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Neurological Complications of COVID-19 with Igor Koralnik, MD

COVID-19 can be a multi-system disease, impacting many organs and the entire nervous system. Igor Koralnik, MD, has been investigating the neurological complications of the disease and published the first study focused on long-term neurologic symptoms in COVID-19 “long haulers.” He explains the study and what he is seeing in the Neuro COVID-19 Clinic at Northwestern Memorial Hospital.

 

"We want to know: How long is 'long COVID'? So we're following those patients over time, six to nine months after their initial visit, to see what improved, what didn't improve and to test, also, other types of interventions."

— Igor Koralnik, MD

Episode Notes

When COVID-19 first appeared more than a year ago it was thought to be a disease of the respiratory system, but as early reports from China and Italy soon detailed, the disease impacted far more than the lungs. Igor Koralnik, MD, and his team have been investigating the neurologic symptoms of the disease. They've published two first-of-their-kind studies in Annals of Clinical and Translational Neurology.

The first study found that more than 80 percent of the first 500 patients who were hospitalized with COVID-19 at Northwestern Medicine experienced some form of neurological manifestations. The second study focused on long-term neurological symptoms in COVID-19 “long haulers. The long haulers in this study refer to people with confirmed symptoms of the disease who were never hospitalized yet have neurologic symptoms lasting more than six weeks and came to the Neuro COVID-19 Clinic for care.

Other topics covered:

  • Koralnik describes common neurological symptoms experienced by some COVID-19 patients including headache, numbness, tingling and "brain fog." Brain fog is a term is used by patients to describe their difficulties with attention, memory, multitasking and the ability to work at their job in their usual capacity. 
  • The most severe symptom is encephalopathy, which is global dysfunction of the brain functions, ranging from mild confusion to coma. Some very sick patients may also have seizures. In addition, patients can experience muscle pain, dizziness, loss of smell and taste and a range of peripheral nerve dysfunction. 
  • The Neuro COVID-19 Clinic at Northwestern Memorial Hospital opened in May of 2020, first through tele-health and now in-person visits. The team at the clinic sees about 60 patients a month. Koralnik is trying to understand whether these patients' symptoms are transient or permanent and offer them treatments.
  • Unfortunately, the road to recovery can be long for many of these patients. About five months from the onset of symptoms, on average, only 64 percent of patients said they felt recovered. 
  • Seventy percent of patients who come to the clinic with "long COVID" are women. The average age is 43, which is about 10 years younger than the average age of those hospitalized with the disease. 
  • A team that includes second-year medical students and a fellow worked on the two studies in Annals of Clinical and Translational Neurology. Feinberg medical student Jeffrey Clark and fellow Edith Graham, MD, share their experiences working on these studies.
  • Koralnik also describes how his background studying HIV/AIDS helped prepare him for the SARS-Cov-2 pandemic. Koralnik's lab studies T-lymphocytes, or T-cells, which are part of the cellular immune response against the COVID-19 virus.

Additional Reading: 

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Recorded on March 30, 2021.

Continuing Medical Education Credit

Physicians who listen to this podcast may claim continuing medical education credit after listening to an episode of this program.

 
Target Audience

Academic/Research, Multiple specialties

Learning Objectives

At the conclusion of this activity, participants will be able to:

  1. Identify the research interests and initiatives of Feinberg faculty.
  2. Discuss new updates in clinical and translational research.
Accreditation Statement

The Northwestern University Feinberg School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

The Northwestern University Feinberg School of Medicine designates this Enduring Material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Statement

Igor Koralnik, MD, receives royalties from chapters on HIV, PML and COVID-19. Edith Graham, MD, and Jeffrey Clark have nothing to disclose. Course director, Robert Rosa, MD, has nothing to disclose. Planning committee member, Erin Spain, has nothing to disclose. Feinberg School of Medicine's CME Leadership and Staff have nothing to disclose: Clara J. Schroedl, MD, Medical Director of CME, Sheryl Corey, Manager of CME, Allison McCollum, Senior Program Coordinator, Katie Daley, Senior Program Coordinator, and Rhea Alexis Banks, Administrative Assistant 2.

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