- While many of the immediate complications of COVID-19 are now well understood, physicians are still trying to understand and manage its long-term effects.
- In a new study, researchers discovered symptoms such as loss of smell, weakness, fatigue, headaches, and anxiety persisted in people who had recovered from acute COVID-19.
- New medical centers are starting to develop neurologic clinics specific to the manifestations of COVID-19.
As COVID-19 case numbers start to decrease throughout the United States, physicians throughout the country are starting to see an increase in neurologic and psychiatric symptoms among people who have recovered from the disease, a new study suggests.
Even with mild symptoms, the study — published this month in the Journal of Neurology, Neurosurgery & Psychiatry and led by a team at University College London — found that symptoms such as loss of smell, weakness, fatigue, headaches, and anxiety persisted in people even after recovering from COVID-19.
The research team identified 215 studies that involved more than 105,000 people from over 30 countries who had had COVID-19.
The studies were then analyzed, and the participants’ neurologic and psychiatric symptoms were assessed.
Symptoms with the highest rate were loss of smell (43 percent), weakness (40 percent), fatigue (38 percent), and either loss of or abnormal taste (37 percent).
“We had expected that neurological and psychiatric symptoms would be more common in severe COVID-19 cases, but instead we found that some symptoms appeared to be more common in mild cases,” lead author Dr. Jonathan Rogers, Wellcome Trust Clinical Fellow in the division of psychiatry at University College London, said in a statement.
“It appears that COVID-19 affecting mental health and the brain is the norm, rather than the exception,” he said.
According to Dr. Sara Martin, assistant professor of medicine and medical director of outpatient palliative care at Vanderbilt University Medical Center, “the most common neurologic symptoms vary widely among patients, from mild brain fog to difficulty concentrating on normal work tasks and, in some patients, severe cognitive impairment. We are also seeing patients with persistent headache as well as symptoms of numbness/tingling in extremities.”
Many of these neurologic findings were reported in people with the most severe complications of COVID-19.
However, 55 percent of those with mild illness reported fatigue, 52 percent had loss of smell, 47 percent reported muscle pain, and 45 percent reported loss of taste.
Dr. Thomas Gut, associate chair of medicine at Northwell Health’s Staten Island University Hospital, has seen many patients with COVID-19-related neurological symptoms, and relates the long-term effects on the severity of the initial infection.
“Patients that I see most frequently had milder disease and are more likely to experience headaches, loss of sense of smell or taste, or muscle aches. Fatigue and sleep problems are also a very common complaint across the board, independent of severity,” Gut told Healthline.
Currently, health experts are unsure how COVID-19 directly affects the brain. However, as more people are recovering from the disease, more long-term complications are becoming apparent.
There are several theories as to why this occurs. Some experts theorize that the coronavirus can cross a protective structure in the body called the blood-brain barrier. In doing so, it can affect the fluid that bathes the spinal cord and brain, resulting in a multitude of neurologic manifestations.
Another possibility is the virus provokes an overall immune response from the whole body. This leads to an inflammatory-related response to many tissues and organs, including the brain.
Throughout the United States, medical centers are starting to develop neurologic clinics specific to the manifestations of COVID-19.
There’s a growing number of post-COVID-19 clinics in the United States as many health systems are seeing increasing cases of long-haul COVID-19, or people with lingering symptoms after recovering from the disease.
“Due to being hit particularly hard in the early waves, at Northwell we have one of the oldest and largest post-COVID recovery programs. These programs are designed using the most current evidence and treatments that can help people get back to regular life,” Gut said.
Other hospital systems are offering comprehensive care for many of these patients.
At Vanderbilt Medical Center, Martin said the “clinic offers support and access to multiple specialists to manage the many symptoms that can be part of long COVID.”
Understanding both the physical and mental toll COVID-19 has taken, these facilities also offer “dedicated physical therapy and cognitive therapy as well as support groups for patients that are diagnosed with long COVID,” Martin told Healthline.
This physician-led team assesses and treats people with long-haul COVID-19 who have neurologic complications.
A clinic such as this allows for a neurologist to conduct screening tests for psychiatric and neurologic conditions and disorders. They’re then able to take this information and create working health plans to help reduce the long-term burden that some people may experience from COVID-19.
There are no direct medications or remedies to treat all COVID-19-related neurologic complications, but many complications do improve with time.
And with more time and research, physicians will better understand not just the immediate complications of COVID-19, but its long-term effects as well.
Rajiv Bahl, MD, MBA, MS, is an emergency medicine physician and health writer. You can find him at www.RajivBahlMD.com.