Study Documents Neurological, Psychiatric Complications From COVID-19

While previous studies and case reports have found that COVID-19 patients have experienced vascular and neurological problems, a new study in the Lancet Psychiatry reports that patients are also showing symptoms of psychiatric disorders, including psychosis and depression.

The study was the result of a collaborative effort of specialists in the United Kingdom to document COVID-19 complications.

“To our knowledge, this is the first systematic, nationwide U.K. surveillance study of the breadth of acute complications of COVID-19 in the nervous system,” wrote Aravinthan Varatharaj, M.R.C.P., of University Hospital Southampton and colleagues.

Earlier this year, researchers created a U.K.-wide online portal through which specialists in neurology, psychiatry, stroke medicine, and neurointensive care could enter clinical data on COVID-19 patients who developed nervous system–related complications. The complications were classified in four broad areas: a cerebrovascular event (such as a stroke or brain hemorrhage), altered mental status (a change in behavior, cognition, or consciousness), peripheral neurological issue (weakness and/or pain in body nerves or muscles), or other.

The researchers focused on data entered between April 2 and April 26—the first three weeks that the portal accepted submissions. Full clinical details on 125 patients were analyzed.

Of this group, 77 patients experienced a cerebrovascular event (primarily stroke), 39 experienced altered mental status, six experienced peripheral problems, and three experienced other nervous system–related complications. Among the 39 patients with altered mental status, 16 were diagnosed with encephalopathy (brain inflammation), and 23 were diagnosed with a psychiatric disorder. Ten of these 23 patients developed psychosis, six developed cognitive problems, and seven developed mood problems including depression and mania.

A greater percentage of younger patients were affected by altered mental status than cerebrovascular events, Varatharaj and colleagues noted. For instance, 49% of the patients who experienced altered mental status were under age 60, whereas 18% of patients who experienced a cerebrovascular event were under 60.

“Our study population represents a snapshot of hospitalized patients with acute neurological or psychiatric complications associated with COVID-19. Larger, ideally prospective, studies should identify the broader cohort of COVID-19 patients both in and outside hospitals ... to determine clearer estimates of the prevalence of these complications and individuals at risk,” the authors concluded.

(Image: iStock/SDI Productions)

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