Neurological symptoms of corona virus cannot be taken lightly

March 24, 2020

New Delhi: As the world in throes of deadly Corona virus struggles to keep control on the rising number of fatalities and rapid spread of the virus among large masses all over the globe, some reports suggest that respiratory distress may not be the only characteristic symptom for Corona virus – one cannot rule out the neurological manifestations.

According to Neurology Today, the official news source of American Academy of Neurology, while understanding of the corona virus is still unfolding, there are hints that it might have a neurologic component in some instances as well.

A University of Colorado School of Medicine’s doctor it says has stated that a report from three COVID-19-designated hospitals in Wuhan, China, indicated that more than one-third of corona virus patients had some type of neurologic symptom, including altered consciousness, evidence of skeletal muscle damage, and acute cerebro-vascular- disease.
The symptoms were found in more severe cases .

It made sense that COVID-19 would have neurologic manifestations because other coronaviruses that affect humans can invade the central nervous system.

“We should be vigilant to see if that occur (with COVID-19) as more cases and experience accumulate,” he said.
Some patients with COVID-19 in Wuhan also showed neurologic signs, such as headache, nausea, and vomiting impaired consciousness, ataxia, acute cerebro-vascular disease, and epilepsy,neuralgia, skeletal mascular systems leading to a belief that this virus may have also been able to invade the nervous system like SARS-CoV and MERS-CoV.

With 358,831 cases and 14,433 deaths worldwide this is perhaps one of the worst pandemics being faced in recent history.

Dr Gagandeep Singh Secretatry Indian Academy of Neurology however says that there is still not much evidence regarding the neurological affect of COVID 19 virus , however those people with a history of stroke need to be extra careful and guard themselves against COVID -19 virus like other persons with pre existing conditions like diabetes or cardio vascular diseases.

He said those with stroke, mostly the elderly, are are at the highest risk once they get infected and therefore must try their best to avoid getting infected.

According to Dr Ava Easton, the Chief Executive of the Encephalitis Society, viruses like COVID 19 can cause encephalitis (inflammation of the brain).

The symptoms of encephalitis are high fever, headache, sensitivity to light, stiff neck and back, vomiting, confusion and, in severe cases, seizures, paralysis and coma.

The Encephalitis Society in a statement says that there are early reports emerging of a possible association between COVID-19 and central nervous system damage and reports of a 56-year-old male in China who developed COVID-19 and the virus was found in his cerebrospinal fluid (CSF). The patient recovered and was discharged from hospital.

“We understand this may be a cause for concern among encephalitis survivors and their families. There are very few reports of central nervous system involvement in COVID-19 and, if confirmed, this appears to be a very rare complication of infection. We don’t know how this infection will develop but it appears that the likelihood of getting encephalitis from COVID-19 is very small.”

However people with immune system compromised or taking medicines to suppress immune system must be more vigilant, she added.

There is a report of a 74-year-old patient who traveled from Europe to the United States and presented with encephalopathy (brain damage leading to altered mental state) and COVID-19.

Interestingly since elderly patients with chronic medical conditions or acute infection are likely to reach hospital in an altered mental state similar to a COVID-19 patient with acute encephalopathy. Therefore doctors must recognize encephalopathy a neurological condition also as a presenting sign for COVID -19 as they do for the condition of respiratory distress, or else many COVID -19 patients may be discharged without treatment.

People with neurologic conditions such as multiple sclerosis (MS), Parkinson’s disease, Alzheimer’s disease, gravis, could also be at high risk .