A range of neurological and psychiatric complications including stroke have been observed in critically ill patients with COVID-19 in the UK, reports a study in the Lancet Psychiatry.
The CoroNerve Studies Group set up a secure UK-wide online network for clinicians in the neuroscience field to report case reports of cerebrovascular events in hospitalised COVID-19 patients. The first data set (n=153) was collected between 2 April 2020 and 26 April 2020, during the UK's exponential phase of the pandemic. Median patient age was 71 (range, 23-94; interquartile range, 58-79) years.
In patients where there was complete data (n=125), the most common brain complication observed was stroke (62%; 77); of which, 57 (74%) were ischaemic strokes, nine (12%) were intracerebral haemorrhages and one (1%) was central nervous system vasculitis.
This was followed by altered mental state (31%; 39), comprising nine (23%) patients with unspecified encephalopathy and seven (18%) patients with encephalitis.
The remaining 23 (59%) patients with altered mental status fulfilled the clinical case definitions for psychiatric diagnoses, and 21 (92%) of these were new diagnoses.
Ten (43%) of 23 patients with neuropsychiatric disorders had new-onset psychosis, six (26%) had a neurocognitive (dementia-like) syndrome and four (17%) had an affective disorder.
Almost half (49%; 18) of the 37 patients with altered mental status were younger than 60 years, whereas 13 (18%) of 74 patients with cerebrovascular events were younger than 60 years.
While it is not possible to draw conclusions about the total proportion of COVID-19 patients likely to be affected with similar complications, the researchers say the study offers the first detailed snapshot of the breadth of neurological conditions in COVID-19 patients and should help direct future research to establish the mechanisms of such complications.
There is also a need to understand brain complications in people with COVID-19 in the community who did not need hospitalisation, they said.