It has been observed that COVID19 seems to have a greater long-term impact on brain health, especially among those on ventilator support and the elderly. As per a study published by the National Institute for Health Research (NIHR), Oxford, out of 2,36,379 patients displayed evidence of substantial neurological and psychiatric impact, six months after COVID-19 infection. The research also highlighted:
- 17 per cent patients displayed anxiety disorders
- 14 per cent showed mood disorders
- 7 per cent were prone to substance misuse disorders
- 5 per cent reported Insomnia!
Last year when the pandemic took its peak, quite a few patients with COVID19 whose symptoms were initially mild, developed long-term neurological problems that were referred to as ‘brain fog’. While there was no strong evidence at that time, researchers around the world continued to dig deep into this subject. Now there are several studies that have made the link between COVID19 and increased risk of neurological disorders.
COVID-19: A Permament Scare & Scar?
This report has raised questions in the minds of the people on whether COVID19 will leave a permanent scar on their health, mind and body! I would like to highlight that people who have been in the ICUs for COVID19 treatment, and especially the elderly population affected by COVID19, have experienced neurological & mental health problems. I have seen at least 20% of my COVID19 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 worsening of Parkinsonism symptoms is commonly encountered; most times these patients make full recovery once the infection subsides, but often it prolongs.
But, the question is, how does a respiratory disease lead to neurological and psychiatric effect?
According to reports, 86% of mild COVID19 patients experienced loss of smell. Besides the hallmark symptoms of COVID, such as fever, cough, shortness of breath, Diarrhea, etc., many people experience symptoms related to their brain & nervous system, including dizziness, headache, debilitating fatigue, and brain fog (which is trouble remembering), learning & concentrating While symptoms tend to go away once they recover, some COVID survivors experience long-term effects.
On the mental health front, 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 & safety. Findings from the latest study emphasize the need for mental health services for the large number of people who may be experiencing symptoms. These symptoms 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, as told by Dr Dhanashri Chonkar, Consultant Neurology, Fortis Hospital Mulund:
- Impaired consciousness
- Uncoordinated muscle movements
- Seizures, and strokes
- Post-Intensive-Care Syndrome
- 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. Also, besides regular screening, medication and follow-up, there should be some amount of exercise prescribed to such patients. It is suggested if patients can involve them self in activities like gardening, aerobics, music therapy, watching comedy, or practice some yoga. The involvement of caregivers in this will matter the most. Isolation, prolonged and difficult illness does cause a lot of mental stress. If an exercise regime is prescribed this will help patients to overcome their physical and mental problems.
With inputs from Dr Dhanashri Chonkar, Consultant Neurology, Fortis Hospital Mulund
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