SARS-CoV-2 mainly affects the respiratory system, but many research studies have shown neurological involvement.
“Emerging research potentially links COVID-19 to increased incidences of intracerebral haemorrhage, ischemic stroke, encephalomyelitis, encephalopathy, seizures (epilepsy) and neuromuscular diseases.”
A majority of experts say that increasing cases of such neurological manifestations pose a severe challenge for the management of these conditions in affected patients.
The most common Emerging neurological complications of COVID-19
So far, anosmia – The absence of the sense of smell (as caused by damage to olfactory nasal tissue or the olfactory nerve or by obstruction of the nasal passages) – is a common finding.
It is followed by hypogeusia (a reduction of the sense of taste) ageusia (complete loss of taste), dizziness, fatigue, muscular weakness and headache – these remained the other common neurological complications.
Hyposmia (Lessened sensitivity to odours) and anosmia are the most common conditions. Myalgia and fatigue are the other common neurological manifestations.
Emerging Neurological Complications
However, cerebrovascular diseases, encephalopathy and encephalitis are also emerging as common neurological complications. Furthermore, seizures, demyelinating disorders, neurodegenerative disorders, Guillian-Barre syndrome, neuromuscular junctions’ disorders have also been reported as some of the emerging complications of COVID-19.
The Rapidly Emerging Neurological complications of COVID-19
Stroke is an Emerging Complication: Stroke and encephalopathy account for the majority of the COVID-19 associated complications followed by less frequent Guillain Barre syndrome and encephalitis. Guillain-Barre’ syndrome can occur within the first few days of infection (acute phase). The overall risk of stroke is relatively high in COVID-19 patients. Ischemic stroke and rarely intracerebral haemorrhage (ICH) are the potential risks in critically ill patients report several studies.
Epileptic seizures are on the Rise
Acute symptomatic seizures (epileptic seizures) are being reported within 7 days of acute brain injury. Acute symptomatic seizures could be due to meningoencephalitis and secondary CNS damage and may also indicate primary CNS involvement.
Neurological Involvement Could Become Widespread and Pose Huge Challenges
In almost 50% of patients with COVID-19 fatigue, myalgia and muscle pain are the most common initial neurological symptoms. As the number of infected persons increases throughout the world, the neurological disease could become widespread with potential complications.
There is a Huge Risk of Long-term Disability
COVID-19 infection can lead to both acute and long-term neurological complications. complex neurological manifestations can be due to both direct neuroinvasion or indirect involvement.
Whether it is a direct involvement of the COVID-19 virus or indirect, neurological complications – such as stroke and encephalitis can cause life-long disability with the requirement of long-term care and economic burden.
The need of the hour is to aggressively monitor patients with COVID-19 for neurological involvement in the acute phase itself and continue to do so on a long-term basis to minimize future risks of stroke, paralysis and neurodegenerative disorders.
The challenge and the matter of huge importance for intensive care medicine are these neurological manifestations – encephalopathy, meningo-encephalopathy, haemorrhagic or ischemic strokes and rapidly progressing polyneuropathies. Therefore, the knowledge of neurological involvement may help in planning and strategizing supportive intensive care therapy.
Dr. Vikram Sharma