An Overview of Recent Studies on Neurological Effects of Covid-19 Virus

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Introduction

In this post, my goal is to create awareness of the progressing research in the scientific and therapeutic fields related to the neurological effects of the Covid-19 virus. I provide links to studies published in scientific journals.

Prior research before the Covid-19 pandemic has exhibited inflammatory effects of severe viral infections in the brain. Thus, scientists currently leverage this knowledge by reviewing the established literature and conducting new studies for the current situation.

From my preliminary investigation of the topic, very little data about Covid-19 related to neurological effects is available. Only reported cases in the form of anecdotal evidence make most of the available information — a potential resource to initiate studies.

In addition, current views also contradict each other. While some believe the virus might directly impact nerves, others think that it indirectly affects the nerves. For example, Dr Allen Aksamit, a Mayo Clinic neurologist, discusses the potential neurological effects of Covid-19 in this interview, believing the case for an indirect effect.

Some hypotheses are being developed based on prior knowledge. However, many unknowns require comprehensive and collective investigation. Nevertheless, it is inspiring and promising to see new research studies planned or progressing with secured funds. These new initiatives focus on the role of immune and autoimmune reactions that some patients experience after their initial recovery.

In addition to medical literature, I also follow the progress in the press. For example, Chief Investigator Professor Craig Anderson mentions that “Covid-19 puts patients at high risk of strokes from intense inflammation in the body and being critically ill. However, the virus may disrupt neural pathways in more subtle ways from direct invasion of the brain.” A government-funded study will test the anti-inflammatory effects of statin that can maintain memory and other cognitive capabilities after Covid-19 infection.

According to the National Institute of Neurological Disorders and Stroke, so far, research indicates many neurological symptoms of Covid-19, which are likely a result of the body’s overall immune response to infection rather than the virus directly infects the brain or nervous system.

NIH documented some anecdotal reports of neurological conditions that may be triggered by the immune system response to the Covid-19 virus. For example, the report mentioned dysautonomia, transverse myelitis, encephalomyelitis, facial nerve palsies, multi-system inflammatory syndrome, and Parkinson’s disease-like symptoms.

Even though we have very little data on the current situation, experts link prior knowledge of the brain’s inflammatory effects of severe viral infections. Here is a condensed review of literature from my recent readings.

Recent Studies on Neurological Effects of Covid-19

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This section provides indications on neurological effects of the Covid-19 virus from several scientific papers and medical articles that I recently reviewed from reliable sources in the medical field.

According to this paper, “increasing evidence suggests that infection with Sars-CoV-2 causes neurological deficits in a substantial proportion of affected patients. While these symptoms arise acutely during the course of infection, less is known about the possible long-term consequences for the brain.”

This news article from The Georgia Institute points out that:

“Neurological complications have emerged as a significant cause of ongoing ill health in the ongoing Covid-19 pandemic. Many of those affected complain of various symptoms such as brain fog, dizziness, headaches, insomnia and fatigue. They may also be at increased risk of long-term complications, such as stroke and memory impairment.”

In this cohort study of 3,744 patients in two large consortia published in JAMA:

“Neurological manifestations were found in approximately 80% of patients hospitalized with Covid-19. The most common self-reported symptoms included headache and anosmia or ageusia. The most common neurological signs and/or syndromes were acute encephalopathy, coma, and stroke. Presence of clinically captured neurologic signs and/or syndromes was associated with increased risk of in-hospital death.”

Another cohort study followed 13,001 adults in Norway in May 2021. Six hundred fifty-one participants with the Covid-19 positive group reported problems concentrating. Two hundred sixty-seven participants in the positive group reported memory problems, worsening of health, such as feeling depressed, having less energy, or pain.

A study observing 214 patients identified neurologic symptoms in 36.4% of Covid-19 patients and found it more common in 45.5% of patients with severe infection according to their respiratory status. They included acute cerebrovascular events, impaired consciousness, and muscle injury.

This study investigated an association between cross-sectional cognitive performance data from 81,337 participants between January and December 2020. People who had recovered from Covid, including those no longer reporting symptoms, exhibited significant cognitive deficits versus controls. Finer grained analysis of performance across sub-tests supported the hypothesis that Covid-19 has a multi-domain impact on human cognition.

This article on Neurology reported two cases highlighting the rare occurrence of Miller Fisher syndrome and polyneuritis cranialis during the Covid-19 pandemic. According to the article, these neurologic manifestations may occur because of an aberrant immune response to Covid-19; however, the full clinical spectrum of neurologic symptoms in patients with Covid-19 remains to be characterized.

This article in the New England Journal of Medicine reported:

“five cases of large-vessel stroke in patients younger than 50 years of age who presented to the health system in New York City. These five patients were diagnosed with Covid-19 infection.”

According to this paper:

“CoVs are neuro-invasive causing additional inflammation and neuro-degeneration.” It confirms that the long-term consequences of SARS-CoV-2 neuro infections are unknown. The document discusses potential chronic changes to the central nervous system related to accelerated brain aging and age-related neuro-degenerative disorders.

This review paper related to the potential role of Covid-19 virus in neuro-pathogenesis provides:

“detailed information about the virulence, epidemiology, and insights into molecular pathways involved in the infectivity of the SARS-CoV-2 virus, along with an in-depth view of current concepts about the neurological significance of the SARS-CoV-2 virus and its neuro-pathological competence.”

This paper presents a literature review of 765 Covid-19 patients, in which 18% had neurological symptoms and complications, including encephalopathy, encephalitis and cerebrovascular pathologies, acute myelitis, and Guillain-Barré syndrome.

This paper informs that:

“SARS-CoV-2 is a neuro-invasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of Covid-19 infection on the onset and progression of neuro-degenerative and neuro-psychiatric diseases of neuro-inflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term.”

“Therefore, the cognitive and neuro-psychological functions should be closely monitored in Covid-19 survivors” as advised in the paper.

Conclusions

As I pointed out, not much data is available and not many studies have been conducted regarding the neurological effects of the Covid-19 virus so far. Current views on whether the virus directly or indirectly impacts the nervous system are undetermined and still debatable.

However, several reviews and preliminary studies indicate that this virus might have direct or indirect neuro-invasive, neuro-inflammatory, neuro-psychiatric, and neuro-psychological risks, yet to be determined. Mental health is critical for humans to survive and thrive. Humanity struggles with many mental health issues caused by metabolic, environmental, and genetic factors.

Now, as this virus affects millions of people globally, we need to identify neurological risks and mitigate them using the power of research, leveraging the body of knowledge and new studies. As known, excessive cytokines can lead to organ damage. This is not a trivial matter.

My aim is to create awareness by looking at the indications in the literature. In addition to hearing many anecdotes, I also experienced this situation in my life. My partner who was diagnosed with the Covid-19 virus unfortunately experienced severe neurological symptoms.

Therefore, by sharing our experiences, we can contribute to upcoming studies to identify the risks. Reported cases and anecdotes also play an essential role in science, especially in building hypotheses.

I am optimistic that with collective intelligence, we can find more effective ways to mitigate the risks.

Thank you for reading my perspectives.

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