Literature on the neurological manifestations of COVID-19 continues to emerge, as does the medical community’s started understanding of how COVID-19 impacts the course of underlying neurological conditions. Coronavirus threat to the entire nervous system, and neurological symptoms may appear before fever or cough. COVID-19 patients can experience a wide range of neurological complications, including stroke, meningoencephalitis, Guillain Barre Syndrome headache, dizziness, decreased alertness, difficulty concentrating, seizures, movement disorders, and cognitive impairment.

What is COVID 19?

Coronavirus disease 2019 (COVID-19), also known as the coronavirus, or COVID, is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 

The first known case was identified in Wuhan, China, in December 2019. The disease has since spread worldwide, leading to an ongoing pandemic. It is clear that many people with COVID-19 exhibit respiratory issues along with extrapulmonary symptoms like neurological involvement or mental health issues.

Although most people with COVID-19 have mild to moderate symptoms, the disease can cause severe medical complications and lead to death in some people. Older adults or people with existing medical conditions are at greater risk of becoming seriously ill with COVID-19.

Complications can include:

• Pneumonia and trouble breathing
• multi-organ failure
• cardiac problems
• A severe lung condition that causes a low amount of oxygen to go through your bloodstream to your organs (acute respiratory distress syndrome)
• Blood clots, thrombotic episode
• Acute kidney injury
• Additional viral and bacterial infections

Detail about the neurological problem in COVID patient

1. Strokes-: stroke has been seen as a manifestation of COVID-19 in various studies showing that 0.9% to 23% of COVID-19 patients developed stroke. It has two types of presentations:

• Stroke in severely affected COVID-19 patients who initially develop COVID-19 symptoms and later on develop stroke as a multiorgan involvement.
• Few studies have shown that some patients present with stroke as an initial manifestation and later on found to have COVID-19, these are young patients without risk factors for brain stroke.

2. Encephalitis – it’s another fatal neurological complication where the covid virus directly or through the bloodstream infect the brain tissue or meninges and lead to encephalitis 
3. Headache-: Headache is a common symptom in people infected with Covid, with a prevalence ranging between 13 percent and 74.6 percent. Past studies have also noted that headache usually happens early throughout the illness, and has been tied to a loss of smell and taste.

4. Dizziness -: Dizziness can be quite commonly experienced by people owing to multiple reasons- exhaustion, dehydration, drop in blood pressure levels, or as side-effects of certain medications experts also believe that any unusual spell of dizziness during the current pandemic timeline could also mean a sign of COVID-19.

The first two types of dizziness –
vertigo and lightheadedness – have been associated with COVID-19 infection. The virus that causes COVID-19 can bring on dizziness in a variety of ways, some of which are not yet fully understood. COVID-19 has hit humankind hard and fast, and still presents many unanswered questions to medical science.

5. Decreased alertness & concentration (Disorientation/ Confusion)-: occurs when a person is not fully awake, aware of, or able to respond normally to his or her external environment. Decreased alertness may also mean that a chronic illness has gotten worse. A sudden change in the mental state or level of consciousness may be caused by COVID.
   Read More: What Happens to Your Brain After COVID-19? Dr Navin Tiwari
6. Seizures-: Nearly 10 percent of COVID-19 patients who experienced cognitive symptoms and who were hospitalized during the early days of the pandemic experienced nonconvulsive seizures, many of these patients were found to have abnormalities in brain rhythms that don’t rise to the threshold of a seizure but are still indicative of a decline in brain function.
7. The covid virus seems to trigger the immune system and result in the involvement of peripheral nerves leading to Guillain Barre syndrome, clinically presenting as weakness of all four limbs, facial weakness.
8. Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness. This may be because of the involvement of basal ganglia due to stroke or encephalitis.

Conclusion-:

Apart from pulmonary involvement  COVID-19 can cause neurological manifestations including strokes, headache, dizziness, decreased alertness, difficulty concentrating, seizures, and alerted mental status. In patients who have new-onset seizures and altered mental status along with typical COVID-19 clinical symptoms testing for the SARS, COV-2 virus should be conducted.

Asian Neuro Centre is one of the leading and most experienced centre for the treatment of neurological disorder in Indore where the best & experienced neurologist skilled in various neurological disorder along with the latest and world-class neurodiagnostic facility is working to ensure quality care and successful recovery for their patient with compassion and honesty.

Rhinocerebral Mucormycosis “Black Fungus” causing Neurological complications in COVID patient

Dr. Navin Tiwari
Director and Consulting Neurologist
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