Full recovery distant dream for many patients as Covid may lead to neurological complications


Express News Service

NEW DELHI: Even six months after recovery from Covid-19, several patients are suffering from mild to severe neurological complications.

These may begin or happen during the course of treatment and extend even after recovery, say experts.

“Neurological symptoms can occur prior, during and even after lungs get infected. SARS-CoV-2 can alter the BBB (blood brain barrier), enter the brain and cause neurological symptoms,” said Dr Deepak Gupta, Professor, Neurosurgery, AIIMS, Delhi.

Some patients with Covid-infected lungs can develop intracranial bleeding due to unavoidable anticoagulant therapies.

Meningitis, encephalitis and encephalopathy are some of the frequent neurological complications in Covid-19 patients.

Meanwhile, patients with acute respiratory distress syndrome (ARDS) have a prevalence of encephalopathy in 60 to 84 per cent of cases.

“Such patients experience headache and fever with altered sensorium or coma. The occurrence of encephalopathy in Covid-19 patients is associated with higher mortality, worse neurological outcomes and an estimated three-fold increase in hospital stay,” Dr Gupta added.

Guillain Barre Syndrome is also observed in some patients.

This appears one to four weeks after initial recovery. Such patients initially experience mild sensory symptoms which rapidly lead to weakness in all four limbs and if untreated some of these can rapidly worsen requiring ventilator support.

“Relatives are often taken by surprise when a patient suddenly develops weakness of limbs and becomes paraplegic and hence it is mandatory that all Covid patients while getting discharged are adequately briefed about various neurological issues that can come up in the ensuing months. More than 70 per cent show good prognosis with treatment,” Dr Gupta noted. 

To limit the long-term consequences, it is crucial that healthcare professionals detect possible neurological symptoms early.

Among children, Covid leads to multisystem inflammatory disease. This usually manifests in two-four weeks after recovery.

“Stroke can also happen to an individual as Covid does bring in changes in blood. There have been cases where patients have improved and then suddenly succumbed owing to stroke. But directly proving this is not possible at this stage,” said Dr Achal Srivastava, professor of Clinical Neurophysiology, AIIMS.

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