COVID-19 | Delhi hospital reports ‘troubling rise’ in neurological cases in post-COVID patients

Dr Asha Bakshi, a senior neurosurgeon at Moolchand Hospital said these issues are "severely affecting their (patient’s) personal and professional lives”, and many say they find it “extremely tough to focus during work and are struggling with work-life adjustment issues”. (Representative Image: Reuters)

Moolchand Hospital, a leading private facility in the national capital, has recorded a “troubling rise” in neurological issues, including emergency cases of brain haemorrhage, among post-COVID-19 patients, it said in a statement.

“The Moolchand Hospital has been recording increasing cases of intracerebral (brain) haemorrhage, and 50 percent of the neuroscience department is filled with such cases," the statement, issued on July 23, read.

Doctors also noted that people who recovered from COVID-19 are increasingly coming back to the hospital “many weeks later” with symptoms such as anxiety, cognitive difficulties, depression, fatigue, giddiness, headache, memory problems, stroke, pain and sleep disorders.

They further said that up to 60 percent of out-patient department (OPD) cases present mental health issues such as anxiety, depression, the feeling of loneliness and suicidal thoughts. “(A) majority of these cases are those who had COVID-19 in the past, with a gap of two to three months," Dr Asha Bakshi, a senior neurosurgeon at Moolchand Hospital said.

She added that this is “severely affecting their (patient’s) personal and professional lives”, and many say they find it “extremely tough to focus during work and are struggling with work-life adjustment issues”.

Dr Bakshi cited a large cohort study of over 3,700 patients, conducted by the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) and the European Academy of Neurology Neuro-COVID Registry (ENERGY), which showed approximately 80 percent of hospitalised COVID-19 patients showed neurological manifestations.

Stating the data, she said 37 percent of patients reported symptoms, including headache; while 26 percent reported anosmia or ageusia. The most common neurological syndromes reported were acute encephalopathy (49 percent), coma (17 percent), and stroke (6 percent).

“Presence of clinically captured neurologic signs or syndromes was associated with increased risk of in-hospital death," she added and noted that over 42 percent of people surveyed by the US Census Bureau in December reported symptoms of anxiety or depression.

"Data from other surveys suggest that the picture is similar worldwide. In India, a study from Assam (Hazarika and colleagues) found that 46 percent had anxiety, 22 percent had some form of depression and five per cent had suicidal thoughts," Dr Bakshi added.

She emphasised the need for addressing the incidence of neurological disorders and long-term mental health issues in the post-Covid population.

"This needs to be addressed seriously especially when such a large populace is affected as it has a direct implication on our social fabric and more importantly on work-life and subsequent economic health of the nation," Bakshi added.

Moolchand Hospital is not alone in its observations. Akash Healthcare, another Delhi-based hospital on July 23 said it received 15-20 cases with neurological conditions – all patients who recovered from COVID-19.

Dr Madhukar Bhardwaj, a neurologist at Aakash Healthcare Super Speciality Hospital said the most common condition reported are migraine headaches and post-COVID encephalopathy apart from proximal myopathy.

“… other rarer conditions included Guillain-Barr syndrome. Typically, headaches are migrainous in character, present in younger age group and do not respond that well to common medications used for common migraine," he added.

Post-Covid encephalopathy presents with progressive decline in behaviour and alertness in the elderly. The patients usually come with various questions about post-Covid conditions and are very anxious, doctors said.

"So far, we have not seen children coming up with such conditions. People are coming to us with these neurological conditions after one-two months of recovering from Covid," Dr Bhardwaj added.