Can COVID19 increase risk of falls? Yes, read here to learn how...

It appears that COVID19 virus protein has a particular affinity to the human ACE2 protein which it uses in order to invade the host's body (Nature 10.1038/s41586-020-2179-y). Surprisingly, nicotine in the cigarette smoke indirectly increases the production of the ACE2 protein (Mol. Pharmacol. 97, 351.10.1124/molpharm.120.000014), putting smokers possibly at a higher risk of complications.

Unfortunately the ACE2 protein is naturally found in many different tissues including the lung tissue, blood vessels and ... the brain! (J. Med. Virol. 1–4. 10.1002/jmv.25728).

Emerging evidence implies that COVID19 virus invades the brain cells by traveling up the nasal cavities, into the olfactory nerve (the nerve in charge of smelling) and making its way into the thalamus and the brain stem areas of the brain (J. Med. Virol. 1–4. 10.1002/jmv.25728). The olfactory nerve involvement seems to explain why some patients with COVID19 report decreased sense of smell. Some believe that virus effects on the medulla oblongata, part of the brain stem in charge of heart and lung function, is responsible for the altered breathing patterns seen in the COVID19 patients. It has been reported that COVID19 can cause strokes, seizures, confusion and dizziness, in addition to the commonly known fever and cough associated with pneumonia (ACS Chem Neurosci. 2020 Apr 22 and Rev Neurol. 2020 May 1;70(9):311-322).

Questions had been raised about the possibility that long term consequences of virus activity in the brain may result in chronic neurological conditions like Parkinson's or Multiple Sclerosis (ACS Chem. Neurosci. 11, 1192.10.1021/acschemneuro.0c00174).

Overall, it appears that in additional to the commonly known acute infectious (e.g. confusion due to fever), causes, both acute and chronic neurological (e.g. dizziness, etc...) complications listed above can increase one's risk of falls.

What should we do? Steady Strides: Fall Prevention and Stroke Rehabilitation Medical Institute encourages all of us to overcome the cabin-fever urge to break the social distancing rules recommended by the public health officials and if possible to make efforts to quit smoking (yes, there is one more reason not to smoke, believe it or not).

If we can help answer any of your questions, please don't hesitate to reach out to us at 443-898-8160, check out our blog at www.steadystridesmd.com/blog. If you or your loved ones need to schedule an appointment with Dr Atanelov, MD or any of our physical or occupational therapists we do offer remote telehealth services covered by insurance. Call 443-898-8160 or book appointment on-line if needed.