At least 80% of people hospitalised for Covid-19 suffer neurological symptoms, from brain fog to delirium

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  • More than 80% of hospitalized coronavirus patients experience neurological symptoms ranging from dizziness to an altered mental state. 
  • People who suffered from the most severe complication tended to share characteristics with President Trump, like being male, older, and admitted to the hospital soon after symptoms set in. 
  • Past research and anecdotes have demonstrated Covid-19's wide-ranging impact on the nervous system, causing everything from loss of taste and smell and delirium and hallucinations in some patients. 
  • Visit Business Insider's homepage for more stories.

More than 80% of people who are hospitalised with Covid-19, like President Trump, experience neurological symptoms including head and muscle aches, confusion, and dizziness, according to a study out Monday in the Annals of Clinical and Translational Neurology.

About a third of patients hospitalized by the disease, caused by the novel coronavirus, experience encephalopathy, a broad term describing altered brain function or structure, the study found. Encephalopathy was also associated with an increased risk of additional complications and even death.

Patients who experienced encephalophathy tended to be male, older (65 years old, on average), and enter the hospital soon after symptoms set in. Trump is 74, and was admitted to Walter Reed Medical Center less than 24 hours after announcing his diagnosis. 

The study, conducted well before Trump's positive test, adds to existing literature suggesting the coronavirus can affect the brain, and highlight how often those symptoms can occur and how wide-ranging they can be. 

Patients with neurological symptoms had an increased risk of death 

For the study, researchers at Northwestern Medicine looked at the records of 509 patients who'd been hospitalized in the hospital's network between March 5 and April 6. 

They found 42.2% of patients experienced neurological symptoms when they first became sick, 62.7% reported such symptoms by the time they were hospitalized, and 82.3% had them at any time over the course of their disease. People who had severe Covid-19 cases and who were younger were most likely to experience any of these symptoms.

The most common symptoms were muscle aches, headaches, dizziness, and encephalopathy, which can lead to a range of issues from temporary trouble focusing and lethargy to personality changes and permanent brain damage. Almost a third of hospitalized coronavirus patients experienced encephalopathy.

While 71.1% of patients were doing well by the time they left the hospital, those who'd experienced encephalophathy were more likely to be less functional upon discharge and more likely to die within 30 days of leaving the hospital. 

"What we'd like to know is if the virus somehow infects the brain itself or the wrapping of the brain in patients with encephalopathy," Igor Koralnik, the chief of neuro-infectious disease at Northwestern Medicine in Chicago and one of the study authors, told Bloomberg

Past research and anecdotes have revealed how the virus may affect the brain 

Early in the pandemic, doctors and researchers mostly thought of Covid-19 as a respiratory disease. But it's become increasingly clear the virus can affect many, if not all, of the body symptoms, including the brain and nervous system. 

A review of research published in the Annals of Neurology in June, and also conducted by Koralnik and colleagues, found that about half of hospitalized coronavirus patients experience neurological symptoms including dizziness, difficulty concentrating, a loss of smell and taste, seizures, strokes, and weakness. 

Another published in July study in the journal Brain found some patients developed brain swelling and delirium, others developed nervous-system disorders like Guillain-Barré syndrome that can cause paralysis, and a few experienced life-threatening strokes — even if they'd had relatively mild illnesses, Business Insider's Aylin Woodward previously reported

It makes sense that the nervous system can be affected by Covid-19 if, for example, the virus's wear on the lungs and heart make it tough to get enough oxygen to the brain. That in turn can contribute to the strokes some Covid-19 patients have experienced. 

The virus may also infect the brain directly, some researchers say, and the immune system's reaction to it can cause inflammation that damages the brain and nerves. 

It's unclear how long neurological symptoms can linger, but some experts worry that for some survivors, some effects may be permanent, or even lead to another epidemic of brain damage

The symptoms worry patients and survivors themselves, with some reporting terrifying hallucinations, coordination issues, or memory lapses leading them to, for example, believe their spouse has died, trip over furniture, or be unable to solve a simple math problem. 

"I thought I just had a lung disease. Why am I crying? Why can't I think straight for more than five minutes?" post-ICU patients often think, Dr. Craig Weinert, a pulmonologist and critical-care physician at the University of Minnesota, told Business Insider. "That's the part that's unexpected, and therefore particularly bothersome."

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