Corona virus #COVID19: Is There Any Impact On Our Brain?

The world has been shaken by the novel corona virus COVID-19 pandemic. Epidemiological data confirms the respiratory disease burden to be the major phenotype of COVID-19. Moreover, elderly patients or folks with compromised immune status tend to be at higher risk of morbidity and mortality. This blog will discuss if there is any data suggesting neurological manifestations of COVID-19.

A Chinese retrospective study from Wuhan, currently in the preprint phase, analyzed 200+ patients with a confirmed diagnosis of COVID-19 treated January and February 2020. This report posted online on a preprint server (MedRxiv) has not been peer reviewed yet. Professor Hu and colleagues in Wuhan reported the following: The majority of patients with severe manifestation of COVID-19 were older than 50 years of age. Although acute ischemic or hemorrhagic stroke were extremely uncommon in non-severe COVID-19 patients, approximately 6% of the severe COVID-19 cases ended up having a cerebrovascular event. None of their patients had COVID-19 related seizures or new onset epilepsy. The most common neurological manifestations related with corona virus/COVID-19 were dizziness (15 to 20%), headaches (10 to 17%) and altered consciousness (found in 15% of the severe cases). Headache and dizziness was noted to be present in 10% to 15% of the non-severe patients. Due to the small sample size, most of these numbers shared here were not statistically significant per the study, except the altered consciousness (prevalence of 2% in non-severe cases and 15% in severe cases) and acute cerebrovascular accidents (prevalence of less than 1% in non severe patients and 5.7% in severe COVID-19 patients). The study also reports of muscle aches being more prevalent in severe cases, upto 1 in 5 severe COVID-19 cases had muscle breakdown in their lab work.

In the end, Professor Hu and his colleagues report something unique, relevant for clinicians managing COVID-19. Patients with neurological manifestations especially central nervous system like altered consciousness and stroke, had lower lymphocyte count in their CBC (blood work). This was especially noted in patients with severe neurological manifestations. This was probably due to immune consumption during an aggressive viral invasion in the body. This was a retrospective observational study with a relatively small sample size. More epidemiological studies in the next few months will give us more data on this topic.