COVID-19 Neurologic Conditions in Patients with the Coronavirus

COVID-19: Neurologists in Italy to Colleagues in US: Look for Poorly-Defined Neurologic Conditions in Patients with the Coronavirus

Neurology Today By Jamie Talan March 27, 2020

Following the COVID outbreak in Italy, ER doctors and neurologists are observing several neurological disorders that they say have taken them by surprise even though similar neurovirulence and neurological effects were seen with SARS and MERS. Currently, they have observed the patients most severely affected by the virus may also be suffering from neurological disorders such as stroke, delirium, seizures, and encephalitis. Italian doctors know it’s attacking the CNS but are yet unsure if the virus is directly entering the CNS or are the symptoms are indirect results of a cytokine storm.

Dr. Alessandro Padovani, M.D. and his team at the Institute of Neurology Brescia, believe that the neuroinvasiveness of this virus may be through cranial nerves, such as the olfactory nerve, the trigeminal, vagus, and peripheral nerves. Dr. Tyler, the chair of neurology at the University of Colorado, is not surprised that a subset of patients are experiencing neurological symptoms and expects post-viral complications such as GB and acute disseminated encephalomyelitis as this was observed with SARS and MERS. However, he believes it is a result of sepsis or organ failure. One thing the doctors do agree on it that it will change the way neurologists look at the practice of neurology.

Interestingly, many of our doctors have been reporting that viruses can invade the CNS and cause neurological symptoms. Doctors hypothesis that COVID 19 may initiate and enter through the nasal cavity affecting cranial nerves, which Dr. Agalliu observed in his animal model from Columbia University. Dr. Agalliu demonstrated that streptococcus is transmitted through the nasal cavity into an area called the NALT in the rat, which is functionally similar to the olfactory bulb in humans. Symptoms such as encephalitis, delirium, and Gillian Barre have also been observed in P/P patients. In addition, doctors treating COVID believe there is an increased risk of post-viral infection. Post viral and post bacterial infection in PANDAS/PANS patients and has been reported in the scientific literature for many years.

As this COVID virus evolves and we learn more and more about it, this may bode well for the PANDAS/PANS community. If neurology starts accepting that micro-organisms can cause a cascade of pathological effects in the body leading to physical and neurological symptoms and see that these systems are ultimately inter-related and that infection can lead to neuropsychiatric symptoms, then we could see some incredible scientific breakthrough and further treatments.

Caoimhe Dardis – ASPIRE Research Review Committee

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