Scientists identify neurological, psychiatric complications in COVID-19 patients

A nurse helping a coronavirus patient

The findings could help guide future research into the neurological complications of COVID-19 and may lead to treatments, the study authors said in a journal news release.

"These people represent the first notifications that we as CoroNerve have received, and will represent the most severe of cases as most people will have been hospitalised". However, most published reports have been limited to individual cases or small case series and even larger studies have been limited by both geography and specialty. Data was collected between 2 April and 26 April 2020, during the exponential phase of the pandemic.

"This (is) an important snapshot of the brain-related complications of Covid-19 in hospitalised patients. It is critically important that we continue to collect this information to really understand this virus fully". World Health Organization has also busted some myths surrounding coronavirus.

The study is small and based on doctors' observations, so can not provide a clear overall picture about the rate of such complications. This can help determine the "frequency of these brain complications, who's most at risk of getting them, and ultimately how best to treat".

Full clinical details were provided for 125 patients using multiple testing methods, including chest x-rays and CT scans as well as PRC testing at 6 and 114 people, respectively.

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

After adjusting for age, gender, and risk factors, the scientists found that COVID-19 infection had a significant independent association with acute ischemic stroke - caused by a clot that blocks a blood vessel in the brain. In contrast, cerebrovascular events were seen more in people older than 60 years (82%, 61 of 74 patients) while only 18% (13 of 74 patients) were younger than 60 years.

Nearly a third experienced signs of confusion or changes in behavior reflecting an altered mental state.

Going further, it is also seen that 39 patients showed altered changes in their psychological behavior due to the inflammation of the entire brain termed as encephalitis. Long-term follow-up studies to assess duration and severity of these complications are needed.

About half of the patients with an altered mental state were younger than 60, the study found. Although most psychiatric diagnoses were determined as new by the notifying psychiatrist or neuropsychiatrist, the researchers said they can not exclude the possibility that these were undiagnosed before the patient developed COVID-19.

These patients with psychiatric diagnoses included ten patients with a new-onset psychosis, and six patients with a dementia-like syndrome, the study noted as per the PTI report. Psychiatric complications include psychosis, neurocognitive dementia-like syndrome, personality change, catatonia (abnormality of movement and behaviour arising from a disturbed mental state), mania, anxiety or depression, chronic fatigue syndrome, and post-traumatic stress disorder.

"Altered mental status (defined as an acute adjustment in personality, behaviour, cognition, or consciousness) was identified across all age groups, and many (49%) younger patients had this presentation", they write.

The researchers noted that some of these could have existed before the patients contracted Covid-19, but remained previously undiagnosed. This study provides valuable and timely data that are urgently needed by clinicians, researchers, and funders to inform immediate steps in Covid-19 neuroscience research and health policy.



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