Neurological symptoms of COVID-19

Neurological imbalances or disorders maybe even earlier signs of the illness than flu-like symptoms. The known list of neurological symptoms of COVID-19 include:

• Headaches
• Dizziness
• Stroke
• Weakness
• Reduced alertness
• Muscle pain
• Loss of smell and taste (anosmia and ageusia)
• Seizures
• Difficulty concentrating

In "Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study", an article published on 25 June 2020, in The Lancet Psychiatry, UK-based researchers presented data on patients who had experienced the psychological symptoms of COVID-19—this data was collected sometime between 2 April and 26 April by three medical associations in the UK.

Of the 125 patients in the study,

• 62% had a cerebrovascular event. Of these:
  • 57 had an ischaemic stroke (when a blood clot blocks the supply of oxygen and blood to the brain)
  • Nine had an intracerebral haemorrhage (brain haemorrhage)
  • One had vasculitis of the central nervous system (swelling in the small blood vessels of the brain)
  • Most of these patients were older than 60 years.
• 31% of patients were reported to have an altered mental state. Of these,
  • Nine had unspecified encephalopathy (brain damage)
  • Seven had encephalitis (swelling in the brain)
  • 23 met the criteria for altered mental status. Ten of these 23 patients experienced "new-onset psychosis", six had dementia-like problems (neurocognitive syndrome), four had a mood disorder. Twenty-one of these were new diagnoses; meaning these patients did not have altered mental state before the onset of COVID-19.

While this study gathered its data from the UK, it is a dipstick of what doctors everywhere are reporting: moderate to severe COVID-19 may be accompanied by altered mental state and psychosis in patients.

Doctors are now also recommending that recovered patients get themselves tested for post-traumatic stress disorder or PTSD.

Read more: Complications of severe COVID-19 infection

According to research published in the Annal of Neurology, significant neurological complications were also caused by previous coronavirus outbreaks like SARS in 2003 and MERS in 2013, although they were extremely rare. However, the researchers added that the overall number of cases for both those outbreaks combined was significantly lower than the COVID-19 outbreak, which began in late 2019 and is still on the rise.

The researchers studied neurological symptoms displayed by patients admitted in hospitals in China and France and observed the development of various neurological conditions among patients who tested positive for COVID-19.

Neurological conditions associated with COVID-19

Symptoms of the following neurological conditions were observed among patients who had tested positive for COVID-19:

• Encephalopathy
• Encephalitis
• Viral Encephalitis
• Viral Meningitis
• Stroke
• Anosmia (loss of sense of smell)/Ageusia (loss of sense of taste)
• Acute disseminated encephalomyelitis (ADEM)
• Guillain-Barre syndrome
• Muscle injury

Authors of the study also pointed out that patients, as well as healthcare workers, must be aware that many of the neurological symptoms may present in patients before the onset of respiratory symptoms or fever or cough become visible.

While the research published in Annals has elaborated on the many neurological disorders appearing in COVID-19 patients upon hospitalisation, several other studies have also researched the link between the new coronavirus infection and the neurological problems it may cause—either over the short term or long term.

One of the reasons why neurological problems may begin to show among patients may be the lack of oxygen reaching the brain due to the infection being caused by the SARS-CoV-2 virus, which according to the researchers, maybe the reason for the occurrence of strokes among some patients. (Read more: What is hypoxemia?)

Another study published in The New England Journal of Medicine suggested that as many as 65% of COVID-19 patients had experienced delirium as a symptom, which may present as significant cognitive changes highlighted by the feeling of disorientation, hallucinations, irritability or other similar experiences that a patient may feel after a long stay in intensive care.

Symptoms involving the nervous system also include the feeling of anxiety or panic attacks that have also been reported among COVID-19 patients who were admitted in the hospital. Healthcare workers and authorities have also called for people to keep a pulse oximeter handy to be able to monitor their own oxygen saturation levels in the blood, as a significant drop, or a reading below 94, may require a patient to visit the emergency room.