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Stuttering and Word-Finding Difficulties in a Patient With COVID-19 Presenting to the Emergency Department
Nathan Morrison1, Joshua Levy1, Talia Shoshany2
1Internal Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, USA.
Insights
This case report details a COVID-19 patient experiencing stuttering and word-finding difficulties, highlighting potential neurological impacts of the virus. Early recognition of these rare symptoms is crucial for patient care and disease understanding.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic with diverse symptoms.
- Characterizing COVID-19 is challenging due to its wide symptom spectrum.
- Neurological manifestations like stuttering have not been widely reported.
Observation:
- A 53-year-old female presented with symptoms consistent with COVID-19.
- During her second emergency department visit, she reported new-onset stuttering and word-finding difficulties.
- She tested positive for COVID-19 via PCR nasopharynx testing.
Findings:
- Speech difficulties persisted for at least seven days post-discharge.
- These symptoms suggest COVID-19 may cause acute neurological events.
- The COVID-19 spike protein's potential to breach the blood-brain barrier may explain these findings.
Implications:
- This case expands the recognized spectrum of COVID-19 symptoms.
- Identifying unrecognized COVID-19 complications aids disease characterization and surveillance.
- Considering neurological symptoms in COVID-19 diagnosis is important for patient management.
Abstract:
Coronavirus disease 2019 (COVID-19) was designated as a global pandemic by the World Health Organization (WHO) on March 11, 2020. The Cochrane Database of Systematic Reviews documents that COVID-19 has a wide range of common symptoms, which have made it difficult to characterize the disease. To date, the neurological symptoms of stuttering and word-finding difficulties have not been reported in confirmed COVID-19 cases. This case report describes the clinical course of a 53-year-old female that presented to the emergency department (ED) twice with varying symptoms consistent with COVID-19. At the second ED visit, she complained of new-onset stuttering and word-finding difficulties and tested positive for COVID-19 using the polymerase chain reaction (PCR) nasopharynx test. When contacted, the patient stated that her speech issues persisted at least seven days after discharge from her second ED visit. As a result, the virus may cause symptoms of an acute neurological event and should be taken into diagnostic consideration. These neurological findings may be explained by the recent discovery of the COVID-19 spike protein's ability to destabilize the blood-brain barrier (BBB) and enter the central nervous system (CNS). Increased classification of unrecognized COVID-19 symptoms and complications may aid in the characterization, surveillance, and prevention of the disease.
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