Relias Media - Continuing Medical Education Publishing

The trusted source for

healthcare information and

CONTINUING EDUCATION.

  • Sign In
  • Sign Out
  • MyAHC
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • My Subscription
      • Subscribe Now
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    Home » Effects of COVID-19 on the Brain

    Effects of COVID-19 on the Brain

    Infection, stress of pandemic are dual risks to healthcare workers

    August 1, 2020
    No Comments
    Reprints
    Facebook Twitter Linkedin Share Share

    Related Articles

    The Effects of COVID-19 on the Brain

    TJC Offers Guidance on Accreditation and Effects from COVID-19

    Related Products

    Preventing Sexual Transmission of Zika, Case in Dallas Prompts CDC guidelines

    25% of HCWs May Refuse to Treat Patients in Next Pandemic Threat

    Keywords

    brain

    cognitive

    response

    neurological

    COVID-19

    cytokine

    neurocovid

    By: Gary Evans

    Healthcare workers and patients who have contracted SARS-CoV-2, particularly if they were hospitalized, could be at risk of neurological deficits in the short term and as well as later cognitive problems, says Majid Fotuhi, MD, PhD, the lead author of a new paper on the effect of COVID-19 on the brain.1

    “For healthcare workers, there are two issues,” he says. “One is the impact of [the] SARS-CoV-2 virus itself [on the] brain. The other is the stress of the COVID-19 pandemic, seeing patients die before their eyes. That causes post-traumatic stress disorder (PTSD). I think we need to monitor frontline healthcare workers even more closely [than patients], because the stress response in our body can actually harm the brain significantly.”

    Loss of sense of smell (anosmia), “stroke, paralysis, cranial nerve deficits, encephalopathy, delirium, meningitis, and seizures are some of the neurological complications in patients with COVID-19,” Fotuhi and co-authors note. “There remains a challenge to determine the extent to which neurological abnormalities in COVID-19 are caused by SARS-Cov-2 itself, the exaggerated cytokine response it triggers, and/or the resulting hypercoagulapathy and formation of blood clots in blood vessels throughout the body and the brain.”

    The article reviews neurological problems reported in COVID-19 patients and proposes a basic “NeuroCovid” classification scheme.

    “Keeping accurate registries of COVID-19 patients with neurological deficits may enable us to establish plausible connections with aging-associated and neurodegenerative disorders, such as Parkinson’s disease, in the future,” the authors conclude. “Standardized evaluations, such as quantitative EEG (electroencephalogram), fluid biomarkers, cognitive evaluations, and multimodal neuroimaging can also lend insight to possible long-term neurological sequalae in COVID-19, such as depression, memory loss, mild cognitive impairment, or Alzheimer’s disease.”

    Fotuhi is medical director of  NeuroGrow Brain Fitness Center in McLean, VA, and an affiliate staff member at Johns Hopkins Medicine in Baltimore. The paper identifies three distinct NeuroCovid neurological categories or stages.

    In Stage I, the virus damage is limited to epithelial cells of nose and mouth. “The majority — 95% — recover without any problem,” he says. “These are the patients who are least likely to have long-term neurological problems.”

    In NeuroCovid Stage II, patients may experience blood clots in their brain caused in part by an inflammatory immune response called the “cytokine storm.” This can result in mini-strokes that can cause cumulative neural damage.

    “We can talk of large strokes the same way we do in patients that do not have COVID-19,” he says. “But when they have small strokes, the patient may have no symptoms, an MRI (magnetic resonance imaging) is not done, and no one knows what this patient has suffered. These patients, long-term, are likely to have depression, memory loss, and other neurological [problems].”

    In NeuroCovid Stage III, there is damage to the blood-brain barrier, which protects the blood vessels of the brain, causing seizures or encephalopathy.

    “The cytokine storm is so huge that it ruptures and damages the blood-brain barrier, such that the virus particles get inside the brain, along with the inflammatory markers,” Fotuhi says.

    “When that happens, there is significant damage to the brain cells, and these are the patients that I think will have the highest degree of neurological issues in the future,” he adds.

    There are blood tests to measure the intensity of the inflammatory immune response, which may be responsible for the relatively rare severe infections in younger people.

    “It is the body’s own immune systems that harms the patient,” he says.

    In healthcare workers, the neurological effects of COVID-19 could be compounded by the stress of fighting the pandemic.

    “The more stressed you are, the more the part of your brain for memory — the hippocampus — shrinks,” Fotuhi says. “Frontline healthcare workers dealing with patients in dire situations experience an extreme amount of stress. The cortisol that is produced in response to stress indirectly harms the hippocampus. We need to monitor our healthcare workers dealing with COVID-19 patients closely. They may have secondary harm due to PTSD even if they don’t have the virus [itself].”

    PTSD can harm areas of the brain affecting regulation of emotion, memory, and executive functions, he adds.

    Overall, the basic measures to boost brain performance, regardless of patient history, include vigorous exercise, stress reduction, and eight hours of sleep nightly, he recommends.

    REFERENCE

    1. Fotuhi M, Mian A, Meysami S, Raji CA. Neurobiology of COVID-19. J Alzheimers Dis 2020;76:3-19.

    Recent Articles by Gary Evans

    COVID-19 Mutations not Expected to Elude Vaccine

    Flu Vaccination Hesitancy in the Time of COVID-19

    Expert: Anti-Vaxxers Will Try to Undermine Pandemic Vaccine

    Post a comment to this article

    Report Abusive Comment

    www.reliasmedia.com

    Hospital Infection Control & Prevention

    View PDF
    Hospital Infection Control & Prevention (Vol. 47, No. 8) - August 2020
    August 1, 2020

    Table Of Contents

    Trial by Fire: IPs Stand Fast Amid Unrelenting Pandemic

    CMS Continues Infection Control Inspections for Coronavirus

    Patient Handwashing: An Idea Whose Time Has Come?

    Effects of COVID-19 on the Brain

    Pandemic Necessity Is the Mother of Invention

    Pandemic Coronavirus May Kill the Handshake

    We’d Love to Hear from You!

    Begin Test

    Buy this Issue/Course

    Financial Disclosure: Peer Reviewer Patrick Joseph, MD, reports that he is a consultant for Genomic Health, Siemens, and CareDx. Senior Writer Gary Evans, Editor Jason Schneider, Associate Editor Mike Gates, Nurse Planner Patti Grant, RN, BSN, MS, CIC, and Editorial Group Manager Leslie Coplin report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.

    Shop Now: Search Products

    • Subscription Publications
    • Books & Study Guides
    • Webinars
    • Group & Site
      Licenses
    • State CME/CE
      Requirements

    Webinars And Events

    View All Events
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • My Subscription
      • Subscribe Now
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    • Help
    • Search
    • About Us
    • Sign In
    • Register
    Relias Media - Continuing Medical Education Publishing

    The trusted source for

    healthcare information and

    CONTINUING EDUCATION.

    Customer Service

    customerservice@reliasmedia.com

    U.S. and Canada: 1-800-688-2421 x 2

    International +1-404-262-5476 x 2

    Accounts Receivable

    1-800-688-2421 x 3
    ReliasMedia_AR@reliasmedia.com

    Sales

    1-800-688-2421 x 1

    Mailing Address

    • 1010 Sync St., Suite 100
      Morrisville, NC 27560-5468
      USA

    © 2022 Relias. All rights reserved.

    Do Not Sell My Personal Information  Privacy Policy  Terms of Use  Contact Us  Reprints  Group Sales

    For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, DPO@relias.com

    Design, CMS, Hosting & Web Development :: ePublishing