Diabetic, hypertensive COVID-19 patients are at higher risk of neurological complications like bleeding in the brain and stroke, according to a study being presented at the annual meeting of the Radiological Society of North America (RSNA).
Coronavirus' impact has also been felt in other systems of the body apart from the respiratory system.
"COVID-19's effects extend far beyond the chest," said study lead author Colbey W. Freeman, M.D., chief resident in the Department of Radiology at Penn Medicine in Philadelphia. "While complications in the brain are rare, they are an increasingly reported and potentially devastating consequence of COVID-19 infection."
They concluded that, of the 1,357 patients with COVID-19 admitted, 81 had a brain scan performed. The most common reasons for the brain scans were altered mental state and speech and vision problems.
Out of 81 patients with brain scans, around one in five, had emergency or critical findings, including strokes, brain bleeds and blocked blood vessels. Half the patients had history of high blood pressure and/or type 2 diabetes. Three patients with emergent/critical findings died while admitted.
"COVID-19 is associated with neurologic manifestations, and hypertension and type 2 diabetes mellitus are common in individuals who develop these manifestations," Dr. Freeman said. "These populations may be at higher risk for neurologic complications and should be monitored closely."
Majority of the patients were African American, suggesting that these patients also may require closer monitoring.
Inflammation associated with the infection could be the primary culprit. In the study, blood markers of inflammation were high in people with critical results.
"When your body is in an inflammatory state, it produces all these molecules called cytokines to help recruit the immune system to perform its function," Dr. Freeman said. "Unfortunately, if cytokines are overproduced, the immune response actually starts doing damage."
Researchers are also identifying the incidence of neurologic complications in COVID-19 patients on extracorporeal membrane oxygenation (ECMO), a pump system to circulate and replenish oxygen in the blood. Several patients in the study needed ECMO during their time at the hospital.
"In addition, we have plans to initiate a larger prospective study evaluating delayed, long-term, and chronic neurologic manifestations that may not be known in this early period in the pandemic," Dr. Freeman said.