Are my symptoms from COVID or is this Multiple Sclerosis?

Here is My Question:
I have been having multiple symptoms since I had Covid back in January. I have had extreme fatigue for months that comes and goes. It seems to be getting worse and not better. I have weakness on my left side, especially in my left hand, When I try to do anything that require fine motor skills I have a difficult time. Even washing my hair with my left hand is difficult. I also have been having tremors on that left arm and hand that are worse when I try to do something that requires concentration. I’ve always suffered with headaches/migraines but they have gotten worse since all this started.

I have low vitamin D levels and take 50,000 units a week. My vision is blurry especially when I wake up in the morning. I have numbness and tingling in my toes on my left foot. My PCP ordered an MRI. The MRI was done in February and I have attached the results below. All the symptoms have worsened since the MRI. My doctor said she thought I had Covid brain and I basically have been waiting hopefully that this would go away. I am convinced that it is something else and I’m going to see my PCP this week and ask to see a neurologist. I am 47 years old and I am a registered nurse and a mother of two children. I want to feel better and function like I used to.

Answer:
We are so sorry to hear about the emergence of your symptom complex following your SARs-CoV-2 infection. As you may already know from reports in the press, at least 10 % of people experience persistent fatigue, brain fog (impaired concentration, attention, and memory), paresthesia (numbness and tingling which can be painful) and weakness, all associated with a decline in self-reported quality of life following COVID19 infection. This is more common in women particularly those who experienced asymptomatic or mild infections. To be sure, it is also common for patients hospitalized with more severe forms of COVID19 to experience persistent symptoms, but these symptoms are more easily attributed to the lung or cardiovascular injury from the acute infection. 

The cause of Long COVID is still unknown and under investigation at multiple academic medical centers. Because there is no diagnostic test for Long COVID and the symptoms can mimic other conditions, including Multiple Sclerosis, it is important for people with Long COVID to undergo an evaluation by a neurological specialist to exclude these other conditions. Many academic centers have specific clinics for post COVID patients. There are able to provide an initial evaluation and refer you to an appropriate specialist to exclude other conditions, such as MS. I would call the medical center in your area with the most experience dealing with COVID19 and find out if they offer a Long COVID clinic for an initial evaluation. You will also need to see a neurologist. In the meantime, try to keep up your activity level and get adequate sleep.

Good luck

​Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego