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People hospitalized for Covid-19 often suffer from neurological problems. This is the conclusion reached by researchers working with Igor Koralnik of the Northwestern Medicine hospital operator in Chicago. According to their analysis, about four out of five corona-infected people (82 percent) who had to be treated as inpatients at the hospital developed corresponding symptoms at some point.
Koralnik’s team examined the files of 509 infected people who were treated at ten Chicago hospitals from March 5 to April 6. About a quarter of the patients had to be ventilated. Most of the patient’s neurological conditions were comparatively mild and transient. Almost 45 percent of the patients complained of muscle pain in the meantime, about 38 percent reported headaches.
However, as the third most common symptom, the experts recorded pathological conditions of the brain, the so-called encephalopathies. They occurred in just under a third of the Covid 19 patients examined in hospitals, the scientists report in the journal “Annals of Clinical and Translational Neurology.” Experts have not investigated how common these disorders are among all corona-infected people.
From attention deficit to coma
“Encephalopathy is a generic term for something that is wrong with the brain,” Koralnik told the New York Times. According to the researchers, the disease leads to attention disorders in some Covid 19 patients, while others have short-term memory or concentration problems. There have also been confusion, stupor, a state in which awake patients appear frozen and no longer react to speech, and coma.
Apparently, encephalopathies are also an indicator of the progression of a Covid 19 disease. Patients with these symptoms became more seriously ill and, according to the analysis, had to be treated three times more in hospital than Covid 19 patients without them. corresponding findings. Their risk of dying was also seven times higher than in the comparison group.
After discharge from the hospital, only 32 percent of affected patients were able to go about their daily lives independently, such as cooking, Koralnik and his colleagues report. For comparison: Among the 19 Covid cases treated in the hospital without encephalopathy, this was the case in 89 percent.
The researchers found the symptoms mainly in patients older than 65 and in men. Those affected also often had previous illnesses, such as other neurological disorders, cancer, kidney disease, diabetes, heart failure, high blood pressure, or high cholesterol.
It is not clear what affects the brain
What triggers encephalopathies in Covid 19 patients is still unclear. Various diseases can be the cause. Most experts have so far assumed that the cause is inflammation, and therefore the immune system’s reaction to the Sars-CoV-2 coronavirus.
This is also indicated by a current analysis from Germany. Researchers from Hamburg and Freiburg examined 43 deceased who were infected with Sars-CoV-2. In 21 deaths, they found the virus in the brain stem or in the nerves that originated there.
The amounts of viruses were, however, very small, the researchers write in the journal “The Lancet Neurology.” The patients with the highest viral load also would not have shown more changes in the brain than those who died in whom no virus was found. In the dead whose brains were infected, the researchers demonstrated an immune reaction.
Therefore, they also assume that inflammatory cells could be responsible for neurological symptoms ranging from olfactory disorders to headaches and strokes. “We were able to show that it is not the new coronavirus itself that damages the brain, but that neurological symptoms are probably an indirect consequence of the virus infection,” said Markus Glatzel of the Institute of Neuropathology at the Eppendorf University Medical Center (UKE) .
Different studies, slightly different results
Experts are just beginning to understand how Sars-CoV-2 affects the nervous system, even in the long term. After encephalopathies, Koralnik’s study in Chicago also found dizziness among the most common neurological symptoms. 30 percent of the patients complained.
Taste and smell disorders occurred in about 16 and 11 percent, respectively. Strokes, movement disorders, and motor and sensory deficits, on the other hand, were very rare with a proportion between 0.2 and 1.4 percent.
In addition to Koralnik’s team, two other groups have so far examined how common such ailments are in relation to a Sars-CoV-2 infection. A study from China found something in around 36 percent of patients (read more here), a study from Europe in around 57.
As a reminder: US researchers got a value of 82 percent. They attribute the different results, among other things, to the fact that Chicago hospitals weren’t overloaded and that neurological complaints were possibly recorded more accurately. Only the largest studies in which symptoms are systematically documented can provide clarity.
