By ALESHA CADET
Tribune Features Reporter
WHILE there is at this time not enough data to prove that coronavirus can be the root cause of neurological complications, medical professionals note that, like other viruses such as influenza, patients with COVID-19 may experience headaches, anosmia (loss of sense of smell), dizziness, Guillain-Barre syndrome (the immune system attacks your nerves), and even strokes.
Dr Felipe De Los Rios, medical director of the stroke programme at the Miami Neuroscience Centre, part of Baptist Health South Florida, said they have seen patients in intensive care units who have COVID-19 and suffer a stroke with much greater impact compared to a normal stroke.
Additionally, in relation to the virus, patients experience high levels of anxiety and depression, which impacts the brain,” he told Tribune Health.
As part of his clinical duties, Dr De Los Rios cares for patients with neurological disorders who may or not have COVID-19. Given that Miami has become a global hotspot for this infection, he routinely tends to individuals who have both coronavirus and neurological disorders.
“Individuals most susceptible to having a stroke as a result of COVID-19 are those over the age of 50 who suffer from a pre-existing cardiovascular condition such as diabetes or heart disease, as well as those who have already suffered a stroke or heart attack in the past. Most patients with COVID-19 - more than 95 percent - will not suffer a stroke because of the disease. Regarding younger patients, between 13 percent to 20 percent of strokes exist in people under the age of 50, with or without COVID-19,” he said.
The way to mitigate against strokes in connection to COVID-19, Dr De Los Rios said is to take the necessary precautions to avoid catching the virus. This includes continuing to wash hands frequently, avoid touching one’s mouth or eyes, social distancing and wearing masks to reduce your risk.
For individuals who may be at a higher risk, such as those with pre-existing cardiovascular conditions or elderly individuals, they should follow the treatment and prevention regimen established by their doctor, maintain a healthy diet, continue taking their prescribed medication, and follow-up with their medical consultations. By being proactive, individuals can prevent contracting the virus and avoid potential complications.
“Collectively, all individuals need to follow prevention guidelines for the virus. While we still do not have complete clarity on how COVID-19 can increase risk of stroke, it is important that individuals also take preventative measures to reduce their risk of heart disease and stroke. The American Heart Association recommends managing blood pressure and cholesterol, reducing blood sugar, staying active, maintaining a healthy diet, losing weight, and quitting smoking,” said Dr De Los Rios.
“At the Miami Neuroscience Institute we are ready to help the Bahamas further develop their local neuroscience resources by sharing our expertise and technological advancement to the benefit of their community. We currently offer an international hospital development programme for stroke care and can provide others as needed by local medical professionals. We are also ready to assist with the care of patients that require medical attention that cannot be provided locally on the island.”
When it comes to blood clots in relation to COVID 19 patients, Dr De Los Rios said studies have indeed demonstrated an increased risk of blood clots in some patients. However, the exact percentage by which blood clot risk increases is not yet clear and likely varies depending on how serious the patient’s COVID-19 case is. When blood clots happen in the brain they can cause a stroke, and this can happen in anywhere between one and five percent of patients most severely affected by COVID-19 admitted to the ICU.
“Risk factors that can increase one’s probability of developing blood clots, regardless of having an infectious disease such as COVID-19, or an autoimmune disorder - including neurovascular involvements, inflammation, conventional risk factors such as high blood pressure, high cholesterol, diabetes, and smoking, among others, as well as treatment side effects - such as medications that can increase cardiovascular risk,” he said.
“It does appear that COVID-19 patients who suffer a stroke experience more severe stroke symptoms and disability. It also remains to be proven that stroke is a more common complication of COVID-19 compared to other infections or influenza-like illnesses.”
When speaking of other neurological complications caused by coronavirus, Dr De Los Rios said there is evidence of direct damage to the central neurological system, the peripheral nervous system, and the muscular system. Difficulty smelling or perceiving taste can be caused by damage to the peripheral nervous system or the cells that support the peripheral nervous system. The virus can diffusely affect the peripheral nervous system, producing Guillain-Barre syndrome, where the immune system attacks the nerves.
In general, he said, the virus can affect the nervous system not only through direct invasion of the brain, but also through an inflammatory reaction the body produces in response to the virus, which can affect the brain or arteries of the brain, leading to a stroke.
“We are also seeing people suffer from lack of concentration and memory issues that can last months after infection. We are seeing indirect effects of the virus on the neurological system, which include anxiety, reduced attention span, insomnia, depression, and high blood pressure, which is caused by stress produced by the pandemic,” he said.
“Neurological conditions can be varied, so it is difficult to identify symptoms for each one. For strokes, for example, individuals can identify one with a quick and effective tool known as FAST (Face, Arms, Speech, and Time) to detect abnormalities in one’s body movements. This includes limitation in the movement of the arms or legs, inability to express oneself with facial expressions to muscle weakness, or inability to form words or speak clearly. These symptoms usually affect one side of the body and can be identified through an individual’s external movements.”