High incidence of neurological symptoms reported with COVID-19

An article originally published in The Conversation by Jeremy Rossman at the University of Kent discusses  how we are starting to observe an increase in the reports of neurological symptoms in up to a third of patients with COVID-19. You can read the original article here.

[H/T: Inverse]

In a great majority of cases of the virus, a respiratory infection with fever, aches, tiredness, sore throat, cough and finally, shortness of breath and respiratory distress in the more severe cases, was observed.

We now know COVID-19 can infect cells outside the respiratory tract thus causing a wide range of symptoms such as gastrointestinal disease (diarrhea and nausea),  heart damage and blood clotting disorders. We need to add neurological symptoms to this list, too.

Several recent studies have identified the presence of neurological symptoms in COVID-19 cases.

In some of these studies there are reports where symptoms are observed in individuals. There have been several reports where Covid-19 patients are suffering from Guillain–Barré syndrome, which is a neurological disorder whereby the immune system responds to an infection and ends up mistakenly attacking nerve cells, resulting in muscle weakness and eventually paralysis.

In several other case studies, severe COVID-19 encephalitis--brain inflammation and swelling--and stroke in healthy young people with otherwise mild Covid-19 symptoms.

Larger studies from Communist China and France have also investigated the prevalence of neurological disorders in Covid-19 patients. It was shown that 36 percent of patients have neurological symptoms and included mild symptoms such as headache or dizziness that might be caused by robust immune response.

But more specific and severe symptoms were also observed that include loss of smell or taste, muscle weakness, stroke, seizure, and hallucinations.

These symptoms are seen more often in severe cases, with estimates ranging from 46% to 84% of severe cases showing neurological symptoms. Changes in consciousness, such as disorientation, inattention, and movement disorders, were also seen in severe cases and found to persist after recovery.

This should scare people at least to the point of maintaining caution once they return to work or go out in public.

Crossing the blood-brain barrier — SARS-CoV-2, the coronavirus that causes COVID-19, may cause neurological disorders by directly infecting the brain or as a result of the strong activation of the immune system.

Recent studies have found the novel coronavirus in the brains of fatal cases of COVID-19. It has also been suggested that infection of olfactory neurons in the nose may enable the virus to spread from the respiratory tract to the brain.

Cells in the human brain express the ACE2 protein on their surface. ACE2 is a protein involved in blood pressure regulation and is the receptor the virus uses to enter and infect cells. ACE2 is also found on endothelial cells that line blood vessels. Infection of endothelial cells may allow the virus to pass from the respiratory tract to the blood and then across the blood-brain barrier into the brain. Once in the brain, replication of the virus may cause neurological disorders.

Respiratory viruses getting into the brain is thankfully a rare occurrence. But with millions of COVID-19 infections worldwide, there is the risk of significant neurological disease, especially in severe cases.

It is important to be aware of the possibility of neurological manifestations of COVID-19, both during acute illness as well as the possibility of long-term effects. This also highlights the continued importance of preventing viral transmission and identifying those who are and have been, infected.

Other coronaviruses have also been found to infect the brain and cause neurological disorders. The related seasonal coronavirus, HCoV-OC43, typically causes very mild respiratory symptoms but can also cause encephalitis in humans. Similarly, the coronavirus that causes Mers and the 2003 Sars virus can cause severe neurological disorders.

So keep wearing your mask, maintain physical distance from others outside your family at home, and always be aware of not touching your face.

 And continue washing your hands whenever you come home. Please stay safe.



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