The Neurologic Effects of COVID-19

The rollout of COVID-19 vaccine programs across the country gives us hope as we continue to confront this pandemic. Yet across the nation and around the world, one in three people who survived COVID-19 has reported disturbing symptoms: effects on the nervous system, some of which continue to linger and impair quality of life. For some people diagnosed with COVID-19, these effects were minor and limited to distortions or loss of taste and smell. For others, they were much greater: extreme fatigue, dizziness, cognitive impairment described as “brain fog,” lightheadedness, and headaches. Patients who were hospitalized with severe COVID-19 are more likely to have experienced confusion and delirium.

Others have had strokes due to coronavirus-related blood clots, or seizure. Some survivors report increased or new onset depression and anxiety. Some patients develop psychotic symptoms. For some survivors, persistent neurologic symptoms make it impossible to return to their previous level of activity. Others cannot return to work.

Florian Thomas, MD, PhD, chair of the Neuroscience Institute and the Department of Neurology at Hackensack University Medical Center and Hackensack Meridian School of Medicine, is not surprised. "Neurologic symptoms are not unique to the COVID-19 virus. It is not unusual to see neurological manifestations in people who have been hospitalized for a severe illness," he noted. "When there is a lot of inflammation in the body, which can happen with COVID-19, we witness neurologic manifestations."

Moreover, the tendency of neurologic symptoms to persist long after patients have left the hospital has been recognized. Patients who were very ill while in the hospital, particularly those who are elderly, are at particular risk for cognitive problems. Fatigue and cognitive decline have been reported years after hospital discharge in people who experienced delirium while in the hospital.

Hackensack University Medical Center investigators are participating in several studies that seek answers about the impact of COVID on the nervous system. Of interest to the researchers is what makes patients more likely to experience neurologic symptoms and which types they may develop. Those with risk factors such as older age and obesity, which predispose them to severe COVID-19 if they contract the infection, are more likely to experience delirium and confusion if they have a lengthy hospital stay. They are also interested in the impact of the COVID pandemic when patients with other neurologic conditions such as Parkinson’s are admitted to the hospital.

"We've learned a lot about COVID-19 over the last year, and the care we provide for people with the virus is much better now, since we have become more knowledgeable about what works best," Thomas added. "Hopefully the frequency of neurologic symptoms will diminish as well."

He asserted that everyone should continue taking steps to minimize their risk of contracting the virus, including getting vaccinated when eligible and continuing to mask, physically distance, practice hand hygiene, and achieve and maintain a healthy weight. He emphasized that anyone experiencing new neurologic symptoms should get to a hospital right away. "This is not the time to delay your health care. If something changes neurologically, come to the hospital," Thomas urged. "It may save your brain and save your life."

Source: Hackensack Meridian Health

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