COVID-19 affected brains of most patients hospitalized with disease, Chicago study finds
Four out of five patients with COVID-19 experienced neurological symptoms such as dizziness, confusion and headaches within a hospital network in Chicago, according to the largest study on the topic since the pandemic began.
Patients with encephalopathy — a general term for a permanent or temporary disease that affects brain function — were more likely to have worse medical outcomes and were seven times more likely to die from COVID-19 within 30 days of hospitalization compared to those without it.
What’s more, younger patients were more likely to develop neurological symptoms than older ones, despite how severe patients’ respiratory systems were attacked. The study was published Oct. 5 in the journal Annals of Clinical and Translational Neurology.
The Northwestern University researchers said the “severity and persistence” of “neurologic manifestations” of the coronavirus is increasing, but their frequency “and associated risk factors remain unclear.”
“Only 9 months into the pandemic, the long‐term effects of Covid‐19 on the nervous system remain uncertain,” the researchers wrote in their study.
They note that “broad recognition and screening” for cognitive reactions to the disease may have “potential to improve patient outcomes.”
That’s because the coronavirus doesn’t just affect the upper respiratory tract, it also has a “unique ability” to attack multiple organs.
Most hospitalized patients had altered mental state
The study looked at the first 509 COVID-19 patients admitted to the Northwestern Medicine Healthcare system, which consists of one academic medical center and nine other hospitals in the Chicago area, between March 5 and April 6.
The majority of patients, 82% or 419 individuals, experienced neurological symptoms during the course of their COVID-19 infection and stayed at the hospital for longer than those who did not exhibit cognitive reactions.
The most common neurologic symptoms included deep muscle aches (45%), headaches (38%), encephalopathy (32%), dizziness (30%), loss of taste (16%) and loss of smell (11%). Strokes, motor and sensory deficits, seizures and impaired coordination were uncommon, but 134 patients did develop severe COVID-19 and require mechanical ventilation.
Patients with encephalopathy were not only seven times more likely to die than those without altered mental states, but they also stayed three times longer in the hospital than others in the study.
But it was the age disparity that surprised researchers the most. Younger patients developed these symptoms more often than older patients.
Meanwhile, encephalopathy was more common among older individuals who were also more likely to be male and have a history of neurological disorders, cancer, chronic kidney disease, heart failure, diabetes and high blood pressure, the study said.
The researchers said there may be an age gap because doctors may have been more focused on respiratory problems rather than cognitive ones in older patients.
Neurological symptoms are long-lasting
The neurological effects were long-lasting, too: 32% of patients with altered mental function said they could handle “daily activities such as cooking and paying bills”, compared to 89% without cognitive issues who were able to manage just fine, study senior author, Dr. Igor Koralnik, chief of neuro-infectious disease and global neurology at Northwestern Medicine, told The New York Times.
“This is an important study, since the neurological complications of the infection seem to be frequent and in many cases long lasting, but yet have not received much attention,” Dr. Avindra Nath, chief of the section on infections of the nervous system at the National Institute of Neurological Disorders and Stroke, told the Times.
Nath was not involved in the study.
The researchers say overcoming COVID-19 doesn’t declare the end of a vast journey on its own. Long-term follow-up is necessary in order to understand “the true burden” of these neurological effects and what that might mean for future function.
This story was originally published October 6, 2020 at 5:12 PM with the headline "COVID-19 affected brains of most patients hospitalized with disease, Chicago study finds."
