A new review of neurological symptoms of COVID-19

COVID-19 threatens the entire nervous system.


In less than six months, the Coronavirus has spread worldwide, infecting nearly 8 million people and killing over 433,000. Initially thought to be restricted to the respiratory system, scientists now have understood that the COVID-19 also involves multiple other organs, including the central and peripheral nervous system.

A new study by Northwestern Medicine reviewed neurological symptoms of COVID-19 patients. It reveals that the COVID-19 poses a global threat to the entire nervous system.

Nearly 50% of patients have neurological manifestations of COVID-19, such as headache, dizziness, decreased alertness, difficulty concentrating, disorders of smell and taste, seizures, strokes, weakness, and muscle pain. 

What’s more, scientists cautioned that the disease could affect the entire nervous system, including the brain, spinal cord, and nerves, as well as the muscles. There are many different ways COVID-19 can cause neurological dysfunction.

As the disease may affect multiple organs such as kidney, lungs, and heart, there is a possibility that the brain may also suffer from lack of oxygenation or from clotting disorders that may lead to ischemic or hemorrhagic strokes. 

Scientists also suggest that the virus may cause direct infection of the brain and meninges. Finally, the reaction of the immune system to the disease may cause inflammation that can damage the brain and nerves.

Lead author of the review, Dr. Igor Koralnik, Northwestern Medicine chief of neuro-infectious diseases and global neurology said, “It’s important for the general public and physicians to be aware of this, because a SARS-COV-2 infection may present with neurologic symptoms initially before any fever, cough or respiratory problems occur.”

“This understanding is key to direct appropriate clinical management and treatment.”

Koralnik and colleagues have formed a Neuro-COVID research team and started a retrospective analysis of all COVID-19 patients hospitalized at Northwestern Medicine to determine the frequency and type of neurological complications, as well as response to treatment.

Koralnik said“Since knowledge about the long term outcome of neurologic manifestations of COVID-19 is limited, I will follow some of those patients prospectively in my outpatient Neuro-COVID clinic to determine if neurological problems are temporary or permanent. These studies will provide the foundation on how to diagnose, manage, and treat the many neurologic manifestations of COVID-19.”

Journal Reference:
  1. Igor. J Koralnik M.D. et al. COVID ‐19: a global threat to the nervous system. DOI: 10.1002/ana.25807
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