that cannot be managed in other settings."