Headaches, loss of smell part of COVID’s impact on brain function

“Early on, as most people know, it was thought to be more of a pulmonary disease. And those of us who are treating it realized it’s much more complex,” said Dr. Thomas Steineke, Medical Director of Neuroscience at Hackensack Meridian Health Central Region. A team of neurologists at Hackensack Meridian Health is trying to understand how the coronavirus impacts a person’s neurology, or brain function. Dr. Florian Thomas, Medical Director of Neuroscience at Hackensack Meridian Health Northern Region, added, “every day, essentially, there are new reports that further delineate, and expand actually, the range of neurological manifestations of COVID-19.”

Dr. Steineke continued, “the first reports really were about loss of sense of smell, and taste and then other reports came in with problems of sensation, discoordination. By and large, most patients will have some element, when they’re severely ill, of headaches and confusion. Some of those patients had strokes or hemorrhaging with severe impacts on the brain.”

Dr. Steineke said during the worst of the pandemic, it was nearly impossible to document and study the patients coming through the hospital system. But now that emergency rooms have slowed down, he and Dr. Thomas are starting a research study to understand these neurological impacts. “There very well may be long term consequences that are not necessarily strictly due to a stroke, but perhaps due to the inflammation around the brain or the direct infection of the brain,” said Dr. Steineke.

Many of the worst cases have already passed through the hospitals. How much of this is retroactive, looking at patients that have already been infected, or is it all forward-looking? Dr. Thomas answered, “we are doing both. We are looking at all patients that have ever been admitted and diagnosed with COVID 19 in our system, and that’s some 4,000 individuals. We are looking at what other doctors recorded for these patients as neurological symptoms and signs. We need to know how often patients present with muscle weakness, with peripheral nerve involvement, with stroke, with altered mental status and seizures and so forth.” Are those impacts, let’s say they are long term. Are they reversible? Can you heal the brain and retrain the brain once there’s some kind of trauma like this? Dr. Steineke answered, “so neurological recovery is very slow. It takes a long time for neurons and nerves to heal. And then, through different therapies and processes, other areas of the brain start to take over and mitigate the symptoms and problems a patient may have.”

It’ll take at least three months before any research is ready to be shared, although the study will continue for months to years. The doctors will follow-up with patients sometime between 90 to 120 days after their hospital discharge but they encourage anyone who’s struggling with on-going symptoms to reach out to a neurologist who’s been treating COVID patients.