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COVID-19 symptoms may also include confusion and altered sense of reality

COVID-19 symptoms may also include confusion and altered sense of reality
One of the rare symptoms of COVID-19 is altered sense of reality and confusion, lethargy and sometimes coma. @Shutterstock

COVID-19 symptoms may sometimes also include neurologic signs like encephalopathy and myalgia. Read on to know more about these uncommon signs.

Written by Jahnavi Sarma |Updated : April 9, 2020 10:18 AM IST

With COVID-19 cases surging alarmingly across the globe, most people know what to look out for in case of an infection. We all know that this new strain of coronavirus causes respiratory distress and common symptoms are fever, runny nose, dry cough and shortness of breath. In severe cases, patients face viral pneumonia and respiratory failure. Sometimes, patients may also exhibit neurological symptoms of muscle weakness and headaches. But now, US neurologists say that COVID-19 symptoms may sometimes also include neurologic signs like encephalopathy, ataxia and more. Many patients also report severe fatigue, trigeminal neuralgia, complete or severe anosmia and myalgia.

An article in the Journal of Medical Virology says that 'increasing evidence shows that coronaviruses are not always confined to the respiratory tract and that they may also invade the central nervous system, inducing neurological diseases'. This may answer the question as to why so many younger people with a healthy immune system sometimes succumb to COVID-19.

Many earlier studies have shown that coronaviruses can invade the central nervous system and cause damage to nerve cells in the brain. Studies from 2002 and 2003 found virus particles inside brain cells, including the cells in the brainstem that regulate breathing. But experts are not very sure of how the virus enters the brain though they suspect that it may be through the respiratory system. Let us look at some of the neurological symptoms of COVID-19 here.

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Myalgia

This is basically muscle pain or tenderness. You may also experience redness and swelling of muscles in any part off the body. This is a relatively common symptom of COVID-19. Many people may also complain of joint pain and tenderness of tendons.

Encephalopathy

One of the rare symptoms of COVID-19 IS altered sense of reality and confusion, lethargy and sometimes coma. This may be due to acute necrotizing hemorrhagic encephalopathy, which induces altered levels of consciousness. On March 31, a 58-year-old woman treated at Henry Ford Health System in Detroit succumbed to the first presumptive case of encephalitis linked to COVID-19.

Guillain-Barre syndrome

In China, a 61-year-old woman came in with symptoms of the autoimmune neuropathic condition, GBS. The signs of this condition includes weakness in the leg and severe fatigue. This woman had no fever, cough, or chest pain. But she had muscle weakness and distal areflexia that became worse with time. It was much later that she exhibited the common symptoms of COVID-19 like dry cough and fever.

What scientists say

Experts agree almost unanimously that neurological symptoms are rare in COVID-19. Only a small percentage of patients may exhibit these symptoms. But it is not unknown. Therefore, doctors and caregivers need to be alert to such symptoms too. Sometimes, patients may also exhibit other symptoms like loss of smell and taste sensation. Yet others may come with more serious symptoms like seizures, spinal cord disease and brain stem disease. Some experts from Johns Hopkins School of Medicine in Baltimore, Maryland, have also suggested that 'brain stem dysfunction may account for the loss of hypoxic respiratory drive seen in a subset of patients with severe COVID-19 disease. But, at the same time, they also caution that it is still too early to come to any conclusion.

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