The medical and scientific communities have a fairly clear understanding of COVID-19’s impact on the lungs and respiratory system, but what the coronavirus can do to our central nervous systems is more of a mystery. As more time has passed, and additional COVID-19 symptoms have been uncovered, it’s come to light that many patients are experiencing neurological issues as well.
Now, a new study just released by the University of Cincinnati is offering up the most comprehensive examination of COVD-19 neurological symptoms thus far. After analyzing and reviewing neuroimaging and symptoms among over 700 Italian patients, the research team says that a broadly defined “altered mental state” and stroke are the two most common neurological symptoms in COVID-19 patients.
Moving forward, if doctors keep an eye out for early warning signs of these symptoms, it could go a long way towards improving health outcomes for countless COVID-19 patients.
“Studies have described the spectrum of chest imaging features of COVID-19, but only a few case reports have described COVID-19 associated neuroimaging findings,” says lead author Abdelkader Mahammedi, MD, assistant professor of radiology at UC and a UC Health neuroradiologist, in a university release. “To date, this is the largest and first study in literature that characterizes the neurological symptoms and neuroimaging features in COVID-19 patients. These newly discovered patterns could help doctors better and sooner recognize associations with COVID-19 and possibly provide earlier interventions.”
For their research, the team at UC collaborated with colleagues from three major Italian learning institutions. Italy, of course, was the second major epicenter of the global coronavirus outbreak. Those three schools were the University of Brescia, the University of Eastern Piedmont, and the University of Sassari.
In total, reports and data on 725 hospitalized coronavirus patients treated between February 29th and April 4th were analyzed. Of that group, 108 (15%) experienced severe neurological symptoms and underwent subsequent brain or spine imaging, thus qualifying for further analysis. Virtually all of those patients (99%) had a brain CT scan performed, 16% had head and neck CT imaging, and 18% underwent an MRI.
Over half of those 108 patients (59%) reported an altered mental state of some form and 31% suffered a stroke. Other, less common, documented neurological symptoms included dizziness (4%), headache (12%), and seizure (9%).
“Of these 108 patients, 31, or 29%, had no known past medical history. Of these, aged 16 to 62 years, 10 experienced strokes and two had brain bleeds,” Mahammedi explains. “Seventy-one, or 66%, of these patients had no findings on a brain CT, out of which 7 of them (35%) brain MRI showed abnormalities.”
It’s also important to note that older COVID-19 patients seem to be experiencing changes in their mental state more frequently. So, it appears older adults are more susceptible to this neurological symptom.
This study is a big step in our understanding of COVID-19’s effect on the brain and central nervous system, but there’s still a lot to uncover. Specifically, whether or not the coronavirus actively attacks the central nervous system. It’s equally fascinating and puzzling that many patients (66%) who experienced neurological symptoms showed no abnormalities or findings of note in their brain CT scans.
“This topic definitely needs more research,” Mahammedi concludes. “Currently, we have a poor understanding of the neurological symptoms in COVID-19 patients, whether these are arising from critical illness or direct central nervous system invasion of SARS-CoV-2. We hope further study on this subject will help in uncovering clues and providing better interventions for patients.”
The full study can be found here, published in Radiology.
John Anderer is a frequent contributor for Ladders News.