Rare neurological condition linked to COVID-19 cases in 21 countries

Press release:

As researchers continue to study the neurological impacts of COVID-19, a Houston Methodist international collaboration has documented an unexpectedly frequent occurrence of acute transverse myelitis (ATM) – inflammation of the spinal cord – in 43 COVID-19 patients. Led by Houston Methodist neurologist Dr. Gustavo Roman, the study of existing scientific literature found that patients from 21 countries developed spinal cord lesions after contracting the virus. Symptoms included paralysis and sphincter/bowel dysfunction. The patients ages ranged from 21 to 73 and included about half-and-half women and men. ATM, a rare neurological condition, affects between 1.34 and 4.6 cases per million per year, and researchers believe the unusually high rate in post-COVID-19 patients merits additional investigation. Moreover, 3 ATM cases were reported during the trials of the Oxford AstraZeneca vaccine. The study is published in Frontiers in Immunology. Dr. Roman collaborated with researchers from Hospital Paitilla, Interamerican University of Panama and Hospital Santo Tomas (Drs. Fernando Gracia, Antonio Torres, Alexis Palacios, Karla Gracia and Diogenes Harris).

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COVID-19 related strokes, other neurological impact under study

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Traditional stroke treatments like clot-dissolving tPA and surgical removal of big clots in the brain are good choices as well when the stroke results from SARS-CoV-2 infection, investigators report.

Excessive blood clotting and stroke — even in young, previously healthy people — are among the myriad of effects the virus is having on people across the globe. Another effect is keeping people away from hospitals even when they experience signs of stroke, like sudden and particularly one-sided weakness in the face, arm or leg, say stroke specialists at the Medical College of Georgia and Augusta University Health System.

“What we know about COVID-19 and stroke is people need to be treated urgently and they tend to do really well with tPA and mechanical thrombectomy (clot removal) if they come in within a short time window,” says Dr. David Hess, stroke specialist and MCG dean, who encourages those with signs of stroke for any reason to get to the hospital as soon as possible.

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COVID-19 frequently causes neurological injuries

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Without directly invading the brain or nerves, the virus responsible for COVID-19 causes potentially damaging neurological injuries in about one in seven infected, a new study shows. These injuries range from temporary confusion due to low body-oxygen levels, to stroke and seizures in the most serious cases, say the study authors.

Led by researchers at NYU Grossman School of Medicine, the study showed no cases of brain or nerve inflammation (meningitis or encephalitis), indicating no immediate invasion of these organs by the pandemic virus, SARS-CoV-2.

While this should reassure patients, the neurological complications of COVID-19 should be taken seriously because they dramatically raise a patient’s risk of dying while still in hospital (by 38 percent), researchers say. Such adverse effects also raise a coronavirus patient’s likelihood (by 28 percent) of needing long-term or rehabilitation therapy immediately after their stay in hospital.

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Neurologic complications common even in moderate COVID-19 cases

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MINNEAPOLISCOVID-19 can lead to a broad range of neurologic complications including stroke, seizures, movement disorders, inflammatory diseases and more, even in moderate cases, according to a new study published in the December 9, 2020, online issue of Neurology® Clinical Practice, an official journal of the American Academy of Neurology.

“We looked at people with neurologic symptoms and COVID at a racially and socioeconomically diverse hospital and found a wide range of neurologic complications–spanning inflammatory complications, stroke and other vascular conditions, metabolic problems, exacerbation of underlying neurologic conditions and more,” said study author Pria Anand, M.D. of Boston University School of Medicine in Massachusetts and a member of the American Academy of Neurology. “Yet the majority of these people did not require critical care, suggesting that neurologic complications may be common in people with moderate COVID-19 as well as those with severe disease.”

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