- Intensivists and neurologists from the healthcare group point out as symptoms mental confusion, hallucinations, distortion of reality, disorientation, memory loss and muscle weakness that can lead to temporary tetraplegia
- In the cases of hospitalized patients who do not require ICU, Ribera's neurologists point out everything from encephalitis with seizures and tretraparesis to severe headaches resistant to the usual analgesics, along with loss of smell and taste as usual symptoms.
- Once the disease has been overcome, cognitive alterations appear in up to 75% of patients and psychiatric disorders (anxiety, depression, stress) in up to 65%.
More than 50% of critically ill COVID patients suffer from delirium and muscle weakness, which in some cases can be extreme and lead to temporary quadriplegia.
This is explained by the specialists from the Ribera health group who most directly treat these patients, especially in cases of admission to the Intensive Care Units (UCIS). Mari Cruz Martín, head of this Unit in the Torrejón University Hospital, managed by the Ribera group, ensures that these neurological alterations "are very frequent in patients with certain characteristics such as severe cases, with sepsis and prolonged mechanical ventilation, among others." Delirium, explains Dr. Martín, "is an alteration of consciousness characterized by inattention, accompanied by alterations in cognition, perception or both, which develop in a short period of time and fluctuatingly". Specifically, she points out, "patients can be very agitated or hypoactive, have hallucinations and even show a distortion of reality."
Ribera specialists say that 20% of patients have neurological symptoms at the onset of the disease. Dr. Antonio Pato, a neurologist at the Povisa Hospital, managed by the Ribera group, ensures that the most common neurological effects after nine months of COVID cases are mental confusion, disorientation and apathy. “Many patients claim to be more groggy than usual, sometimes with a feeling of numbness and a severe headache,” he explains. To which Dr. Marta González, head of the Ribera Neurology Service at the Torrejón Hospital adds that "very often, patients present with headaches that are resistant to the usual analgesics, loss of smell (anosmia) and altered sense of taste ( dysgeusia)”.
Other serious symptoms highlighted by Dr. Pato "are related to inflammation of the brain or peripheral nerves, and may suffer from encephalitis with seizures or tetraparesis that prevents walking." Less common seem to be oculomotor neuropathies or sensory polyneuropathies, although cases have been detected, says Dr. González.
In patients admitted to the ICU, especially those with mechanical ventilation and with longer stays, the head of the ICU of the Torrejón Hospital, Dr. Martín, assures that "they may present cognitive problems such as lack of memory and attention, and problems emotional disorders such as depression, anxiety, stress and post-traumatic stress syndrome”, effects that, such as respiratory and motor physical dysfunction, coincide with post-ICU syndrome. And Dr. Pato adds: “Mental dullness and memory loss are also common symptoms. Some patients find it difficult, for example, to read the newspaper and remember what they have read, and they refer to it as a fog that leaves them more stunned."
But once the disease is over, what percentage of patients live for a time with this type of neurological effects? Dr. Martín assures that "it is high and also variable". "Cognitive disorders appear in up to 75% of patients and psychiatric disorders (anxiety, depression, post-traumatic stress) in up to 65%," she explains. And she adds: "Although the experience in the follow-up of COVID patients is still short, the post-ICU effects in other critically ill patients persist in 10% of cases at 6 and even 12 months."
For the Ribera specialists, prevention and subsequent rehabilitation are key to a good and rapid recovery of these patients. “Both for the prevention of delirium and for muscle weakness acquired in the ICU, there are practices that have proven effective, such as trying to adjust sedatives to the maximum, controlling pain, trying to disconnect patients from mechanical ventilation or rehabilitation on a daily basis. early childhood and the accompaniment of the family”, assures Dr. Martín. She also adds that “both physical and respiratory rehabilitation as well as cognitive rehabilitation and emotional support are important. Temporal and spatial orientation, the possibility of communicating and offering guidance and alternative communication tools, the presence of the family, psychological support and humanized architecture can prevent many neurological manifestations.
