Reflections on COVID-19: What We Know About the Neurologic Symptoms

As the calendar year concludes, NeurologyLive took the time to look back and reflect on how COVID-19, and the pandemic itself, has impacted clinical care across a range of different conditions and treatment strategies in 2020. This final segment of “Reflections on the Impact of COVID-19: A Short Expert Series,” covers the neurological symptoms associated with COVID-19 and their impact on patient quality of life.

Click here to check out the rest of the series!

Some of the common symptoms for a person infected with COVID-19 include respiratory issues, fever, cough, shortness of breath, and breathing difficulties. The loss of smell or taste are also notable signs of the virus, while more serious cases can cause pneumonia, severe acute respiratory syndrome, kidney failure, and death.

As researchers uncovered more about the virus and its pathology, they found that there are neurologic symptoms associated with infection as well. Headaches, both primary and secondary, were among the more commonly observed neurologic symptoms. Our discussion with Matthew Robbins, MD, in June covers the number of secondary headache disorders observed, including various types of cerebrovascular diseases such as cerebral venous thrombosis, cervical artery dissection, and post-irreversible encephalopathy.

Increased rates of stroke in patients with COVID-19 were also observed in comparison to the general natural history. Shadi Yaghi, MD, director of Clinical Vascular Research at NYU Langone Health, and colleagues conducted a study on the incidence of stroke and COVID-19 and the difficulties in understanding their relationship. He spoke with NeurologyLive in June as part of episode 11 of the Mind Moments podcast.

His coworker, Jennifer Frontera, MD, professor of neurology, NYU Langone Grossman School of Medicine, led another study which observed 606 of 4491 patients with COVID-19 hospitalized during the study timeframe developed a new neurologic disorder in a median of 2 days from COVID-19 symptom onset. Among those newly diagnosed, the most commonly observed neurologic disorders were toxic/metabolic encephalopathy, seizure, stroke, and hypoxic/ischemic stroke.

Similar results were found in the first study that evaluated children with COVID-19. Other symptoms such as headaches, brainstem, cerebellar signs, muscle weakness, and reduced reflexes were observed in this case-series study involving 27 children.

Guillain-Barré syndrome has been linked to the virus as well. A case-based report included an observation of 5 patients who reported with the syndrome but were unable to determine whether severe deficits and axonal involvement are typical features of COVID-19–associated Guillain-Barré syndrome.

While the neurologic symptoms associated with COVID-19 may have not been at the top of the list for civilians trying to determine if they have the virus, the presence of them garnered plenty of attention from within the neurology community. Click the links below to take a look at some of the other ways neurologic symptoms played a role as a result of COVID-19.