Neurological Symptoms of COVID-19 May Appear
Before Fever or Cough: New Study
A Northwestern Medicine study published this week in Annals of Neurology reports that the COVID-19 disease poses a global threat to the entire nervous system, according to a new review of neurological symptoms of COVID-19 patients.
About half of hospitalized patients have neurological issues because of COVID-19, including dizziness, headache, difficulty concentrating, decreased alertness, muscle pain, weakness, strokes, seizures, and disorders of smell and taste.
A professor of neurology at Northwestern University Feinberg School of Medicine and the Northwestern Medicine chief of neuro-infectious diseases and global neurology, Dr. Igor Koralnik, the lead author of the review said, “SARS-COV-2 infection may present with neurologic symptoms initially, before respiratory problems or fever, cough occurs and it is thus important for the general public and physicians to be aware of this.”
The different neurological conditions that might occur in patients affected with COVID-19 and insights on how to diagnose them, as well as likely pathogenic mechanisms are described in the review.
Koralnik said, “This understanding is key to direct appropriate treatment and clinical management.”
The entire nervous system, including the brain, nerves, spinal cord, as well as the muscles, can be affected by the disease. COVID-19 can cause neurological dysfunction in many different ways. It might lead to ischemic or hemorrhagic strokes as the brain may also suffer from lack of oxygenation or from clotting disorders given that this disease may affect multiple organs (lung, kidney, heart). Additionally, direct infection of the brain and meninges can also be caused by the virus. Inflammation that can damage the brain and nerves can also be caused by the reaction of the immune system to the infection.
To determine the frequency and type of neurological complications, as well as response to treatment, a Neuro-COVID research team was formed by Koralnik and colleagues and they started a retrospective analysis of all COVID-19 patients hospitalized at Northwestern Medicine.
To determine if neurological problems are temporary or permanent, Koralnik also will follow some of those patients prospectively in his new outpatient Neuro-COVID clinic since the knowledge about the long term outcome of neurologic manifestations of COVID-19 is limited. He said that a foundation on how to treat, manage, and diagnose the many neurologic manifestations of COVID-19 will be provided by these studies.