COVID-19 infections have at least some neurological impacts for the majority of hospitalized patients, according to new data.
Published in the Annals of Clinical and Translational Neurology, a new study examines the neurological manifestations of COVID-19 infection in 509 patients in 10 institutions in a Chicago hospital network from March 5 to April 6.
The researchers found that neurological manifestations resulting from COVID-19 infections were present at the onset of infection in 215 patients, or 42.2% of the sample population.
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Upon admission to hospital, 319 patients saw neurological symptoms associated with coronavirus infection, accounting for 62.7% of the total sample. More generally, 419 patients observed some neurological diseases of COVID-19, accounting for 82.3% of the monitored group.
The most common neurological symptoms included myalgia (muscle pain), headache, dizziness, encephalopathy (31.8%), dysgeusia (loss of taste) and anosmia (loss of smell).
More serious neurological diseases, such as strokes, movement disorders, motor and sensory deficits, and seizures were rare, affecting only 0.2% to 1.4% of patients.
Medical ventilation was required for a larger portion of the sample, with 134 receiving respiratory surgery. This represented 26.3% of the sample.
While severe infections tended to see more cases of neurological disease, often resulting from a higher frequency of encephalopathy in patients, several other trends were identified in the study. Patients with neurological diseases concurrent with coronavirus infection experienced longer hospital stays on average.
The researchers also noted that younger patients tended to exhibit neurological manifestations alongside coronavirus infections more often than older patients.
Older patients, alternatively, were more likely to experience encephalopathy and saw a shorter time between onset of a coronavirus infection and hospitalization. These patients were also more likely to be men and to have a history of neurological disorders or cancer, chronic kidney disease, heart disease, smoking, and diabetes, among other pre-existing conditions.
“The fact that any neurological manifestations as a whole were more likely to occur in young people is surprising and could potentially be explained by a greater clinical emphasis on the risk of respiratory failure than other symptoms in older patients,” the study wrote.
Cases of encephalopathy were also associated with a higher risk of serious illness and death, external to the severity of the initial COVID-19 infection.
Finally, neurological symptoms associated with COVID-19 infections were recorded in more than four-fifths of the patients monitored.
Although the cause of the encephalopathy in patients could not be determined, scientists believe it originates from systemic disease and inflammation caused by COVID-19 and direct neuroinvasion by the virus.
This report adds to the scientific literature documenting symptoms of COVID-19 infections outside of respiratory symptoms such as shortness of breath and persistent cough. Loss of smell and taste has been documented in coronavirus patients in Wuhan, China and published in JAMA in April.
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