Is COVID-19 more fatal than we perceived till now besides being a severe breathing disease?

Student Contributors: Koustav Kiran Das (B.Sc. 3^rd Year), Sampurna Nandi (B.Tech. 2^nd Year).

COVID 19 has become the most used jargon in recent times due to its huge impact on the daily lives of humankind worldwide. SARS-CoV-2 i.e. Severe Acute Respiratory Syndrome Coronavirus 2019, the virus responsible for COVID 19, emerged in Wuhan, China in 2019, and rapidly spread all over the world. The most characteristic clinical symptoms of this particular disease are respiratory distress and spontaneous breathing incapability, along with other symptoms. Some patients with this viral disease also exhibited some neurological signs and symptoms such as headache, nausea, and vomiting. Moreover, it has also been reported by various scientific groups that this virus is not always restricted it’s spreading only to the respiratory tract, moreover, it can also conquer it’s viral propagation into the CNS i.e. Central Nervous System, inducing a wide range of neurological problems.

Some Scientific Facts:

• Genomic analysis shows that the virus responsible for COVID-19, i.e. SARS-CoV-2 is related to other beta-coronaviruses like MERS-CoV (Middle East Respiratory Syndrome Coronavirus) and SARS-CoV, and it shares high homology with SARS-CoV.
• The entry of SARS-CoV-2 into its host cells i.e. human cells has been associated with the same receptors like SARS-CoV.
• Surprisingly, it has been reported that most coronaviruses have very similar kinds of structural features and they also employ a very common infection pathway, and therefore the infection mechanisms previously reported for other coronaviruses, may be relevant for SARS-CoV-2 also.
• SARS-CoV-2 enters the human host cells by a cellular receptor Angiotensin-Converting Enzyme 2 (ACE2), it is an enzyme which is present in various groups of cells and organs such as cells on the alveolar surface, cells on the intestinal wall, the inner lining of arterial and venous cells and also in cells of skeletal muscles and vascular cells of Brain and nervous system.
• This enzyme acts as a protecting factor in these organs and regulates blood pressure and prevents the build-up of plaque in the arterial walls. However, this enzyme is also a target for various coronaviruses.
• In addition to this, the virus can also enter the CNS via the olfactory nerve, the nerve that leads to the brain from the nasal cavity.
• A study on Covid-19 patients recently found that along with severe breathing troubles, some other neurological symptoms also manifested, including headaches, disturbed consciousness, and burning sensation in hands, arms, or legs. This list also includes ischemic and hemorrhage type strokes.

So from these scientific facts, it can be easily suggested that there is a strong correlation been observed between COVID 19 infection and other neurological diseases, which need to be addressed immediately by our medical professionals and scientists. Keeping in mind the neurological cases arising in the wake of the CoViD-19 pandemic, the presence  of Neurologists at the frontline have now become extremely important to assess the clinical situations. Moreover, it is imperative to note that other neurological diseases could also occur due to COVID-19 infection and which is very alarming. So, here is a small list of some other neurological diseases caused by this deadly virus.

Other Neurological Infections that could be caused by SARS-CoV-2

• Viral encephalitis: Infections in CNS; lesions in the brain and nervous tissue and neuronal damage. Symptoms include headache, high fever, vomiting, epilepsy, and consciousness disturbances.
• Infectious toxic encephalopathy: A reversible brain dysfunction syndrome led by systemic toxemia (toxins produced by body cells due to infection), metabolic disorders, hypoxia (deprival of oxygen in the body), and cerebral edema (swelling of the brain). Symptoms include mild headache, mental disorder, mental confusion, emotional disruption, thinking disability to serious loss of consciousness, mental disorientation, coma, and paralysis.
• Acute Cerebrovascular disease: Breathing related infection is an independent risk factor for cerebrovascular disease. Symptoms include ischemic brain injury and cerebral hemorrhage due to cytokine storm. It also causes elevated levels of D-dimers in severely infected patients with severe platelet reduction too.