Hiccups, tinnitus and stammering: yes, they’re bizarre signs of Covid too

A CONSTANT cough, high temperature, thumping headache and a sudden loss of smell or taste are all common symptoms of Covid-19. But what is now clear is that the virus can actually affect the body from head to toe.

Many people complain of confusion and an inability to concentrate, while chilblain-like lesions, dubbed ‘Covid toe’, are a frequent manifestation, according to medical reports.

And some cases are truly bizarre. Take, for example, a 33- year- old woman from the French city of Strasbourg who was rushed to hospital last year after being found naked in the basement of a building, complaining of hearing voices when there was nobody with her.

She had no history of mental illness and her vital signs – such as heart rate and blood pressure – were fine. But her speech was incoherent and she was convinced the hospital was a castle.

With no signs of cough, fever, breathlessness or tummy upset, she ticked none of the boxes for Covid. Yet she tested positive.

In a report on the case, doctors said the virus had invaded her central nervous system and caused ‘multiple neurological and psychiatric consequences’. She was stabilised with anti-psychotic medicine and later discharged.

Tales of rare but serious psychiatric effects have led the UK to set up CoroNerve – a national surveillance programme for neurological complications from Covid-19. Already it has hundreds of examples of UK virus victims who have suffered psychological reactions to infection thought to be due to inflammation in the brain. And several are reported to include psychotic episodes like the case in France.

Surprisingly, speech appears to be one of the first things that can be affected by the virus – albeit rarely. Doctors at a medical centre in Philadelphia were puzzled when a 53- year- ol d woman turned up at A&E with obvious Covid signs – cough, breathlessness and fever – but also one less obvious symptom. Overnight, she had developed a severe stammer that meant she struggled to get out any words. The condition lasted more than a week after she tested positive.

Again, doctors suspect the virus managed to cross into the central nervous system, where it attacked the brain cells responsible for controlling speech.

Even hiccups could be a sign t hat t he vi r us has got i nto your body, according to a report last July in the American Journal Of Emergency Medicine by doctors from Cook County Hospital in Chicago. They treated a 62year-old man who had been hiccupping for four days but showed no other signs of illness.

When they took an X-ray and CT scan of his chest, they found the characteristic signs of Covid19 – tiny white patches, that look just like ground glass, scattered around the lungs. The man was kept in for three days, treated with drugs and then sent home – and it was only when the infection started to clear that his hiccups finally stopped. It is now recognised that Covid attacks the diaphragm, the wall of muscle t hat controls breathing and which goes into spasm, and the result is hiccups.

Other scientific reports talk of sudden hair loss, ringing in the ears, double vision and even trouble passing urine as possible first signs of Covid infection.

But why would a virus whose main route of entry is through the mouth, nose and eyes trigger such bizarre symptoms elsewhere in the body?

Scientists t hink i t may be because the ACE2 receptor – t he t arget which t he vi r us aims for when it is trying to break into healthy cells so it can use them to reproduce – is found everywhere from t he brain, stomach and lungs to the skin, bone marrow and kidneys.

‘There’s still a great deal we do not understand about this virus,’ says Dr Stephen Griffin, a virologist at Leeds University School of Medicine. ‘But one thing we do know is that the ACE2 receptor is found on lots of different tissues around the body. And post-mortems have shown the virus can reach all sorts of places.’

Professor John Oxford, a virologist at Queen Mary University, London, says many viruses would probably have the same variety of effects seen with Covid. The difference now is simply the scale of infection.

‘We are probably seeing these more unusual symptoms mainly because of the sheer numbers of people being infected,’ he says.

‘Symptoms that might be overlooked during an epidemic within one country or region tend to be much more noticeable during a pandemic across continents.’

Doctors now suspect that the virus can attack the brain cells