Covid-19 brain complications include strokes and psychosis

A A new survey reveals a wide range of serious Covid-19-related psychiatric and neurological complications, including stroke, psychosis, and a dementia-like syndrome. The study highlights how aggressively it can attack the coronavirus beyond the lungs, and the risk the disease may pose for younger adults.

The study examined 125 hospitalized patients with Covid-19 who also had some form of neuropsychiatric complication. Fifty-seven had had an ischemic stroke, caused by a blood clot in the brain. The second most common problem, affecting 39 patients, was an altered mental state, the researchers reported. That included encephalitis (an inflammation of the brain that can cause various symptoms, from confusion to mobility problems) and encephalopathy (a general term for a disease that alters brain function). Ten patients were recently diagnosed with psychosis and six had dementia-like cognitive problems, according to the study, published in Lancet Psychiatry.

“What was particularly interesting was that this spanned the neurological spectrum,” said lead author Benedict Michael of the University of Liverpool, a neurologist specializing in infectious diseases.


People in the study ranged in their 20s to 90s, and the researchers noted that because they focused on hospitalized patients, the detailed complications probably represent the most serious.

While strokes were more common among older patients, the researchers found that about half of those who experienced an altered mental state were under the age of 60.


Smaller studies and case reports from China and other European countries had raised the connection between Covid-19 and neuropsychiatric complications, but for the new study, the researchers set out to get a complete picture of the range of those complications. To accumulate as wide a dataset as possible, they created a network of reports across the UK that included specialists in stroke, neurology, psychiatry and critical care.

“They all focus on mortality, which they should, and respiratory problems, which is the leading cause of death,” said Mark George, a psychiatrist and neurologist at South Carolina Medical University, who was not involved in the study. . But, George said, “the virus certainly has brain effects.”

As the pandemic has spread worldwide, doctors have found themselves treating complications in almost all body systems as a result of Covid-19, including diabetes, kidney damage, and even injuries to people’s feet. With some of these, it is believed that because there are so many global cases happening so quickly, doctors may notice enough rare cases to make a connection.

But with complications in the brain, experts are still trying to figure out exactly how rare they are. More serious problems can occur infrequently, but scientists and doctors were aware of the detection of the nervous system virus from the beginning, when the loss of smell and taste became one of the most common symptoms of the virus. inscrutable. Many patients have also reported fatigue, depression, and anxiety.

It is unclear exactly what is causing each neuropsychiatric problem: the viral infection itself; the body’s immune response, which is responsible for other, sometimes fatal complications after infections; Or a combination of the two. (The study also noted that altered mental status is not uncommon in people admitted to the hospital with severe infections in general, especially those requiring intensive care.)

“This is actually a direct effect, in some people, of the virus that enters the brain,” said George.

Viral infections have long been known to cause lasting neurological complications; The 1918 influenza pandemic was similarly associated with encephalitis in some patients. But Michael, the lead author of the new study, said the Covid-19 pandemic presented an opportunity for scientists to discover how a virus can cause those complications, given the spread of the coronavirus and the new technology the researchers have.

What is unknown is how long these complications, or sequelae, in scientific terms, can last for people with Covid-19. Michael said the research team was working to follow the patients in the study.

“Ask me in six months and then we will have some control.”