Covid-19 and Neurological Function

December 7 2020 – Scientists and healthcare providers knowledge of COVID-19 and its treatments have advanced at lightning speed in the last year.  Initially, both the public and caregivers were treating treating symptoms as they occurred and hoped for the best.  We now know earlier treatments in severe cases and those to prevent potential complications, like blood clots, are critical to saving lives.

In the December 2020 AARP Magazine, my colleague, friend and neurosurgeon, Dr Sanjay Gupta, discusses the many neurological complications that have occured with a COVID 19 infection. In his article, he notes that 80% of hospitalized patients with COVID have neurological complications.  He also notes, estimates show “about 1/2 of those with these complication suffer long term effects for months after.”  Serious complications have ranged from headaches to inflammation of the brain called encephalitis.

Three recent clinical studies on neurological complications of COVID-19:

The Lancet Neurology, (published online, 2020)- UK researchers found a range of neurological manifestations, including loss of smell and taste, confusion, encephalitis (inflammation in the brain), and Guillain-Barré syndrome (a disorder in which the immune system attacks the body’s nerves)

The New England Journal of Medicine, Vol. 382, No. 23, 2020 – Reported  67% of patients with neurological changes related to COVID-19 infection.

Journal of Alzheimer’s Disease, lead author, Fotuhi, Majid, Vol. 76, No. 1, 2020 – Estimated between 30% to 50% of hospitalized patients have neurological issues, with most common neurological problems being stroke and delirium. They also noted, “in general, people who experience more serious symptoms of COVID-19 tend to have more brain-related complications.”

In a web newsletter article by the American Psychological Association, Nov 1, 2020, Dr Majid Fotuhi, also a colleague and friend, purposes the stages of COVID-19 reported in hospitalized patients.

  • Stage 1: Damage to the nervous system is limited to the epithelial cells in the nose and mouth. The most common main neurological symptoms include loss of smell and taste.
  • Stage 2: The virus triggers an inflammatory response that leads to the formation of blood clots, which can cause strokes.
  • Stage 3: A explosive inflammatory called a cytokine storm that damages the blood-brain barrier that leads to the worse neurological complications.

Summary

Fortunately, overall the vast majority of COVID19 infections have been mild and not required hospitalization.  But neurological complications can appear and are both serious and perhaps long lasting. Prevention, as has been stressed, is critical, along with reporting any neurological symptoms to your doctor promptly if they occur.  Please be safe and be aware.

DISCLAIMER