NEUROLOGICAL symptoms have been reported in COVID-19 cases, even in patients with only mild illness, and can persist as long-COVID. Researchers from the Boston University School of Medicine (BUSM), Massachusetts, USA, studied 16,225 patients from 179 hospitals in 24 different countries as a part of the Society of Critical Care Medicine’s (SCCM) VIRUS study.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause dysfunction in numerous organ systems, including the nervous system. Researchers from BUSM wanted to understand the prevalence and risk factors associated with neurological manifestation after SARS-CoV-2 infection, as well as patient outcomes.
In the first year of the pandemic, 13% of patients presenting with COVID-19 developed serious neurological manifestations. The most common manifestation at admission was encephalopathy, which alters brain function or structure, with 1,656 cases (10.2%). A further 331 cases (2.0%) had a stroke, 243 (1.5%) had a seizure, and 73 (0.5%) had meningitis or encephalitis at admission or during their stay in hospital.
According to the researchers, neurological manifestations after SARS-CoV-2 infection are more common in individuals with other comorbidities such as a history of stroke or neurological disorder. Furthermore, the authors also found that neurological manifestations increased disease severity, with patients more likely to need intervention from the intensive care unit and ventilator use. Patients with neurological manifestations were also more likely to stay in hospital longer and they had a higher risk of mortality.
Researchers also discovered that neurological manifestations differed by race. Patients who were Black had an increased frequency of encephalopathy, stroke, and seizure compared with patients who were White. Corresponding author Anna Cervantes-Arslanian, Associate Professor of Neurology, Neurosurgery, and Medicine at BUSM, had this to say on the topic: “Given the association of neurologic manifestations with poorer outcomes, further study is desperately needed to understand why these differences occur and what can be done to intervene.”