Most of the research performed on COVID-19, or the novel coronavirus, has centered on resolving acute infection and saving lives. Scientists have only recently begun studying the role of various autoimmune reactions and the changes that the virus can cause in individual organs and whole-body systems, including the nervous system. Discover what we know so far about COVID-19 and the nervous system.*

What are some known effects of COVID-19 on the nervous system? 

Research suggests that many neurological symptoms of COVID-19 are likely a result of the body’s wider immune response to the infection, rather than the virus’ direct effects on the brain and nervous system. Studies show changes in cerebrospinal fluid (which bathes the brain) after being infected by COVID-19. It’s still unclear whether or not viral injuries to the nervous system will resolve over time or whether they’ll lead to chronic neurological disorders.  

What are some of the acute effects on the brain?

Most people infected with the novel coronavirus have few, if any, symptoms associated with the brain or nervous system. Most patients hospitalized with COVID-19, however, do experience such symptoms, most commonly:

• Muscle aches
• Headaches
• Brain fog
• Dizziness 
• Altered taste and smell senses 

Some people develop delirium (severe confusion). The disease can also cause seizures and major strokes, though these are rare. Muscular weakness, nerve injury, and pain syndromes are common in people who require intensive care during infections. 

Other rare developments include inflammatory disorders of the nervous system, like:

• Guillain-Barré syndrome, an autoimmune disease
• Transverse myelitis, or inflammation of the spinal cord 
• Acute necrotizing leukoencephalopathy, i.e., rare, brain disease-causing cell death
• Facial nerve palsies, such as Bell’s palsy, which causes paralysis
• Parkinsonism, even in patients with no family history of Parkinson’s disease

The virus doesn’t just affect nerves in the brain, however; it can also weaken arteries and veins, causing breakages and leaks. 

Bleeding in the brain can lead to:

• Inflammation (encephalitis)
• Blood clots
• Hypoxia (insufficient oxygen) 
• Acute infection

In serious cases, these can result in stroke, heart attack, cognitive and motor impairment, and permanent damage and disability.

What are some possible long-term neurological complications?

Post-acute effects of COVID-19 typically include fatigue combined with several other symptoms, such as:

• Nerve damage, including peripheral neuropathy
• Alternation senses of hot and cold
• Fatigue and post-exertional malaise (feeling tired or sick after even minor effort/exertion)
• Poor concentration and memory
• Muscle, joint, and/or chest pain
• Lingering loss of smell or taste sense
• Persistent fever and chills
• Prolonged coughing, shortness of breath, or other respiratory effects
• Headaches
• Sleep disturbances
• Anxiety, depression, and post-COVID stress

Some of the symptom clusters reported by people with long COVID-19 overlap with symptoms described by patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). ME/CFS is not diagnosed unless you’ve experienced key symptoms for more than six months, which include severe fatigue, post-exertional malaise, and unrefreshing sleep.

Which neurological disorders create a higher risk for severe COVID-19 illness?

COVID-19 seems to disproportionately affect certain racial and ethnic populations. This may be due to higher rates of pre-existing conditions, like heart disease, diabetes, and lung disease. All demographics, however, are at greater risk for severe illness from COVID-19 if they are experiencing or have a history of:

• Cerebrovascular disease
• Stroke
• Obesity
• Dementia
• Diabetes
• High blood pressure

Social health factors, such as socioeconomic status and access to care, also contribute to health risks and outcomes.

More information about neurological symptoms and COVID-19 can be found in the Scientific American article, “What We Know So Far about How COVID Affects the Nervous System.”

*National Institute of Neurological Disorders and Stroke. (2021, Mar. 12). Coronavirus and the Nervous System. https://www.ninds.nih.gov/Current-Research/Coronavirus-and-NINDS/nervous-system 

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.