Neurological complications of COVID-19 are common – even in moderate cases of the disease

COVID-19 can lead to a wide range of neurological complications, including stroke, seizures, movement disorders, inflammatory diseases and more, even in moderate cases, according to a new study published in the online December 9, 2020 issue. Neurology® Clinical Practice, an official journal of the American Academy of Neurology.

“We looked at people with neurological symptoms and COVID in a racially and socioeconomically diverse hospital and found that there are a wide range of neurological complications – including inflammatory complications, stroke and other vascular conditions, metabolic problems, exacerbation of underlying include neurological conditions and more, “the study said. author Pria Anand, MD of Boston University School of Medicine in Massachusetts and a member of the American Academy of Neurology. “Yet the majority of these people did not need critical care, suggesting that neurological complications may be common in people with moderate COVID-19 as well as in people with serious illnesses.”

The study involved 74 people who tested positive for COVID-19 between April 15 and July 1, 2020 and who were evaluated for various neurological conditions in a large hospital in Boston, Massachusetts. The average age was 64. A total of 47 people had a neurological disease in the past.

At the time of hospitalization, 18 people had strokes, 15 had seizures and 26 people had some kind of brain dysfunction causing confusion and delirium. Seven people had movement disorders, including five people with myoclonus, which involved sudden, short twitches of the muscles. Three people had traumatic brain injuries due to falls in their homes after the development of COVID-19. One person had signs of developing autoimmune encephalitis, a rare, complicated disease where the body’s immune system attacks itself, but these symptoms improved after the person received corticosteroids.

Ten people died in hospital. The people who survived, on average, had moderate to severe disability at the time of leaving the hospital, compared with mild disability before their hospitalization. A total of 27 people were able to return home with or without home health services, 20 went to competent nursing homes, including 11 who previously lived at home, and nine went to acute rehabilitation centers, including eight who lived at home. . Three people were taken to long-term care for acute care and five people were admitted to hospital, either at home or as an inpatient.

“More research is needed to fully understand the extent of neurological complications associated with COVID-19 infection,” Anand said. ‘In addition, our study included a large percentage of people from subordinate racial and ethnic groups and we know that COVID-19 excessively affects these populations, but our study did not include enough people and enough people affected by each neurological condition to any relationships between factors such as race and ethnicity, access to health care and housing and the neurological outcomes of people. We plan to conduct additional studies to determine what factors may influence people for neurological complications or to protect them against these complications, with the aim of using the results to identify people at greatest risk and to seek prevention methods. ”

A limitation of the study was that some people with neurological complications were not evaluated by neurology or neurocritical care, and therefore were not included in the analysis. This could include people with mild neurological symptoms, as well as critically ill patients who have received a limited neurological examination.

Reference: December 9, 2020, Neurological clinical practice.

The study was supported by the Grinspoon Junior Faculty Research Grant.

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