COVID-19 Frequently Causes Neurological Injuries

October 14, 2020

Without directly invading the brain or nerves, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes potentially damaging neurological injuries in about 1 in 7 infected, according to a study published in Neurology.

These injuries range from temporary confusion due to low body-oxygen levels, to stroke and seizures in the most serious cases, according to Jennifer Frontera, MD, New York University Grossman School of Medicine, New York, New York.

The researchers conducted a prospective, multicentre, observational study of consecutive adults hospitalised in New York City with laboratory-confirmed SARS-CoV-2 infection between March 10 and May 20, 2020. Of 4,491 patients hospitalised for coronavirus disease 2019 (COVID-19), 606 (13.5%) developed a new neurologic disorder in a median of 2 days from COVID-19 symptom onset. The most common diagnoses were toxic/metabolic encephalopathy (6.8%), seizure (1.6%), stroke (1.9%), and hypoxic/ischemic injury (1.4%).

No patient had meningitis/encephalitis, or myelopathy/myelitis referable to SARS-CoV-2 infection and 18 of 18 cerebrospinal fluid specimens were negative for SARS-CoV-2 on reverse transcriptase-polymerase chain reaction (RT-PCR).

Patients with neurologic disorders were more often older, male, white, and more likely to have diabetes, hypertension, be intubated, and had higher sequential organ failure assessment (SOFA) scores (P PP

“The results of our study showed no signs that the coronavirus directly attacks the nervous system,” said Dr. Frontera. “The neurological complications seen in COVID-19 are predominately the secondary effects of being severely ill and suffering from low oxygen levels in the body for prolonged periods of time.”

“Our study results suggest that physicians need to be more aggressive in stabilising body oxygen levels in patients with COVID-19 as a potentially key therapy for stopping, preventing and/or possibly reversing neurological problems,” added Steven Galetta, MD, New York University Grossman School of Medicine.