With coronavirus infection, people suffering from neurological and vascular diseases are at risk. In addition to the high fever, cough, and shortness of breath that traditionally accompany coronavirus pneumonia, some infected people experience mental changes due to neurological disorders. Some descriptions of clinical cases say that COVID-19 may cause necrotizing encephalopathy – an acute lesion of the main organ of the central nervous system. At the same time, the coronavirus can cause neurological complications without damaging the lungs at all.
Disorders of the brain are evidenced, in particular, by such a symptom as loss of smell. Also, the pathogen can harm the cardiovascular system. British scientists have warned that COVID-19 can lead to a wave of brain damage and neurological complications, in particular inflammation, stroke, psychosis, and delirium. The neurological complications of coronavirus are still poorly understood. They can appear during the acute period of infection. Such symptoms may also be delayed as they do not arise immediately but later after the infection heals. The researchers explain that neurological complications are likely due to the immune system’s response to the coronavirus infection and not a direct result of the virus itself.
Various consequences of COVID-19 disease
Recently, there has been ample evidence that the new SARS-CoV-2 coronavirus is actively attacking the lungs and respiratory tract, and other human body organs.
New clinical studies of diseases caused by the coronavirus confirm fears that the virus may cause long-term health problems in some patients. Patients may have disorders such as inflammation of the central nervous system, transient encephalopathy (brain disease) with delirium or psychosis, stroke, nerve damage, mainly with Guillain-Barré syndrome. Many patients feel short of breath and fatigue long after they recover. Others who have recovered suffer from limb numbness, weakness, and memory problems.
Since the peripheral nervous system often suffers from COVID-19, young patients are also at risk. After all, the infection can proceed without pneumonia, and the young person does not understand that they are sick. And then their hands and feet may become numb. Such cases are known. It happens that non-aged patients come to the clinic with complaints of burning pain in the distal extremities due to covid.
The whole spectrum of diseases and complications caused by SARS-CoV-2 has probably not been identified yet. Many patients are in hospitals in too bad shape to do brain examinations or other procedures. British neurologists fear that COVID-19 may leave such brain damage in some patients that will become noticeable only in the coming years. According to the study, patients also had similar complications after the devastating Spanish flu of 1918-1920. Probably nearly a million people also had difficulties in the form of brain damage.
Many chronic neurological patients receive therapy that suppresses the immune system – for cancer, rheumatological diagnoses, or, for example, patients with multiple sclerosis. It is believed that they are at risk during a pandemic. Because when treating the underlying disease, their immunity is artificially suppressed. However, the disease cases can vary. The new type of coronavirus is also capable of disrupting the process of normal hematopoiesis. Based on this, scientists proposed measuring the level of platelets in patients’ blood to predict severe forms of the disease.
Which neurological diseases may develop or worsen with COVID-19?
Neurological manifestations occur in about half of hospitalized coronavirus disease 2019 (COVID-19) patients and include headache, dizziness, myalgia, altered consciousness, impaired smell and taste, weakness, strokes, and seizures. Unfortunately, it is not yet fully understood which of these neurological problems are specific to COVID-19 and caused by comorbidities and/or complications observed in critically ill patients in general. What happens most often:
- Infection is a trigger for such chronic neurological disease as a myasthenic crisis, but there has been no reported increase in its incidence in COVID-19 patients. Patients with myasthenia gravis who develop COVID-19 are at risk of worsening the disease with certain medications.
- Encephalopathy (dystrophic damage to brain tissue) can develop in the background because the immune system cells of a person infected with coronavirus begin to release cytokines into the blood actively. In excess, these substances can damage the walls of blood vessels and cause hemorrhages in the brain, which leads to the development of specific neurological symptoms (depending on the affected section)
- Stroke has been associated with COVID-19 in about 1-3% of hospitalized patients, with a higher proportion in patients with more severe COVID-19. Several subtypes of a stroke may occur, including ischemic stroke, intracranial hemorrhage, and venous sinus thrombosis.
- Several cases of Guillain-Barré Syndrome (GBS) have been noticed in patients with coronavirus. This syndrome is a rare condition in which a person’s immune system attacks their peripheral nerves. Associated syndromes are also described.
Since chronic neurological diseases can worsen the prognosis of COVID-19, preventive measures are significant for these patients. An increased risk of contracting COVID-19 is predicted, as well as a higher mortality rate in patients with dementia and active epilepsy.
How should people with neurological diseases behave?
During the pandemic, outpatients with chronic neurological disorders are usually treated with telemedicine.
Patients with chronic neurological (such as epilepsy and migraines), who have had to seek emergency care in the event of a worsening, should have emergency treatment plans that can be applied at home if necessary. It is crucial to thoroughly follow all the recommendations for the underlying disease in a pandemic, even if you get sick with a coronavirus.
In general, with any chronic ailment, it is now crucial to monitor your condition and follow previously prescribed medical recommendations.
It is assumed that brain damage in COVID-19 in most cases occurs indirectly through a systemic inflammatory response, autoimmune processes, and endothelial dysfunction.