Brain Dysfunction in COVID-19 Survivors

The Coronavirus disaster, caused by the new COVID severe strong respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in over 48 million confirmed cases and over 300,000 deaths as of May 19, 2020. Since the 1918 influenza pandemic, this is the biggest and most devastating pandemic.

Although this respiratory illness is the most prevalent and important health issue, reports of neurological symptoms are on the rise. These symptoms appear to be a mixture of non-specific consequences of systemic illness, the impact of direct viral infection, or para-infectious or post-infectious inflammation of the nervous system and vasculature.

Since the COVID-19 pandemic began in March 2020, there has been concern that survivors might be at an increased risk of neurological disorders. This concern, initially based on findings from other coronaviruses. Similar concerns have been raised regarding psychiatric consequences of COVID-19, with evidence showing that survivors are indeed at increased risk of mood and anxiety disorders in the 3 months after infection. 

However, neurology scientists need larger scale, robust, and longer-term data to accurately identify and quantify the consequences of the COVID-19 pandemic on brain health. Such information is required both to plan services and identify research priorities.

In April 2021, a 6-month research study was conducted of those who recovered from the coronavirus. They found case series and reviews reporting neurological and neuropsychiatric disorders during acute COVID-19 illness with proper evidence of existing one provided.  There were no violations of the proportional hazards assumption for most of the neurological outcomes. 

According to the research, literally every neurological disease, including different brain dysfunctions, increases its chances to appear and get worse after the patient recovers from the coronavirus. One of the base documents of their research was the electronic health records study of the psychiatric consequences in the 3 months after a COVID-19 finding. It was revealed that an increased risk for anxiety and mood disorders and dementia occurs after COVID-19 diagnosis, compared with a range of other health diseases; the study also reported the cause-effect relationship of each disorder.

What is the impact of Covid on the brain?

Mood and anxiety disorders were the most prevalent symptoms the researchers encountered out of 14 brain illnesses, followed by drug use disorders and insomnia. Neurological problems were more uncommon, with an ischemic stroke occurring in 2.1 percent of patients, dementia in 0.7 percent, and brain hemorrhage in 0.6 percent. Patients who were seriously unwell with COVID-19, especially those in critical care, were at the highest risk for mental health and neurological issues.

The researchers then compared the COVID-19 survivors to patients with influenza and other respiratory tract illnesses, finding that the COVID cohort had a much higher risk of neurological or mental disorders than the other two groups.

These facts, no doubt, are worthy of attention and an immediate response from neurology scientists all over the world to prevent the coronavirus from spreading any kinds of brain dysfunction and other diseases caused by it. It is a great disappointment to see the whole situation with neuropsychiatric illnesses that increased after the COVID.

How does Coronavirus influence the brain?

COVID-19’s effects on the brain are still a mystery to scientists. Inflammation is one possibility. Blood vessel damage was discovered in the brains of deceased COVID-19 patients in a recent research study done by the National Institutes of Health (NIH), which likely was caused by the body’s inflammatory reaction to the coronavirus. According to other studies, the virus may directly infect the brain and its cells. Even worse, it can be a combination of different factors. 

Given the anosmia in COVID-19, viral entrance to the brain via the olfactory bulb—the sole area of the CNS not covered by dura—is a probable pathway for SARS-CoV-2. The herpes simplex virus, the most prevalent cause of sporadic viral encephalitis, is thought to adopt this entrance pathway. 

Human coronavirus OC43 invades the CNS via the olfactory pathway in mice models after intranasal injection. Carried through the blood–brain barrier, after viraemia, or by infected leukocytes are all possible entrance sites.

SARS-CoV-2 binds to the angiotensin-converting enzyme 2 receptor in the brain vascular endothelium and smooth muscle for entering into cells. In vitro, SARS-CoV-2 replicates in neural cells.

The virus may cause damage to the CNS or PNS directly, or it may be caused by the body’s innate and adaptive immunological responses to infection. Unlike herpes simplex virus, several enteroviruses, and some arthropod-borne viruses, which can cause widespread neurodegeneration, there is little evidence that SARS-CoV-2 or similar coronaviruses are especially neurovirulent.

While the findings of the study are substantial, there is no reason for concern. You’re not doomed to suffer neurological or mental disorders just because you’ve had a coronavirus infection. Whether you begin to experience new or unexpected symptoms that continue or recur after using COVID-19, you should consult your personal physician to check if there is indeed something wrong. 

The study also serves as a warning to health care practitioners that COVID-19 should be on their radar as a likely contributor to catastrophic brain diseases like stroke.

Doctors anticipate an influx of patients with symptoms connected to the brain.

With the number of COVID-19 cases in the United States continuing to rise, Sara Manning Peskin, a neurologist at Penn Medicine who treats patients with post-COVID-19 brain fog, predicts that the health system will begin to see an “influx” of patients experiencing brain-related symptoms after COVID-19. 

Health services need to be organized and resourced to meet this expected need. Several hospitals and health systems have established clinics to assist those suffering from the long-term consequences of COVID-19, with some specializing in neurological disorders. The clinics are in high demand because people are having these experiences, and no one knows what to do.

The National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health has also developed a database to document all of the neurological symptoms and outcomes found in coronavirus patients across the United States.

There is no single remedy that has been found to prevent COVID-19-related brain problems to date. That’s why it’s critical to “stay attentive” and stick to tried-and-true prevention strategies like wearing a mask in public, keeping at least 6 feet away from others, washing your hands often, avoiding crowds and poorly ventilated rooms, and getting a vaccination if available. In terms of future steps, scientists concur that further study is needed to enhance the understanding of COVID-19 and the brain, particularly potential long-term consequences of coronavirus infection.

Conclusion

The extensive spectrum of CNS and PNS connections with COVID-19 is not surprising, given existing knowledge of other coronaviruses and respiratory viruses, and this is the subject of most recent findings. However, based on knowledge of prior epidemic viral infections and cases documented thus far, neurological illness is anticipated to be found more frequently in individuals who are SARS-CoV-2 positive but have few or no classic COVID-19 characteristics.