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40% of people with severe COVID-19 experience neurological complications

Last updated: 04-15-2020

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40% of people with severe COVID-19 experience neurological complications

A patient is moved out of Gateway Care and Rehabilitation Center, a skilled nursing facility in Hayward, Calif., on Thursday. Photo by Terry Schmitt/UPI |

April 10 (UPI) -- People with severe COVID-19 may experience neurological symptoms, including confusion, delirium and muscle pain, and could be at higher risk for a stroke, a new study out of Wuhan, China has suggested.

Nearly 40 percent of people with the disease caused by the new coronavirus suffered brain-related complications, according to findings published Friday in JAMA Neurology,

Among those with serious infection as a result of the virus, nearly 6 percent experienced a stroke or stenosis, roughly 15 percent had dementia-like symptoms and roughly 20 percent reported severe muscle pain, researchers in China reported.

"This study indicates that neurological complications are relatively common in people who have COVID-19," S. Andrew Josephson, professor and chair of the Department of Neurology at the University of California, San Francisco and editor-in-chief of JAMA Neurology, told UPI. Josephson also co-authored a related commentary on the study findings.

"However, the majority of those complications are are also relatively common in people with severe pneumonia and viral infections in hospital intensive care units," he added.

That includes symptoms such as muscle pain and "confusion or difficulty thinking," according to Josephson, although he emphasizes that if these neurological issues develop in people who know they have COVID-19 -- or have symptoms of the disease and are among those at high risk for serious illness -- they should be considered a "red flag like shortness of breath," he said.

"Somebody who has COVID-19 and is at home and experiences difficulty thinking or confusion or anything that indicates a possible stroke, that is a sign they should come into the hospital for additional care," Josephson continued. "But a symptom like muscle pain is common in viral infections. People don't need to come into hospital with that."

To date, nearly 1.7 million people worldwide have been infected with COVID-19, and nearly 100,000 have died from the disease. Although numbers vary by country and region, it is believed that approximately 20 percent of people infected by the new coronavirus become ill enough to require hospital care, and roughly 5 percent experience life-threatening symptoms, including pneumonia.

Those at highest risk for serious illness are believed to be the elderly, as are people with a history of diabetes, high blood pressure and heart disease. Of course these same people are also at increased risk for cerebrovascular diseases like stroke and stenosis, Josephson noted.

The new study looked at 214 patients with the disease at three Wuhan hospitals, all of whom were hospitalized between Jan. 16 and Feb. 19.

Of the 214 patients, who had mean age of 53, 87 were men and 126, or 59 percent, had severe infection based on respiratory status -- with shortness of breath caused by a severe lower respiratory tract infection, like pneumonia.

As in prior studies, those with serious illness were older, had more underlying conditions -- particularly high blood pressure -- and had fewer typical symptoms of COVID-19, like fever and cough, when compared to patients with mild to moderate infection.

Additionally, 6 percent of patients experienced "taste impairment" and 5 percent had "smell impairment." What causes people with the virus to experience these neurological complications remains unclear, according to Josephson. Because of the known heart-related complications associated with the virus, it's possible they are the result of blood clots emanating from the heart, he added.

"As with all of the research coming out about the virus, this study shows we still have a lot more to learn," Josephson said. "The bottom line is that people should be aware of these neurological symptoms, and seek medical attention if they need it."


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