Evidence is overwhelming that infection with the SARS-CoV-2 virus causes various organ systems, including the neurological system, to malfunction. Even in individuals with mild illnesses, neurologic symptoms are frequently recorded, and for some patients, these neurologic symptoms may continue as a result of long-haul COVID.
To describe the prevalence, associated risk factors and outcomes of serious neurologic manifestations among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, researchers from Boston University School of Medicine (BUSM) studied 16,225 patients from 179 hospitals in 24 countries as part of the Society for Critical Care Medicine’s Viral Infection and Respiratory Illness University Study.
According to the study’s findings, 13% of COVID-19 patients treated in the first year of the pandemic experienced severe neurologic symptoms. Specifically, 1,656 (10.2 percent) had encephalopathy (any diffuse disease of the brain that alters brain function or structure) at admission, 331 (2.0 percent) had a stroke, 243 (1.5 percent) had a seizure, and 73 (0.5 percent) had meningitis or encephalitis at admission or during hospitalization.
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.
Anna Cervantes-Arslanian
“Our findings show that encephalopathy at hospital admission is present in at least one in 10 patients with SARS-CoV-2 infection, while stroke, seizures and meningitis/encephalitis were much less common at admission or during hospitalization,” explains corresponding author Anna Cervantes-Arslanian, MD, associate professor of neurology, neurosurgery and medicine at BUSM.
They also found that all severe neurologic symptoms were linked to a greater illness severity, a greater requirement for ICU interventions, a longer length of stay, a higher fatality rate, and the usage of a ventilator.
Patients with neurologic signs were more likely to have medical comorbidities, according to the study. The likelihood of acquiring a neurologic manifestation was most significantly enhanced by a history of stroke or a neurologic condition.
Moreover, they found neurologic manifestations differed by race. When compared to white patients, black patients experienced more strokes, seizures, and encephalopathies.
“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,” added Cervantes, who also is a neurologist at Boston Medical Center.
These findings appear online in the journal Critical Care Explorations.
NIH/NCRR/NCATS CTSA grant number UL1 TR002377 provided funding for this study. The registry is funded in part by the Gordon and Betty Moore Foundation and Janssen Research & Development, LLC. Research Electronic Data Capture support provided by the Mayo Clinic.
Parts of these results were presented at the American Academy of Neurology annual meeting (on April 5, 2022), as an oral abstract.
