In an analysis of 214 hospitalized cases of the coronavirus treated in Wuhan city, China, between January 16 and February 19, doctors found that 36.4% experienced neurological symptoms. They added that these symptoms sometimes even came without hallmark symptoms of the virus including a cough and a fever, and that these symptoms tended to become more common in older patients, and as the severity of the illness escalated.
Even though it is not certain whether the coronavirus is a direct trigger of strokes and other neurological issues, the researchers did point out that a rapid clinical deterioration or worsening could nevertheless be associated with a stroke, and may contribute to mortality rates.
Dr Rafael Ortiz, chief of neuro-endovascular surgery at Northwell Health Western Region in New York City and Westchester says, “These findings could be related to direct involvement of the virus in the brain, brainstem and peripheral nerves.”
Although interesting findings, researchers caution that further studies are needed before any conclusions can be made about whether or not the virus can trigger neurological symptoms. In particular, Ortiz mentioned that a prospective, observational study with a large number of patients and more robust brain-imaging and diagnostic tests are needed before any conclusions can be made.
This study comes alongside other evidence suggesting possible neurological side effects of the virus. A woman in her late fifties who, after three days of having a cough, fever and an ‘altered mental status’, developed acute necrotizing hemorrhagic encephalopathy, a rare central nervous system complication known to develop from influenza and other viral infections.
After undergoing tests confirming that she did indeed have COVID-19, and that the neurological condition could not be due to a secondary viral infection, doctors from the Henry Ford Health System in Detroit said, “This is the first reported case of Covid-19-associated acute necrotizing hemorrhagic encephalopathy...As the number of patients with Covid-19 increases worldwide, clinicians and radiologists should be watching for this presentation among patients presenting with Covid-19 and altered mental status.”