There are many unknowns about the long-term effects of COVID-19 on the brain – but new research investigates the potential impact of Post COVID-19 Neurological Syndrome (PCNS)
As the global COVID-19 pandemic continues, with currently more than 38 million COVID-19 cases worldwide, we’re beginning to understand the long-term impact of the virus on the human brain. Something we’re calling Post-COVID-19 Neurological Syndrome, or PCNS.
The symptoms are similar to those experienced post-stroke – but the age group is much younger – and, given the scale of global infection, PCNS has the potential to become a major problem.
The neurological impacts of various infections have been explored and investigated in the past, but as COVID-19 is a new virus, we are still working to understand the longer term impact of the infection.
Daily, more and more reports are appearing in the mainstream media of recovering patients describing lingering symptoms that won’t go away. In scientific journals, like Nature, research has found similar symptoms linked to earlier epidemics including the Middle Eastern respiratory syndrome coronavirus (MERS-CoV) and the severe acute respiratory syndrome virus (SARS-CoV).
Many people who have officially recovered from these viruses cite disabling chronic fatigue (that is, fatigue lasting more than six weeks) and a series of persistent attention and cognitive problems – similar to post-stroke symptoms such as fatigue, depression and apathy among patients.
If we look to Europe, a series of large online questionnaires focusing on COVID-19 recovery found that less than one percent of surveyed patients were symptom-free 79 days after the infection – which suggests the high likelihood of PCNS in over 90 per cent infected people.
The European survey involved more than 2,000 non-hospitalised younger COVID-19 patients and just over 100 hospitalised (but only mildly affected) COVID-19 patients with a mean age 47 years and good health before the COVID-19 infection.
To make matters more complicated, there are a number of re-infection reports emerging from different parts of the world, reminding us that there are still so many unknowns when it comes to COVID-19, post-COVID-19 issues and a potential vaccine.
Recovery and trauma
The physical stress of infection might end, but COVID-19 patients can carry emotional and neurological scars from the experience for months and years, often in the form of post-traumatic stress disorder (PTSD).
For example a large Chinese study earlier this year revealed that an alarming 96.2% of recovering COVID-19 patients have clinical evidence of severe post-traumatic stress disorder (PTSD).
A total of 730 COVID-19 clinically stable patients were assessed and a large percentage – 96.2 per cent – were found be suffering from severe PTSD; something we believe is one of the first signs of PCNS.
Similar reports have previously been reported following the SARS epidemic in 2009. Almost 50% of people recovering from the virus developed PTSD symptoms that were still evident four years after infection.
PCNS is real and what is beginning to emerge is the undeniable evidence of persistent long-term neurological and affective symptoms post-COVID-19.
The impact of infection
Interactions between our immune system and the central nervous system are one of the most complex and interactive regulatory networks in mammals. So, the fact that the brain is affected by COVID-19 is not surprising.
Our research looked at the local and global immunological response to the viral infection with the help of readily available peripheral markers of inflammation such as neutrophil-lymphocyte ratio, CRP -and D-dimer.
We carried out an in-depth analysis of the neurological symptoms of several patients with COVID-19.
COVID-19 and acute stroke share common pathobiology at a cellular level.