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Infectious Diseases

Updated 15 October 2020

Eight in 10 Covid-19 patients suffer neurological symptoms, study finds

Encephalopathy, which is characterised by altered mental function ranging from mild confusion to coma, is the most severe neurologic manifestation of Covid-19, a study says.

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Researchers have revealed concerning new findings: Neurological symptoms occur in eight out of 10 hospitalised Covid-19 patients.

These symptoms include muscle pain, headaches, dizziness, encephalopathy and "brain fog".

"Encephalopathy, which is characterised by altered mental function ranging from mild confusion to coma, is the most severe neurologic manifestation of Covid-19," said study co-author Dr Igor Koralnik. He oversees the Neuro Covid-19 Clinic at Northwestern Memorial Hospital in Chicago.

Long-term neurologic effects 

For this new study, the researchers analysed the charts of more than 500 patients hospitalised for Covid-19 within the Chicago-based Northwestern Medicine health system. The investigators identified neurological symptoms in 42% of patients when their Covid-19 symptoms surfaced, 63% of patients when hospitalised, and 82% of patients at any time during the course of Covid-19.

Many patients reported muscle pain (45%) and headaches (38%). Encephalopathy and dizziness were seen in almost one-third of patients. The study also found 16% had taste disorders and 11% had smell disorders.

After discharge from the hospital, only 32% of patients with encephalopathy were able to care for their own affairs, compared to 89% of those who didn't develop encephalopathy, the findings showed.

Also, the death rate in patients with encephalopathy was much higher (about 22%) than in those without encephalopathy (3%), according to the study.

"We are now looking to characterise the long-term neurologic effects of Covid-19 and the cognitive outcomes in patients with Covid-19-associated encephalopathy," Koralnik said in a hospital news release. He is chief of neuro-infectious diseases and global neurology at Northwestern Medicine.

Shaping long-term care

"We're studying this in patients who are discharged from the hospital, as well as in Covid-19 'long-haulers', who have never been hospitalised but also suffer from a similar range of neurological problems, including brain fog," he added.

The report was published on 5 October in the Annals of Clinical and Translational Neurology. The findings will help shape long-term care for people who suffer from neurological complications of Covid-19, Koralnik said.

"Patients and clinicians need to be aware of the high frequency of neurologic manifestations of Covid-19 and the severity of altered mental function associated with this disease," he noted.

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