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Babak Navi, the division chief for stroke and hospital neurology at Weill Cornell Medicine and a neurologist at New York-Presbyterian, has been working on the front lines of the coronavirus pandemic in New York City for several weeks. And during that time, he's noticed a troubling pattern of symptoms beyond respiratory distress in patients with COVID-19, the illness caused by the new coronavirus.
Some have developed strokes; others have experienced seizures. A handful have woken up to slower-than-normal cognitive speeds. The common thread among these COVID-19 patients? All point to disruptions in the nervous system.
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As the sum of coronavirus cases continues to climb, experts are learning more about the virus and the illness it causes. And an increasing number of reports from hospitals around the world show that in some patients, the disease can damage more than just the lungs. It can harm the brain, too.
A study in JAMA Neurology found that more than 36 percent of 214 patients in Wuhan, China, experienced neurologic symptoms during the course of their COVID-19 illness. Dizziness and headache were among the most common symptoms listed; instances of stroke and loss of taste and smell were also reported. Other published accounts document a more-than-usual prevalence in COVID-19 patients of Guillain-Barré syndrome, an affliction that can lead to temporary paralysis, plus instances of confusion and severe agitation.
"I think at this point, I would say that we know something” is happening when it comes to COVID-19 and the brain, says Sherry Chou, associate professor of critical care medicine, neurology and neurosurgery at the University of Pittsburgh. “But we definitely don't know enough.”
Among the biggest questions on her mind — and the minds of experts across the globe — are why and how the novel coronavirus produces neurological symptoms in some. Does it target the nervous system directly? Or is the brain merely a victim of the body's reaction to the infection?
"We're really in uncharted waters here,” Chou says, noting that most of what we do know about how the virus attacks the body is still anecdotal due to its newness and the current focus on care and containment. Chou is hopeful the gap in knowledge will soon narrow, however. She's leading a research consortium of physicians and scientists from around the world to better understand the virus’ impact on the brain and the nervous system.
"We need to figure out as quickly as we can, and as accurately as we can, how big a problem this is, how often is this happening, and who is it happening to,” Chou adds.