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COVID-19: What are the most common neurological consequences?

What are the most common neurological consequences of COVID-19?

After surviving COVID-19, some affected individuals show persistent neurological symptoms that can lead to significant impairments in everyday life. The most common of these are symptoms such as chronic fatigue syndrome, pain, impaired concentration, memory problems, and sleep disturbances, the German Society for Neurology (DGN) reported in a recent press release.

Some COVID-19 patients continue to suffer long-term neurological consequences weeks or even months after their disease. The Neurology Working Group in the National Pandemic Cohort Network (NAPKON) is therefore dedicated, among other things, to researching these long-term consequences of COVID-19. “Particularly important is the question of whether the viral disease can possibly also impair cognition in the long term or even promote the development of neurodegenerative secondary diseases (such as Alzheimer’s disease) in old age,” according to the DGN release.

Noticeable neurological symptoms

Often, neurological symptoms such as olfactory and gustatory disturbances or headaches, muscle pain and the so-called fatigue syndrome (permanent exhaustion and fatigue) are already apparent during the acute phase of COVID-19, the DGN reports. In addition, “so-called encephalopathies (disorders of consciousness and brain function) are quite common in COVID-19, especially in severe courses.”

“Life-threatening neurological complications can also occur during or directly after COVID-19 disease, such as strokes or Guillain-BarrĂ© syndrome,” the DGN further reports (see also: COVID-19 research: Guillain-BarrĂ© syndrome after SARS-CoV-2 infection). In addition, according to information from the professional society, a study from last summer has already consolidated evidence that neurological symptoms can occur even longer after an illness with COVID-19.

Chronic exhaustion lasting for months

For example, a Dutch-Belgian study evaluated the persistent symptoms of 2,113 COVID-19 patients (112 hospitalized participants) three months after the onset of the disease and found that after three months, 87 percent of the patients still suffered from fatigue (chronic exhaustion). During the acute phase of the disease, the figure was 95 percent.

Other long-term effects of COVID-19

Chronic fatigue is the most common complication and long-term consequence of COVID-19, but it is far from the only one. For example, a study of about 2,500 participants published in the journal Nature Communications cites pain, shortness of breath and runny nose/rhinitis as the most common long-term symptoms, in addition to fatigue. And in a British prospective cohort study of 163 COVID-19 patients, sleep disturbances were also cited as a frequent long-term symptom.

Quality of life limitations

What is surprising, according to the DGN, is that symptom persistence also affected patients with mild COVID-19 courses, but after a severe course, neurological symptoms seem to be particularly persistent and long-lasting. For example, a French study also described significant reductions in quality of life after severe disease courses. After three months, 89 percent continued to experience pain, 47 percent showed limited mobility due to muscle weakness, and 42 percent experienced anxiety and depression.

“In summary, long-term neurological sequelae affect a high proportion of COVID-19 patients, and we need to provide neurological follow-up care for these people,” emphasized DGN Secretary General Professor Peter Berlit. Although the neurological symptoms of many of those affected improve over time, there are also patients who fell ill in the first wave of the pandemic in the spring of 2020 and are still not symptom-free.

More research needed on late effects

“Since COVID-19 is a novel disease, we need to clarify the causes of the symptoms and late effects in order to be able to take targeted action against the neurological symptoms,” Professor Berlit continued. The NAPKON project, is expected to make a significant contribution here. “In addition, we are also concerned with open research questions, especially with regard to possible late effects,” explains Dr. Samuel Knauss, spokesman for the Young Neurologists and deputy spokesman for the specialist neurology working group in the NAPKON project.

For example, he said, the question is whether patients with neurological symptoms should fear lasting effects on cognition or whether neuro-COVID can promote the development of neurodegenerative diseases such as Alzheimer’s or Parkinson’s disease. However, we will only have assured answers to these questions after years or even decades, the expert explains.

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