Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an unprecedented health crisis worldwide. Besides numerous viral symptoms like fatigue, fever, dry cough, and pneumonia among patients, but it has also caused neurological issues among those with acute symptoms. Several clinical studies have discovered that unusual symptoms like brain fog, anosmia, dysgeusia, headaches, nausea, and brain infarction persist in long haulers during and post COVID-19 recovery.
So how do these neurological issues occur and what can be done to treat them? In this article, we shall explore the answers.
Expert understanding of COVID-19 as well as post-COVID19 syndrome continues to evolve as scientists conduct more research on the virus and its variants. Present evidence shows that neurological complications have been found in over 80% of COVID19 long haulers who were hospitalized. Brain fog, dizziness, encephalopathy, headaches, and myalgias occur in 33% of patients in Europe, China, and the US. Other symptoms like anosmia and dysgeusia are reportedly less common.
In addition, problems with abnormal movement, stroke, seizures, ataxia, motor and sensory deficits were also found to be less prevalent. Those who are critically ill are more vulnerable to neurological disorders than patients having less severe COVID-19 symptoms. Social distancing protocol and a rise in vaccination have mitigated risks to an extent. However, long haulers continue to report the occurrence of symptoms such as headaches, numbness, and cognitive dysfunction.
There are many reasons why symptoms occur in long haulers. There could be an ongoing inflammatory response with increased inflammatory markers. Other mental health issues could arise from fatigue, grief and loss. More studies are being conducted to determine these causes.
The following are some of the most common neurological consequences observed in patients diagnosed with COVID-19:
Encephalopathy, a brain disease that causes seizures and memory loss, was found in 55% of the population in a study of 2,088 critically ill COVID patients. Another study on 509 patients hospitalized with COVID, nearly 32% had encephalopathy. Those affected were found to be male, older, and more likely to have contributing risk factors such as cancer, diabetes, heart failure, chronic kidney disease, hypertension or smoking. Other risk factors for encephalopathy include vision impairment, a history of a stroke or Parkinson's disease, and previously active use of medication.
Olfactory disorder was reported in more than 48% of 27,000 patients hospitalized with COVID in one study. However, it was found to have cured post recovery. A survey of non-hospitalized COVID patients having olfactory disorder in Italy revealed that almost 83% recovered fully from the disorder a little more than a month later. Other patients reportedly recovered over a span of four to eight months.
Although the causal association between COVID-19 and the Guillain-Barre syndrome (GBS) has not exactly been established, rare cases of this syndrome were reported among 1200 hospitalized COVID patients. In this disease, the immune system mistakenly attacks the central nervous system and causes weakness in the legs, visual impairment, fluctuations in blood pressure, rapid heart rate, breathing difficulties, etc. Several long haulers showed symptoms like limb weakness and facial palsy, which progressed more rapidly and severely than was usual for GBS.
In a minor number of cases, stroke was the initial symptom that led to the hospitalization of COVID patients about one to three weeks after the onset of other symptoms. However, ischemic stroke has been less frequently observed in these patients. Even less is the proportion of patients who had hemorrhaged. Another disease, cerebral venous thrombosis (CVT), was found in 8.8 out of 10,000 cases. Cerebrovascular diseases were typically observed in older patients hospitalized with COVID-19 compared to younger patients with COVID or older people without COVID-19.
Several factors exacerbated the risk of stroke in patients. Those with hypertension, atrial fibrillation, and other prior cardiac diseases were more likely to have a stroke. Also, patients with blockage in their blood vessels were at risk of cryptogenic stroke. This was more likely to affect younger patients having risk factors.
Muscle injury, or myalgia, was commonly reported in patients having COVID-19. Fatigue and issues with breathing caused inflammation of muscles which made it difficult for these patients to move their bodies. Many peripheral nerve diseases were also found in patients with COVID-19. These include facial nerve palsy, neuralgic amyotrophy, ocular motor neuropathy, and lower cranial neuropathy.
Other rare neurological consequences of COVID-19 include meningoencephalitis, which was discovered in younger patients who showed symptoms like fatigue, brain fog, headaches, regular seizures, and transformation in mental status.
Autonomic nervous system symptoms also persist among COVID-19 survivors. It can present with lightheadedness, dizziness and fluctuation of blood pressure.
There is no permanent cure for the above neurological illnesses. However, having the right treatment plan can help long haulers with managing symptoms and providing relief from pain.
The first suggestion would be to get vaccinated against COVID-19. Many of the older patients with serious symptoms were found to be unvaccinated, which contributed greatly to the worsening of symptoms. The effectiveness of vaccination may be enhanced in patients whose immune systems were compromised. This can be achieved in the form of immunosuppressive therapy.
Healthcare systems can be effectively utilized to manage symptoms of serious neural disorders. Those experiencing seizures ought to seek treatment immediately. Treatments are usually available in the form of medicines (anti-epileptic drugs), a ketogenic diet, etc.
You can also seek advice in person from a neurologist regarding mechanisms and treatment plans for recovering from neurological disorders post COVID-19.
Although there is no specific treatment for post-COVID19 syndrome but some medical modalities including HBOT (hyperbaric therapy) are being investigated. Chicago Neurological Services provides traditional neurological services and treatment options, as well as providing some alternative approach to some neurological disorders including those who suffer from post-COVID19 syndrome.