MONDAY, Nov. 30, 2020 — COVID-19 patients with high blood pressure or diabetes may be more likely to develop critical neurological complications, including bleeding in the brain and stroke, according to an ongoing study.
University of Pennsylvania researchers studied COVID-19 patients who had a head CT scan or MRI within their health system between January and April 2020. In all, 81 of the 1,357 COVID-19 patients had a brain scan, usually because they had an altered mental state or speech and vision problems.
“COVID-19’s effects extend far beyond the chest,” said study lead author Dr. Colbey Freeman. He is chief resident in the department of radiology at Penn Medicine. “While complications in the brain are rare, they are an increasingly reported and potentially devastating consequence of COVID-19 infection,” Freeman said.
Of the 81 patients, 18 (more than 20%) had critical or emergency brain issues, the scans revealed. At least half had histories of high blood pressure or type 2 diabetes. Three of the patients died in the hospital. Two-thirds of the patients with critical results were Black, according to the report.
“COVID-19 is associated with neurologic manifestations, and hypertension and type 2 diabetes mellitus are common in individuals who develop these manifestations,” Freeman said in a news release from the Radiological Society of North America (RSNA). “These populations may be at higher risk for neurologic complications and should be monitored closely.”
It is possible that inflammation is the reason for the observed neurological effects, the researchers said. 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,” Freeman explained. “Unfortunately, if cytokines are overproduced, the immune response actually starts doing damage.”
The findings are scheduled for presentation at the RSNA’s annual meeting, which is being held online Nov. 29 to Dec. 5. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.
The researchers are also investigating neurologic complications experienced by COVID-19 patients on a pump system that circulates and replenishes oxygen in the blood. They expect to report more findings as they become available.
“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,” Freeman said.
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