Stroke, confusion: Covid-19 often impacts the brain

  • There is an increasing association between Covid-19 infection and neurological or psychiatric complications
  • Stroke was the most common brain complication
  • A high percentage of patients experienced changes that suggested altered mental states 

Patients with severe Covid-19 may be at risk for a variety of brain complications – from stroke to psychosis, new research suggests.

"There have been growing reports of an association between Covid-19 infection and possible neurological or psychiatric complications, but until now these have typically been limited to studies of 10 patients or fewer," said lead study author Benedict Michael. He is a fellow in the Institute of Infection and Global Health at the University of Liverpool in the United Kingdom.

The study, described as the first nationwide look at neurological complications of infection with the new coronavirus, looked at 125 Covid-19 patients treated in UK hospitals during April. Michael emphasised that it focused only on cases that were serious enough to require hospitalisation.

Altered mental state

The most common brain complication was stroke, which occurred in 77 patients.

Of those strokes, 57 were caused by a blood clot in the brain, nine by bleeding in the brain and one by inflammation in the blood vessels of the brain. Most of the patients who had a stroke were older than 60 years of age.

Thirty-nine patients experienced confusion or behaviour changes that suggested they had an altered mental state, the study found.

Of those, nine had unspecified brain dysfunction (encephalopathy), seven had inflammation of the brain (encephalitis), and 23 were diagnosed with psychiatric conditions, the researchers said.

Ninety-two percent of the psychiatric diagnoses were believed to be new. Ten patients had a new-onset psychosis; six had dementia-like conditions; and seven had signs of a mood disorder, including depression and anxiety, the study found.

Snapshot of brain-related complications

Age information was available for 37 of the 39 patients with an altered mental state. Forty-nine percent were younger than 60, according to the study published on 25 June in The Lancet Psychiatry journal.

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.

According to study co-author Sarah Pett, a lecturer in infectious diseases at University College London, "This data represents 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."

Pett said researchers also need to understand brain complications in Covid-19 patients who aren't sick enough to be hospitalised.

"Our study provides the foundations for larger, hospital and community-based studies," she said. "These studies will help inform on the frequency of these brain complications, who's most at risk of getting them, and ultimately how best to treat."

Image credit: iStock

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