COVID-19 Is Not Just a Respiratory Illness
The neurological affects of this novel coronavirus are being uncovered.
Posted May 16, 2020
At the time I’m publishing this post there have been over 4.5 million confirmed cases of COVID-19 and over 300,000 COVID-19-related deaths worldwide. The virus that causes COVID-19, SARS-CoV-2, is similar to the coronaviruses that wreaked havoc before it—for example the original SARS (SARS-CoV) that caused an outbreak back in 2002 and 2003, and the MERS (MERS-CoV) coronavirus, which was first reported back in 2012. Unfortunately, this novel coronavirus is far more contagious—contagious enough to cause a pandemic.
As SARS-CoV-2 has spread across the globe, researchers are learning that it manifests itself in ways reaching beyond flu-like symptoms and respiratory distress.
Last month scientists based in Wuhan, China—where the outbreak began—were the first to report neurological symptoms in COVID-19 patients. The research team collected data from three COVID-19 care centers in a hospital in Wuhan. All of the data came from 214 hospitalized patients who, from mid-January to mid-February, had an active SARS-CoV-2 infection. The team found that 36.4% of these patients showed neurological symptoms, and that those symptoms were even more common in severe COVID cases.
“Neurological symptoms” covers a range of possibilities all over the body—from less-serious to fatal. Symptoms were assigned to one of three categories: central nervous system, peripheral nervous system, and skeletal muscular injury.
Central nervous system manifestations included more minor symptoms like dizziness and headache, all the way up to impaired consciousness, seizures, and ataxia—a condition involving slurred speech and serious lack of coordination. Ataxia is brought on by damage to the cerebellum, a region in the back of the brain that regulates muscular activity. Peripheral nervous system manifestations included taste impairment, smell impairment, vision impairment, and nerve pain. Skeletal muscle injury was diagnosed based on muscle pain and elevated levels of creatine kinase—a protein released into a person’s blood when their muscles are injured.
Of the 214 hospitalized patients, 87 were men and 127 were women, and the average age was 52.7 years. One hundred and twenty-six patients were designated as having non-severe infections, based on respiratory status. The rest of the patients were considered to have severe infections. Although a total of 78 patients (36.4%) showed neurological manifestations, the patients with severe infections were most affected, showing an increase in acute cerebrovascular diseases (5:1), impaired consciousness (13:3), and skeletal muscle injury (17:6). It's important to note that patients with severe infections also tended to be older and have underlying conditions, including hypertension, although they showed fewer “typical” COVID-19 symptoms, like fever and cough.
Although this was just one study including only a couple hundred patients, it could inform ongoing research and help doctors re-evaluate their expectations for what a COVID-19-positive case looks like. If I've learned anything over the last couple of months, it's that the scientific community is more collaborative than ever, and that every bit of research done to better understand this virus is valued because there's no knowing what it might lead to.