Each day, it seems as though we learn something new about coronavirus disease (COVID-19). While that can feel frustrating, it makes sense. This is a new virus creating completely new situations for us. We’re all learning together, in real time. But as information evolves, it brings questions, misinformation, or misunderstanding if there isn’t enough time or space for full context or explanation.
The latter, I worried, might be the case if people skimmed reports like the recent New York Times article describing neurological symptoms, ranging from smell loss to stroke, in people with COVID-19. One of the patients had Parkinson’s, and I feared this diagnosis would stand out more than his age and lung disease, known risk factors for significant coronavirus symptoms.
Here, I’ll describe what we know and don’t yet know about coronavirus, Parkinson’s disease (PD) and neurological symptoms.
What We Know:
- There currently is no evidence that Parkinson’s increases risk of getting COVID-19.
Parkinson’s disease, by itself, does not appear to be a risk for getting the virus or having a more severe course. (If you are younger and don’t have other health conditions, for example, you may not be at higher risk simply because of PD.) But older age (common in people with Parkinson’s) as well as heart and lung disease (common in older age) do increase risk. And people with progressing Parkinson’s, especially those who have significant swallowing, breathing or moving problems, are at increased risk for many types of infection, including COVID-19.
- For people with Parkinson’s, any type of infection worsens symptoms.
If you have Parkinson’s and get an infection, such as a urinary tract infection or pneumonia, your symptoms are likely to increase. If you have tremor, it may be harder to control; if you move slowly, you may be slower. People who have thinking or memory problems may get confused. (Even those with mild or previously unnoticed cognitive changes may have confusion.) So someone with Parkinson’s who has COVID-19 might experience an increase in their usual symptoms, as they might with any kind of infection.
- Some people with COVID-19 have neurological symptoms.
The most common symptoms of COVID-19 are fever, cough and trouble breathing. But doctors have seen some patients with brain symptoms, such as headache, seizure or confusion. In a report of 214 hospitalized patients in Wuhan, China, doctors found that 36 percent had a neurological symptom. Those with more severe COVID-19 were more likely to experience a neurological change.
What We Don’t Yet Know:
- How COVID-19 causes neurological symptoms.
It is not yet clear if the virus is able to directly affect the brain (it gets into the brain or causes brain inflammation) or it affects brain function indirectly, by impacting brain blood or oxygen flow, for example, when it limits heart or lung function. Symptoms such as confusion or generalized seizures (typically arm and leg jerking with loss of consciousness) often indicate a more widespread process that involves the whole body, meaning other body organs and systems are involved. Smell loss, on the other hand, might be harder to explain. The virus could directly affect the smell nerves (which connect to the brain) or cause nasal congestion (a “stuffy” nose) that makes it tough to smell. (Read more about smell loss and coronavirus.)
- Potential long-term effects.
Many people wonder if having coronavirus or brain symptoms increases risk for Parkinson’s or other neurological conditions in the future. Some believe infection can be an “initiating” factor for Parkinson’s, essentially setting the disease in motion and bringing out symptoms that may not have arisen until later. But this remains somewhat controversial – even in the case of increased PD diagnoses following the 1918 flu pandemic – because in most instances, infection is associated with than directly connected to PD. (This means other factors could be involved, and the virus has not been proven as the exact cause.) Aside from the virus itself, the body’s immune system, which fights infection, can potentially cause later problems. In some people, the immune system mistakenly attacks cells in the brain, spinal cord or nerves, causing confusion, weakness, or numbness and tingling, depending on the location and extent. It’s not clear whether this can or will happen with COVID-19, but researchers are thoroughly evaluating how COVID-19 affects the brain and doctors are closely observing for neurological effects.
While doctors and researchers work urgently to learn more, you can work to protect yourself and others. Stay home, stay connected and stay active. If you must go out (to get groceries, to work, or to care for a loved one), wear a mask, wash your hands regularly and keep your distance from others. And you can move the Foundation’s research mission forward remotely from home. Learn more and register for MJFF’s online clinical study at foxinsight.org.