One Third of Hospitalized COVID-19 Patients Have Altered Mental State

In a new study, scientists have shown that almost one third of hospitalized patients that had COVID-19 experienced some kind of altered mental state. The findings were published in the journal Annals of Clinical and Translational Neurology.

It is the largest study of its kind that looked into neurological symptoms in coronavirus patients in the United States. The study found that these patients suffered from a variety of mental conditions like confusion, delirium, and unresponsiveness.

The study also found that patients that suffered these neurological symptoms had also significantly worse medical outcomes. Patients suffering from such altered mental state were likely to stay three times longer in the hospital than the patients without neurological symptoms.

The research team looked at data from 509 patients that were hospitalized due to the viral infection between March and April in the Northwestern Medicine health system in Chicago.

The researchers even found that after the patients were sent off to their homes, only 32 percent of them with altered mental response were able to handle mundane tasks such as paying bills or cooking. In comparison, 89 percent of the people without neurological issues were able to handle such tasks all by themselves.

Altered mental state can also be referred to as encephalopathy. People who suffered from this condition were seven times more likely to die than those without neurological complications.

Dr. Igor Koralnik, chief of neuro-infectious disease and global neurology at Northwestern Medicine and a senior author of the study, explained “Encephalopathy is a generic term meaning something’s wrong with the brain”. It can mean issues with attention, concentration, stupor, short term memory loss, unresponsiveness and a coma like state.

“Encephalopathy was associated with the worst clinical outcomes in terms of ability to take care of their own affairs after leaving the hospital, and we also see it’s associated with higher mortality, independent of severity of their respiratory disease,” Koralnik elaborated.

However, the researchers could not come with a possible cause of this encephalopathy. This condition is also quite commonly associated with other health conditions, especially in older adults.  In many of the cases it can be triggered by inflammation. Right now, scientists do not know if coronavirus can directly target and attack brain cells or not. Many experts believe the neurological symptoms might be a result of inflammatory and immune system responses of the body, after the virus attacks cells.

According to other experts this study highlights the importance of providing closer post-discharge monitoring or rehabilitation to the patients with altered mental state. The study also suggests that such a state might also serve as predictor for worse health outcomes for such coronavirus patients.

Researchers found that out of all the study patients, 162 of them with encephalopathy were more likely to be male and older in age. Those suffering from brain issues were also likely to have underlying health conditions like cancer, neurological disorder, diabetes, hypertension, smoking, cerebrovascular disease, heart failure chronic kidney disease, and high cholesterol.

Many had also raised concerns that President Donald Trump is also likely to suffer from an altered mental state as he in the high-risk group. He is old, male, overweight, and has history of hypertension. However, White House released many videos of him talking to the public to ensure that he is not suffering from any such symptoms.

Trump tested positive for coronavirus just the previous week along with his wife Melania Trump. He was taken to the Walter Reed National Military Medical Center from where he returned this Monday evening.

The study did not only study one symptom of altered mental function. The scientists concentrated on a variety of symptoms. They found that 82 percent of the hospitalized patients had neurological symptoms at some point in the course of the disease from symptom onset through hospitalization.

The important thing of note here is that this rate is way higher than the one reported in studies from Spain and China. Scientists believe that might be due to genetic differences in the populations. They also suggest that it might be due to the fact that the Northwestern hospitals may have had more time to identify neurological issues because they were not as overwhelmed with patients as the other hospitals.

Nearly 45 percent of the patients suffered from muscle pain and 38 percent had headaches. Dizziness was experienced by nearly 30 percent of the patients. Only small percentages of people had issues of taste and smell.

They also found that young people were an increased risk of suffering from neurological symptoms overall, except for encephalopathy. However, encephalopathy was more common in adults. Nearly one fourth of the patients had severe enough respiratory problems to require ventilators. Others were only treated in a ward or in intensive care as they were deemed to have moderate coronavirus infection.

Study also showed that people of color were not more likely than other groups to develop neurological symptoms.

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