Impact of covid 19 in patients with pre-existing neurological pathology:
surprisingly, it is noted that covid 19 has more impact on patient with available established neurological appearance such as stroke, Parkinson’s dementia, etc.due to the previously available neurological manifest it should be noticed that neurotropism of SARS-CoV-2 can also be taken into account and we have to be very careful about that.
It is also cleared from research that patient with available established neurological disease deficient from stroke that have bad outcomes afer being infected by covid virus. And those patients are in very dangerous and critical condition of ICU admit, getting discharge without proper treatment n precautionary and use of mechanical ventilators. The pathophysiology is still yet uknown for these bad results.but it has been established that this bad result is due to concurrent condition such as old age,hypertension, cardiovascular disorders like arrhythmias, diabetes, low immunity related. Such patients are also risk of developing cardioembolic events secondary to viral & bacterial infection or new cerebrovascular event secondary to thrombotic microangiopathy hypercoagulabity leading to macro and micro both types of thrombi formation in vessels,hypoxic injury blood brain barrier & disruption of blood.
Different people sometimes have different diseases but in case of parkinson’s disease they have a bad outcomes. And according to research it is found that main cause of symptom for magnification of parkinson’s disease in different patient was the infection due to lack of caring and use of wrong medicine and anxiety , non observance for treatment . contrary to this covid 19 there are other some reasons and symtoms like change in the environment and going for hospital for treatment some patient carring covid can spread person to person and some intake of medication cause increase in covid 19 cases.
those patients which having disease like Dementia, it shows deteriorating in cognitive performance also delirium , because of due to the fact that infection persuade production of nervous system & systemic secretion of cytokines & prostaglandin.
Those patients which have spinal cord injury, there is more than worse of pneumonia due to having difficulties in breathing and clearings.
There are several different Cytokines which are as follows:
IL-6
IL-1β
TNF- α
These cytokines are secreted during covid infection which are powerful activators of hypothalamic pituitary adrenocortical (HPA) which is central to regulation of systemic immune activation whose activation is activated by blood brain barrier dysfunction & neurovascular inflammation. The covid infection leads to immunosuppression & lymphopeniawhich leads to activation of HPA, leading to release of norepinephrine & glucocorticoids. These mediator acts synergistically to induce splenic atrophy.t cell apoptosis & natural iller cell deficiency. Down regulation of these factors, in concert with calprotectin release from damaged lungs may increase hematopoietic stem sell proliferation skewed towards emergency myelopoiesis that results in lymbphopenia & neutrophilia, which are two hematoglogical features of covid.
Covid virus infection can cause various system i.e multi system failure leading to systemic water, electrolyte imbalance, hormonal dysfunction, accumulation of toxic metabolites which is hypothesized to cause neurological manifestions such as headaches, confusion,agitation etc.
