- The coronavirus is a very complex disease, that affects many organ systems, including what we call the cental nervous system, or the brain and spine. While we still have much to learn about the specific mechanisms by which the virus affects the central nervous system, we have experienced many patients, as many as a third to 50%, with some neurologic manifestation. Anything from headache to fatigue, all the way to severe effects such as coma and even death. One of the mechanisms that's becoming more clear is what we call a hypercoagulable state, caused by the virus, or an increase in the blood's likelihood to form blood clots, and these can lead to strokes. This is a severe manifestation of coronavirus, and fortunately it only happens in a small percentage of patients. But, if a patient experiences stroke-like symptoms, anything from changes in vision, to trouble speaking, to unilateral weakness, it is very important to seek immediate emergency medical attention, and call 911. One of the more common symptoms that's becoming apparent in coronavirus patients is a loss of smell and taste. While the direct mechanism of how the virus is causing this, remains unclear, we are starting to understand that the virus seems to affect both the respiratory mucosa, or the inner lining of your nasal passages, as well as the nerve cells that conduct your sense of smell to your brain. When the virus affects these structures, it can inhibit the ability of these neurons to transmit the sensation of smell to the brain. And this, in turn, can affect the person's ability to taste, because taste and smell are integrally, are related. The good news is that most patients, in our experience, seem to regain their sense of taste and smell with time. The time in which this happens varies. Some people regain it rather quickly, some it takes considerably longer. And it does seem that some patients report a lasting deficit in their ability to smell. But the real long-term effects are still under investigation. The longterm effects of coronavirus on the central nervous system remain uncertain and under investigation. It's unclear, at present, whether patients who were exposed to the virus became ill and got better, or were exposed to the virus and never developed symptoms, will eventually go on to have longterm neurologic effects of the virus. We do know, however, that, the smaller percentage of patients who were exposed to the virus and developed strokes because of the virus, can have lasting symptoms. However, as with stroke in general, the sooner the patient presents to the emergency department for treatment, the better chance of an improved longterm outcome. Here at Montefiore, we are developing several lines of research that will evaluate whether the coronavirus has lasting effects on the central nervous system. Specifically, we are constructing several registries of coronavirus patients, that will follow the patients clinically and with imaging over time, to evaluate for any lasting or longterm effects of coronavirus. And if these are discovered, we will investigate the best ways to manage them over time.