Study: Mental and neurological disorders in nearly one in three COVID-19 patients

Mental and neurological disorders affect almost every third patient with a severe course of COVID-19. Patients develop confusion, delirium, memory impairment, even a coma-like state. What other neurological complications were observed in those infected with SARS-CoV-2? The results of the largest survey in the USA were reported by «The New York Times».

1. COVID-19 is not “only” a threat to the respiratory system, but also to the nervous system – the brain, spinal cord and nerves
2. The largest US study of neurological symptoms in COVID-19 patients: almost every third patient had an altered mental state (encephalopathy) – from confusion to delirium to coma-like state
3. 82 percent of the respondents, neurological symptoms other than encephalopathy were observed: muscle pain, headache, changes in taste and smell
4. For more up-to-date information on the coronavirus epidemic, visit the TvoiLokony home page

Coronavirus – a threat to the brain, spinal cord and nerves

Already in spring, scientists suspected that COVID-19 was not “only” a threat to the respiratory system, but also to the nervous system – the brain, spinal cord and nerves. Subsequent discoveries seem to confirm these fears.

A research review published in June showed that approx. 50 percent. people hospitalized due to infection with the SARS-CoV-2 coronavirus develop neurological symptoms – dizziness, difficulty concentrating, loss of smell and taste, strokes and weakness.

In August, British scientists reported that survivors who were treated in hospitals due to COVID-19 still have health problems after completing therapy, especially neurological disorders.

1. COVID-19 patients often experience severe neurological symptoms – previous research

The largest US study of neurological symptoms in COVID-19 patients has recently been published (published in the journal “Annals of Clinical and Translational Neurology”, which disseminates research related to neurology). The research was conducted in American hospitals belonging to the Northwestern Medicine network in the Chicago area.

The researchers analyzed the medical data of 509 SARS-CoV-2 infected patients hospitalized from March 5 to April 6 in 10 hospitals. Information was also gathered on how they coped after discharge from the hospital. The results are worrying.

Altered mental state in patients with COVID-19

It was found that nearly every third patient enrolled in the study had an altered mental state, ranging from confusion to delirium to a coma-like state. Patients with these symptoms stayed in hospital three times longer than patients without mental disorders (referred to as encephalopathy – brain damage). Moreover, patients with altered mental function were almost seven times more likely to die than those who did not.

“Encephalopathy is a general term for something wrong with the brain,” said Dr. Igor Koralnik, one of the authors of the study and head of Northwestern Medicine’s neuroscience and neurology department. People with this problem may develop attention and concentration problems, short-term memory loss, confusion, dementia and “profound lack of response” or a state of consciousness similar to a coma, he adds.

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Encephalopathy also influenced how patients coped in life after hospitalization. Research shows that only 32 percent. mentally altered patients were able to cope with daily activities such as cooking or paying bills. In the case of people without mental disorders who have experienced COVID-19, 89% of them coped with this type of activity on their own. patients.

– Encephalopathy was associated with the worst clinical outcomes for coping with hospital leave. We can also see that it is associated with higher mortality, regardless of the degree of attack in the respiratory system – emphasizes Dr. Koralnik.

1. How does COVID-19 damage the brain?

So far, scientists do not know why encephalopathy can occur in other diseases, especially in elderly patients. So far, there is little evidence that the coronavirus directly attacks brain cells. Most experts say the neurological effects are likely triggered by a strong immune system response.

Older men infected with COVID-19 are at greater risk of developing encephalopathy, according to the study. Complications were favored by such basic diseases as chronic kidney disease, diabetes, high cholesterol, heart failure, hypertension, neurological diseases, and cancer. Smoking also increased the risk.

Encephalopathy is not the only neurological complication

The alteration of mental functions was not the only neurological complication discovered in patients at Northwestern Medicine hospitals. 82 percent of the subjects, neurological symptoms other than encephalopathy were observed. This is a higher rate than what was found in the surveys in China and Spain. However, researchers say it could be due to genetic factors, or the fact that Northwestern Hospitals may have had more time to identify neurological problems because they were not as overwhelmed with patients as other facilities.

In the mentioned 82 percent. patients with COVID-19 were observed: muscle pain (45% of patients), headache (38%), dizziness (30%), changes in taste (16%) and smell (11%).

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Strokes, movement disorders, motor and sensory deficits, ataxia and convulsions were rare (reported in 0,2 to 1,4% of patients). In the study group, every fourth patient required respiratory support.

According to the researchers’ observations, younger patients were more exposed to the occurrence of the neurological symptoms mentioned (encephalopathy occurred mainly in the elderly). Why? There can be many reasons for this. For example, it is possible that doctors paid more attention to these symptoms in younger people because they had a lower risk of respiratory failure.

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