Outcomes of Patients Admitted to ICU With COVID-19 and Neurologic Symptoms

The coronavirus disease 2019 (COVID-19) has been repeatedly found to impact the brain in various ways. The virus is known to infect neurons and damage brain tissue, leading to dizziness, headaches and, in some more severe cases, microclots and encephalitis. Beyond acute effects, there has also been evidence of long-term symptoms persisting in patients, including cognitive impairment and loss of smell and taste.

The SARS-CoV-2 virus infects the brain by entering host cells using its spike protein to bind to the ACE2 receptor. The highest concentration of these receptors are found in the olfactory bulb, a brain structure that connects with the hippocampus. It has been estimated that between 30% and 80% of those who become infected with COVID-19 will experience some form of neurological symptom.

Due to the fact that COVID-19 is a multisystem disease impacting both the central and peripheral nervous systems, the neurological manifestations that present at the time of disease may lead to more severe outcomes.

Recently, investigators from the University of Louisville set out to evaluate the outcomes of patients who were hospitalized with COVID-19 and were admitted to the intensive care unit (ICU) with neurological symptoms.

Investigators conducted a multi-center, retrospective, observational study that included 700 participants who were hospitalized with COVID-19 from March to June of 2020 around the southern Indiana region. To be included in the study, the patients must have tested positive for COVID-19 and present neurological symptoms such as headache, dizziness, confusion, anosmia, ageusia and an altered mental status.

Findings from the study showed that of the 700 participants, 231 were admitted to the ICU. Of those 231, 92 (39.82%) presented neurological symptoms. The patients from this group had a higher rate of mortality than those who presented no neurological symptoms (50% vs. 30%). Additionally, they were also found to have a higher rate of cardiac arrest and cerebrovascular accident during their hospitalization.