Neurological complications of Covid-19

Covid-19 has been associated with the respiratory system mainly. Few could have imagined that it also affects the heart and brain, leading to a risk of long-term health problems. While most people with Covid-19 recover completely within a few weeks, some of them develop complications through the course of their disease.

What is Covid-19?

Covid-19 is an infectious disease that is caused by the SARS-CoV-2 virus. This virus is a coronavirus that usually results in mild to moderate upper respiratory tract illnesses. Symptoms include runny nose, fever, sore throat, cough, and a general feeling of being sick. Covid-19 becomes more dangerous when the virus spreads from your upper respiratory tract to the lungs and causes viral pneumonia.

What are the long-term neurological complications of Covid-19?

While the exact mechanism of how Covid-19 results in neurological complications is unknown, here is a list of long-term neurological complications of Covid-19.

Nerve damage

The peripheral nervous system connects your central nervous system (CNS) (brain and spinal cord) to all the other parts of your body. Covid- 19 impairs this network and cuts the signals from the CNS to the rest of the body. Nerve dysfunction may also occur in those who have critical illness due to Covid-19.

Stroke

Patients infected with COVID-19 are at high risk for developing stroke and acute cerebrovascular diseases. The risk is especially high in patients with severe symptoms of COVID-19 and underlying vascular disorders. The disease may possibly be due to cerebral thrombosis or spread of clot to the brain through circulation (thromboembolism).

Seizures

Higher risk of stroke in people with COVID-19 also predisposes them to the risk of seizures. Exact mechanism of seizures in COVID-19 patients is presently not known but scientists believe that the cytokine storm during the active phase causes seizures. Cytokine storm may damage the blood-brain barrier and allow the virus to enter the nervous system.

Encephalopathy

Encephalopathy may also occur in COVID-19 patients. There are several reasons for this condition. These are disturbed cerebral homeostasis, severe inflammation, direct invasion of virus, coagulation, and hyperactive immune system post-infection. Several studies have reported that encephalopathy increases the mortality and significant disability independent of severe respiratory symptoms.

Myelitis

Acute myelitis is a rare neurological condition. However, there is a sudden increase in the incidences of this condition. A study reported that most cases of acute myelitis occurred 10 days to 6 weeks after the infection indicating it as postinfection neurological complication. It possibly occurs due to the direct effect of the virus on the nervous system.

Optic neuritis

There are reports of optic neuritis in people with confirmed COVID-19. The virus, through the olfactory bulb, enters the brain and cause inflammation of the optic nerve. COVID-19-asscoaited optic neuritis has also been linked to myelin oligodendrocyte glycoprotein (MOG) antibody.

Guillain-Barre syndrome

Guillain-Barre syndrome is another neurological complication of COVID-19. Studies reported that the initial symptoms of this condition in COVID-19 patients were numbness and lower limb weakness. The gap between the onset of COVId-19 symptoms and the symptoms of Guillain-Barre syndrome was of around 5-10 days.

Fatigue

Fatigue after such a debilitating illness is quite common. Your fatigue will be like what you experience after many viral infections. You may feel fatigued mentally or physically, or both. Tasks like walking, cooking, or doing any daily activity can cause extreme tiredness and fatigue. You may suffer like this for weeks and months after Covid-19.

Cognitive impairment

You may develop confusion, delirium, depression, and a decreased level of consciousness, after dealing with Covid-19. If you have trouble concentrating along with memory problems, you are now dealing with ‘brain fog’.

Pain

Your muscles, joints, and chest continue to ache and pain. Even after recovering from the initial course of the virus, you may experience persistent muscle pain and chest pain.

-Dr. Pramod Krishnan (HOD and Consultant - Neurology, Manipal Hospital, Old Airport Road)