SARS-CoV-2 virus image source

Read our specific page about Post-COVID syndrome / Long-COVID syndrome that is associated with long-term complaints via this link.

 

A publication in Neurology November 16, 2021 confirms that there are specific neurological complications associated with COVID-19 infection.
Some of the people hospitalized with COVID-19 had a CVA (stroke) due to thrombosis (clots), and there are patients who have hypercoagulability (clotting disorders) during the acute phase.
There are people who develop microvascular disease, specifically microhemorrhages throughout the brain at the boundary between the gray matter and the white matter.

 

All over the world there are people who have serious neurological complaints or brain damage from an infection with Covid-19. Not all people with Covid-19 have these long-term symptoms, but they can occur. Most of these symptoms are neurological in nature.

 

These manifestations are of different phenotypes with overlapping syndromes.

• Predominantly exercise intolerance.
• Cognitive and mood disorders.
• Some of the patients have acute anxiety or early onset psychosis.
• There are others who have dysautonomia (blood pressure or heart rate problems and feeling unwell) and some have classic POTS as a syndrome. (postoral orthostatic tachycardia syndrome = extreme increase in heart rate when standing or sitting up.)
• Then there is a fourth group whose symptoms resemble fibromyalgia and other pain syndromes.
• Finally there is a smaller group of individuals who suffer from hearing loss, tinnitus (ringing in the ears) and vestibular disorders (balance problems).

 

A study from Wuhan showed that 36.4% of patients admitted to a hospital had neurological complaints.

There are also people who only entered the hospital with neurological complaints and were found to have Covid-19 without typical Covid-19 complaints.

Dutch researchers have discovered that Corona can cause the immune system in the brain to 'run wild'. Research by autopsy on the brains of deceased people showed more brain macrophages in the brains of people suffering from Covid-19 than in healthy brains.

Brain macrophages are primary immune cells of the central nervous system and continuously monitor whether an infection is in progress.

The brain magrophages of the examined brains looked like a lot of brown specks under the microscope. The large number of brain macrophages shows that the immune system was running wild.

A researcher stated that corona can affect every function in the brain: sensory functions, movements, feeling, memory and concentration.

 

Neurological syndromes as a complication of Covid-19

• COVID-19 encephalopathy.
  There are studies on forms of encephalopathy that can be directly linked to having COVID-19. We will post information on this site as soon as more is known. Preliminary information: https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.855868/full
• Cerebral infarction: Blood clots that end up in the lungs or the brain. They cause a cerebral infarction in the brain. They cause a pulmonary embolism in the lungs. Covid-19 causes blood clots in many people.
• Brain hemorrhage: The patient is treated with anticoagulants against the blood clots caused by Covid-19, but this can in some cases cause a brain hemorrhage.
• Viral encephalitis: inflammation of the brain caused by a virus. https://www.nationalgeographic.com/science/article/how-does-covid-19-affect-the-brain-a-troubling-picture-emerges
• Viral encephalopathy: A rare complication of the flu (influenza) and other viral infections (such as the coronavirus) is acute necrotizing encephalopathy. Necrotizing means that brain cells die. Encephalopathy means reduced brain function.
• White matter abnormalities (WMA) in subcortical frontal (frontal lobe) and parietal lobes. See research link
• Post anoxic encephalopathy (hypoxic-ischemic brain injury): Due to lack of oxygen, the brain works less well.
• Possibly (this connection is suspected and investigated) Alzheimer's and Parkinson's disease, which became apparent after infection with the SARS virus in 2003. The MERS virus (MERS-CoV) caused brain inflammation and autoimmune diseases. Covid-19 produces a strong response from the immune system. This causes the body to produce cytokines (cytokine rush), which causes inflammation

 

Neurological and Neuropsychological Consequences After Corona / Covid-19 Infection

• Neurofatigue, brain fatigue
• Cognitive complaints, brain fog, difficulty thinking, difficulty remembering (forgetfulness), difficulty multitasking, etc.
• Sensory overstimulation
• Speech problems, aphasia, word finding problems
• Reduced smell and taste / loss of smell and taste (anosmia)
• Head ache
• Other visible and invisible consequences of brain injury
• Guillain-Barré complaints (Guillain-Barré syndrome is a neurological condition in which the immune system reacts to an infection and accidentally attacks nerve cells, resulting in muscle weakness and ultimately paralysis)
• Post Intensive Care syndrome after admission to ICU
• Delirium
• A study conducted in the spring of 2023 showed a striking hypoperfusion (poor blood flow) in a widespread cerebral network in the group of people with post-COVID-19, mainly in the frontal cortex, as well as the parietal lobe cortex and the temporal lobe cortex. The hypoperfusion areas identified in the RIGHT HEMISPHERE regions were more extensive.
  These findings support the hypothesis of a large network dysfunction in post-COVID patients with cognitive complaints.

 

Neurological complaints during hospitalization (NON-typical Covid-19 complaints)

People have been admitted to hospitals worldwide without specific Covid-19 complaints such as coughing or fever, but they did have typical neurological complaints.

1. Headache, dizziness, impaired consciousness, ataxia, acute stroke / CVA and epilepsy
   
2. Impaired ability to taste things (hypogeusia), impaired ability to smell and detect odors (hyposmia) and neuropathic pain (neuralgia)
3. Skeletal muscle symptoms.

 

When these patients were tested, they were found to have Covid-19.
In rare cases, the cornavirus appears to be able to enter the brain directly, says Dr. Elissa Fory, a neurologist with Henry Ford Health System.

Observed symptoms

• Disturbances of consciousness / changes in consciousness ranging from drowsiness to coma
• Confusion
• Delier
• Hallucinations
  
• Headache
• Difficulty speaking
• Dizziness
• Ataxia (disturbance in the coordination of movements)
• Encephalopathy symptoms
• Encephalitis (brain inflammation)
• Epileptic activity ranging from mild absence, making repetitive non-intentional movements or a mental status change where people are not themselves, to more severe seizures.

 

Neurologists in Wuhan, China, where the Covid-19 outbreak began, were the first to report the symptoms in a preliminary article published online.
A study showed that 36.4% of the patients admitted there had neurological complaints (acute stroke / cerebrovascular disorders, reduced consciousness and muscle damage).

Since that report, specialists have observed similar symptoms in Germany, France, Austria, Italy, and the Netherlands, as well as in the United States. Including in patients under 60 years of age.

More information can be found here.

 

Four elderly patients who came to Danbury Hospital in Connecticut with an encephalopathy tested positive for Covid-19, although they had no other symptoms. Two of the four developed a mild fever and needed oxygen, but two of them did not.

 

"The way the coronavirus evolved rapidly over days is consistent with viral encephalitis," said Dr. Elissa Fory, a neurologist with Henry Ford Health System to the New York Times.
Some studies report that more than a third of patients show neurological symptoms.

 

SARS-CoV-2, the coronavirus that causes COVID-19, can cause neurological disorders due to direct infection of the brain or due to the strong activation of the immune system. The virus can break the blood brain barrier.

ACE2 is a protein involved in the regulation of blood pressure. It is the receptor that the virus uses to enter and infect cells.
ACE2 can be found on the inner wall (endothelial cells) of the blood vessels. The human brain cells have the ACE2 protein on the surface. Endothelial cell infection can pass the virus from the respiratory tract to the blood and then across the blood-brain barrier to the brain.

Once in the brain, multiplication of the virus can cause neurological disturbances.

Recent studies have found the coronavirus in the brains of people who died of COVID-19.
It has also been suggested that contamination of olfactory neurons in the nose may allow the virus to spread from the airways to the brain.

 

PICS

In addition to cognitive complaints due to brain damage, complaints may also have arisen due to Post intensive care syndrome (PICS). New or worsened complaints that arise as a result of a critical illness and intensive care treatment.

• Physical complaints (fatigue, acquired muscle weakness, difficulty swallowing, loss of condition, shortness of breath)
  
• Cognitive complaints
• Psychological problems (anxiety, PTSD, depression)
• Stimulus sensitivity

Partners, relatives and other loved ones can also develop PICS, called Post Intensive Care Syndrome Family, or PICS-F.
Read more.

 

Check

In case you are unsure whether you have a brain injury or cognitive complaints from the corona infection, you can fill in our ABI checklist. ABI (Aquired Brain Injury) means Non-Congenital Brain Injury, brain damage that has been incurred later in life.

 

Research on long-term (neurological or brain damage) complaints after having Covid-19

 

Langdurige klachten na ongecompliceerde Covid-19, Nederlands Tijdschrift voor Geneeskunde.

Van den Borst, B. e.a., Comprehensive health assessment three months after recovery from acute COVID-19:, Clinical Infectious Diseases (21 november 2020), ciaa1750, DOI

Morris. S.B. e.a., Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020, Morb Mortal Wkly Rep 2020;69: 1450–1456. DOI

Woodruff, M.C. e.a., Clinically identifiable autoreactivity is common in severe SARS-CoV-2 Infection, medRxiv 2020.10.21.20216192; DOI

Oudkerk, M. e.a., Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands, Radiology 2020 297:1, E216-E222, DOI

 

https://www.practiceupdate.com/C/126949/56?elsca1=emc_enews_topic-alert

Avindra Nath MD Published in Neurology

Nierfalen of verminderde nierfunctie door COVID-19

https://www.reuters.com/business/healthcare-pharmaceuticals/covid-raises-risk-long-term-brain-injury-large-us-study-finds-2022-09-22/

https://www.frontiersin.org/articles/10.3389/fnins.2022.855868/full

 

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