February 4, 2021
NeuroCOVID: NIH Launches Database to Track Neurological Symptoms of COVID-19
Medically accurate illustration of the human brainSource: Adobe Stock
A fever. Cough. Fatigue. Sore throat. New loss of taste or smell. By now, we’ve all learned to stay on guard and watch for the common symptoms of COVID-19.
Although COVID-19 is regarded as a respiratory disease, it can have a wide range of effects throughout your body: including effects on your brain.
In light of this, the National Institutes of Health recently announced the launch of “NeuroCOVID,” a database designed to track neurological symptoms associated with COVID-19.
“We know that COVID-19 can disrupt multiple body systems, but the effects of the virus and the body’s response to COVID-19 infection on the brain, spinal cord, nerves, and muscles can be particularly devastating,” said the National Institute of Neurological Disorders and Stroke program director Barbara Karp, M.D.
Karp also said these effects can contribute at a disabling level even after you’ve recovered from the virus.
“There is an urgent need to understand COVID-19 related neurological problems, which not uncommonly include headaches, fatigue, cognitive difficulties, stroke, pain, and sleep disorders, as well as some very rare complications of serious infections.”
COVID-19 and the Brain: What We Know So Far
Spoiler alert: there’s still A LOT of research to be done
Symptoms like brain fog, sleeplessness, and the loss of smell and taste, have sparked interest among researchers on how COVID-19 affects the brain, says an NIH editorial article by Dr. Francis Collins.
You may be wondering, “Well, what’s smell have to do with your brain?” Let us introduce you to the olfactory system. This is one of the oldest sensory systems, yet “one of the least understood.”
“Oderants” (smelling stimuli) stimulate a bunch of olfactory neurons that live in the olfactory epithelium. This is an epithelial sheet that lines the interior of your nose (sort of like the lining to a purse or backpack).
The axons — a long “cable” thinner than a single human hair — then send electrical impulses to neurons in the olfactory bulb.
It’s essentially your olfactory neurons’ way of saying, “HEY! THERE’S A THING HERE AND IT SMELLS! SMELLS?? WHAT IS THIS SMELL??”
Or, to put it quite crassly, the olfactory neurons in your nose turn to the olfactory bulb to “Google” the smell and identify it across multiple “sites” in your brain.
Anyways, back to the editorial article. In a study cited by Francis, researchers examined brain tissue from those who passed after contracting COVID-19.
Based on their findings, it appears COVID-19’s neurological symptoms are likely due to your body’s widespread inflammatory response that kicks into high gear once it detects the virus.
The research team conducted MRI imaging on 19 of these individuals, who were between the ages of 5 to 73 years old. They mainly focused on the olfactory bulb and the brain stem, which regulate smell and breathing/heart rate, respectively.
Their imaging detected an unusual amount of inflammation, as well as bleeding and tiny blood vessels that were abnormally thin. They also observed leaky vessels and clots in the images.
However, these researchers didn’t find any signs that COVID-19 had infected the individuals’ brain tissue.
Yet, this goes against previous findings, which indicate COVID-19 may cross the blood-brain barrier due to its viral spike proteins.
3D print of a SARS-CoV-2—also known as 2019-nCoV, the virus that causes COVID-19—virus particle. The virus surface (blue) is covered with spike proteins (red) that enable the virus to enter and infect human cells. The spikes on the surface of coronaviruses give this virus family its name – corona, which is Latin for “crown,” and most any coronavirus will have a crown-like appearance.Source: NIH
According to a review in the Clinical Neurology and Neurosurgery journal, COVID-19 receptors are expressed in the brain. And there are two routes the virus can take to “penetrate the central nervous system.”
- “Hematogenous spread” — A.K.A. through the bloodstream
- Through the cribriform plate (a bone that transmits olfactory nerves to the olfactory bulb) and olfactory bulb.
“Prior experimental models have shown that other coronaviruses can compromise the nervous system and the respiratory drive by directly targeting neurons located in the cardiorespiratory centers,” the review says.
But preliminary observations of COVID-19 suggest it may focus more on targeting neurons in the CNS.
Out of 214 patients with COVID-19, over 36 percent demonstrated neurological symptoms noted in the review. These included:
- Impaired consciousness
- Ataxia (Impaired coordination due to brain damage)
- Acute cerebrovascular disease
- Hyposmia (reduced ability or complete loss of smell)
- Hypogeusia (reduced ability to taste)
- Neuralgias (a stabbing, burning pain due to nerve irritation or damage)
The review also states these neurological symptoms are more common in those with severe COVID-19 infections.
Headaches are mentioned as a reported symptom, as well. But in the absence of other neurological symptoms, it appears these headaches are due to your body’s response to the virus, rather than the virus invading the CNS itself.
This aligns with the editorial piece, which suggests the headaches may be a result of widespread inflammation, rather than a neurological infection of COVID-19.
“The reports on the neurological findings are increasingly rapid and headache seems to be the leader on the symptom list,” says an article in the American Headache Society journal. “Headache was reported in 11 to 34 percent of the hospitalized COVID-19 patients, but clinical features of these headaches were totally missing in available publications.”
These headaches were new-onset, moderate to severe in bilateral (affecting both sides of the head) pain with a pulsating or pressing quality in the temporoparietal (sides of the head), forehead, or periorbital (eyes) region.
“The most striking features of the headache were the sudden to gradual onset and poor response to common analgesics, or high relapse rate,” the article says.
The article also agrees that COVID-19 related headaches may be the byproduct of inflammation. However, it can have other causes, as well, such as encephalitis or viral meningitis related to COVID-19.
Those who suffer from migraines also noticed their COVID-19 related migraine differed from their usual ones: they didn’t have the hypersensitivity to odors like they normally do, but they were still incredibly light and sound sensitive.
“In a few patients, it was very intractable causing suicidal ideation,” the review adds. This is similar to what’s seen in cluster headaches, also known as “suicide headaches,” which are regarded as the most excruciating headache disorder.
Interestingly, the majority of those who reported headache as a symptom of COVID-19 had no prior history of a headache disorder.
“As a common non-respiratory symptom of COVID-19, headache should not be overlooked, and its characteristics should be recorded with scrutiny,” the article concludes.
The COVID-19 Neuro Databank/Biobank (NeuroCOVID) will be a resource of clinical information as well as biospecimens from people of all ages who have experienced neurological problems associated with SARS-CoV-2 infection.Source: NYU Langone Health
NeuroCOVID was developed and maintained by New York University Langone Health and it’s supported by the NINDS.
“[NeuroCOVID] will be a resource of clinical information as well as biospecimens from people of all ages who have experienced neurological problems associated with SARS-CoV-2 infection,” the NIH press release explains.
The database will house information including neurological symptoms, comorbid conditions, course of the disease, complications, and outcomes.
Healthcare providers and participating clinical sites throughout the US are invited to use NeuroCOVID’s web-based portal to submit de-identified information to the database.
They may also submit relevant biological specimens collected during research studies or previous clinical procedures.
To protect patient privacy, a Global Unique Identifier will be implemented to recognize data and biospecimens from each individual without any personally identifying information.
Scientists who are researching the prevention, management, and treatment of COVID-19 related neurological complications may request access to NeuroCOVID here.
Despite the prevalence of headaches and other neurological symptoms associated with COVID-19, there is still much to learn about their pathology.
NeuroCOVID provides a platform for clinicians and researchers alike to collaborate nationally. Together, we will learn more about COVID-19 and its potential neurological effects.
In the meantime, you can learn more about NeuroCOVID on their official website.
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