Stroke found to be Covid-19’s most common neurological complication

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A study – the first in the UK – also discovered that the brain function of many younger patients had been altered, leading to problems with their mental state, such as confusion or abnormal behaviour.

The findings provide vital insights that will inform future research into the effect of Covid-19 on the brain.

Professor Rustam Al-Shahi Salman, of the University of Edinburgh – who led work on behalf of the British Association of Stroke Physicians – said:

We already knew that older people are more vulnerable to both stroke and Covid-19. This study found that the most common neurological problem in people with Covid-19 in the UK was stroke. The next steps are to try to find out whether Covid-19 is the cause of these neurological problems, and whether treatment reduces the risk.

Neurological complications caused by Covid-19

Reports of potential neurological complications associated with the virus have prompted a series of scientific questions during the pandemic.

These include what those complications are, whether new complications are being recognised, how common these problems with brain function are, and which people are most at risk.

To address this, researchers at the University of Edinburgh have been working with the CoroNerve Studies Group – a consortium from the Universities of Liverpool, Southampton and Newcastle and University College London.

The researchers have been collaborating with professional bodies concerned with neurology, stroke, psychiatry and intensive care to develop a system that rapidly identifies the neurological impact of Covid-19 in patients.

Effects seen in younger patients

During the three-week period when exponential growth of this virus was its height, the team identified 153 people from across the UK who had both a new Covid-19 diagnosis and a new neurological or psychiatric diagnosis.

The results, published in The Lancet Psychiatry, showed that the median age of affected patients was 71, ranging from 23 to 94 years old.

Of the 125 patients where complete clinical data were available, 57 (44 per cent) suffered ischemic strokes and 39 (31 per cent) experienced an altered mental state due to neurological or psychiatric diagnoses.

Sixty one cases of stroke and other blood vessel problems (82 per cent) occurred in those more than 60 years old. Half of those experiencing an altered mental state were under 60.

The team says larger studies of Covid-19 patients – both in and outside of hospital – are needed to estimate more accurately how prevalent these complications are, and to gauge the numbers at risk in the total proportion of people with Covid-19.

Whilst an altered mental state was being reported by some clinicians, we were surprised to identify quite so many cases, particularly in younger patients, and by the breadth of clinical syndromes ranging from brain inflammation – or encephalitis – through to psychosis and catatonia.

Dr Benedict Michael

The researchers are supported by grants from the Medical Research Council, Wellcome, National Institute of Health Research and Academy of Medical Sciences.

The CoroNerve Studies Group is supported by the Association of British Neurologists, Royal College of Psychiatrists, British Association of Stroke Physicians, British Paediatric Neurology Association, and intensive care societies, including the NeuroAnaesthesia and Critical Care Society and the Encephalitis Society.

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Related links

CoroNerve Studies Group