It has been found that this time — in the second wave of the coronavirus infection — patients have started to present some new symptoms, which was not the case earlier. Dr Dhanashri Chonkar, consultant neurology, Fortis Hospital, Mulund has pointed out that among other things, COVID-19 seems to have a greater long-term impact on brain health, especially among those on ventilator support and the elderly.
“Last year, when the pandemic took its peak, quite a few patients with COVID-19 whose symptoms were initially mild, developed long-term neurological problems that were referred to as ‘brain fog’. While there was no strong evidence at the time, researchers around the world continued to dig deep into this subject. Now, there are several studies that have made the link between COVID-19 and increased risk of neurological disorders,” she said.
“I would like to highlight that people who have been in the ICUs for COVID-19 treatment, and especially the elderly population, have experienced neurological and mental health problems. I have seen at least 20 per cent of my patients reporting such problems and it is certainly a cause of concern. We have noticed brain strokes, post-COVID infection neuropathies (Guillian-Barre Syndrome). Worsening of pre-existing dementia or Parkinson’s symptoms is commonly encountered; most times these patients make full recovery once the infection subsides, but often it prolongs,” Dr Chonkar added.
So, how does a respiratory disease lead to neurological and psychiatric effects?
The doctor explained that according to reports, 86 per cent of mild COVID-19 patients experienced a loss of smell. Besides other hallmark symptoms, such as fever, cough, shortness of breath, diarrhea, etc., many people also experience symptoms related to their brain and nervous system, including dizziness, headache, debilitating fatigue, and brain fog (trouble remembering), learning and concentrating. While symptoms tend to go away once they recover, some COVID survivors experience long-term effects, she said.
“These effects do not have direct manifestation, but are more of the aftermath of the disease. With a COVID diagnosis, people tend to get stressed and anxious about their health. Findings from the latest study emphasise the need for mental health services for the large number of people who may be experiencing symptoms. These are more pronounced in patients with Hypoxia (deprivation of oxygen).”
How does one identify neuro and mental health symptoms in COVID-recovered patients?
The common neurological problems include:
* Impaired consciousness
* Uncoordinated muscle movements
* Seizures and strokes
* Post-Intensive-Care Syndrome, which comprises cognitive, psychological, and neurological symptoms
* Sleep difficulties
* Post-Traumatic Stress Disorder (PTSD)
“Neurocognitive testing, psychiatric evaluation, and diagnostic imaging even after recovery should be continued, for at least six months. Apart from this, there is a need for a strong support system for patients and their caregivers,” the doctor advised, adding that besides regular screening, medication and follow-up, there should be “some amount of exercise prescribed to such patients”.
“Activities like gardening, aerobics, music therapy, watching comedy, or yoga is recommended. Isolation, prolonged and difficult illness does cause a lot of mental stress. If an exercise regime is prescribed, it will help patients to overcome their physical and mental problems.”