Neurological Complications

ChristieClinicDepartmentofNeurology

Physicians and other health care professionals have had to learn “ on the job” about the effects of this new virus, this includes neurologists. All over the world doctors have reported on the neurological effects of COVID-19. As it turns out, there are many neurological complications of COVID-19.

You may ask, “ what are neurological problems?” and “how does the virus SARS-COV2 cause them?” These are good questions. First, neurology is the study of diseases and treatment of the nervous system; the brain, spinal cord, nerve, muscle, and neuromuscular junction. Most people are familiar with themostcommoneffectsofCOVID-19, headache, fatigue, and muscle pain. Although these are most likely indirect effects of the virus, symptoms caused by the virus triggering inflammation in the body, they are still considered neurological symptoms. These symptoms typically are short-lived, just likeanyviralinfection,lastingdaysorat most a few weeks. But in some people, these symptoms persist for months, socalled “long COVID” . The cause and treatment of this is yet unknown.

Thenextmostcommonneurological effects of COVID-19 are the loss of the senses of taste and smell. These are also symptoms that can be seen in other viral syndromes. Here it is believed that the virus infects the lining of the airwayandmouth,anddisruptsnormal sensation. In the case of COVID-19, however, it is from here that the virus can be dangerous. In the nose and close to the front and bottom of the skull, it is believed that SARS-CoV-2 can directly pass through the skull and enter the brain. This can lead to devastating complications like stroke

In people over 60 years of age, it is reported that about one-third can experience confusion or even delirium with COVID-19. It also reported that about one out of fifty people over 65 with COVID-19 may suffer stroke. A stroke is when there is an interruption of blood flow to the brain. In the case of COVID-19, it is thought that stroke occurs because of abnormal clotting in the blood leading to blockages of one or even many arteries in the brain. It has been reported that there can be blood clotting in the veins of the brain as well. When stroke occurs there can be paralysis, loss of vision, inability to speak, loss of balance, seizures, or even death.Furtherreportsarethatmortality (the risk of death) in persons over 60 years with more than one neurological complication from COVID-19 was 2530%.

It also possible that SARS-CoV-2 can pass from the blood into brain or even travel along a nerve into the brain. This can lead to other neurological effects of COVID-19 such as the virus causing meningitis or encephalitis. These are infections in the covering of the brain and spinal fluid (meningitis) or the brain itself (encephalitis). With these problems come severe headache and neck pain, nausea, vomiting, clouding of thinking, coma, seizures, and death. SARS-CoV-2 can also attack one or many nerves, leading to pain, weakness, numbness, tingling.

The brain can also be injured if there are bodily complications from COVID-19 like breathing failure or failure of the other organs like the kidney or lung. Sometimes the brain can be severely injured if there is severe loss of oxygen for prolonged periods of time. This is called hypoxia, and unfortunately brain injury from this can be permanent.

Recovery from neurological complications from COVID-19 takes time, sometimes weeks or months. Thankfully, it seems we are currently in a quiet period in our struggle with the virus.Asourknowledgeandexperience with COVID-19 grows, we will be betterabletohelpourpatientswithand hopefully,therewillbenewtherapiesto prevent and treat COVID-19 infection.

Dr. Barry Jay Riskin sees patients at Christie Clinic in Bloomington on Empire, Suite A, 2502 E. Empire St.

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