Dr Ansu Sen (MD / DM Neurology), Sr Consultant (Neurologist) at Ramakrishna Mission Sewa Prathisthan and Columbia Asia Hospitals, Kolkata, explains the neurological impact of the Covid-19 and how its “aggressive” treatment is the order of the day.
Neurological problems are frequently reported in severely critically ill patients with comorbidities like diabetes and hypertension. The virus has the potential to invade the brain either through the olfactory route or by hematogenous spread. The receptor (Angiotensin-converting enzyme 2 receptors) which is utilised by the virus are expressed in the brain. While the coronavirus is known to attack other organs like blood vessels and the heart, its main target is the lungs.
It needs aggressive treatment in stabilising the body’s oxygen level as a potential key therapy for preventing or reversing neurological symptoms. Apart from hypoxia, neuronal inflammation, coagulopathy, autoimmunity plays a role in neurological manifestations.
A range of neurological manifestations include loss of smell and taste, stroke (brain attack) encephalitis (inflammation in the brain) Guillain Barre Syndrome(a disorder in which the immune system attacks the body’s nerves).
There is a wide range of symptoms like headache, dizziness, weakness, paralysis, convulsions. Also, there are cognitive and psychiatric problems. In a few cases, mechanical ventilation has been observed to cause a decline in higher mental functions.
During the pandemic another group of patients deserve the attention of neurologists especially those who have already been in the follow-up for sometime. Patients with reduced mobility and those with immunosuppressive therapies may be more susceptible to infections.
There are challenges in handling patients with dementia, especially those who depend on others for activities of daily living. We assume that the psychiatric and psychological effects of prolonged social distancing will require adequate psychological rehabilitation measures as the pandemic will start waning off. With gradual subsidence of the outbreak, it can be anticipated that several post-infectious complications will surface up.