Coronavirus: Deteriorating Neurological Function

One thing we've learned about COVID-19 is that once you recover, you don't fully recover to your pre-COVID-19 mental and physical state. The New York Times (Oct 5) explores this further:

Nearly a third of hospitalized Covid-19 patients experienced some type of altered mental function — ranging from confusion to delirium to unresponsiveness — in the largest study to date of neurological symptoms among coronavirus patients in an American hospital system.

And patients with altered mental function had significantly worse medical outcomes, according to the study, published on Monday in Annals of Clinical and Translational Neurology. The study looked at the records of the first 509 coronavirus patients hospitalized, from March 5 to April 6, at 10 hospitals in the Northwestern Medicine health system in the Chicago area.

. . . After they were discharged, only 32 percent of the patients with altered mental function were able to handle routine daily activities like cooking and paying bills, said Dr. Igor Koralnik, the senior author of the study and chief of neuro-infectious disease and global neurology at Northwestern Medicine. In contrast, 89 percent of patients without altered mental function were able to manage such activities without assistance.

The study can be viewed here. The average age in the study was 58.5 years with a range of between 42 and 75 (assuming this is based on a statistical measure and that there were some outside this age bracket). The study indicates that young versus old individuals had different reactions to the virus. Younger patients . . . and those with severe Covid‐19 disease . . . were more likely to develop any neurologic manifestations . . . In contrast, older patients were more likely to develop encephalopathy. Neurological means nervous system while encephalopathy means brain function. I did a Google search for that.

If I understand the New York Times correctly, of the 509 patients, about 162 came down with an altered mental state, which the article discusses as encephalopathy versus neurological. Of those 162 patients, 110 were not able to regain prior mental function. Also, if I understand the study, 82% suffered from some neurological manifestations. The New York Times focuses on the altered mental state -- perhaps due to the fact that it impacts older people and therefore might be applied to President Trump.

The Hill (Sep 29) discusses a similar finding from South Korea: 

Results from a preliminary study out of South Korea shows 9 out of 10 coronavirus patients reported experiencing at least one side effect of the disease after recovery, Reuters reports.

An online survey of 965 recovered COVID-19 patients conducted by the Korea Disease Control and Prevention Agency (KDCA) found more than 90 percent of respondents reported experiencing side effects associated with the disease, such as fatigue, loss of sense of taste and smell and psychological effects.

The survey found fatigue was the most common reported side effect, with 26 percent of recovered patients reporting experiencing tiredness, followed by difficulty in concentration. 

The article doesn't provide examples to this word fatigue.  To me, that could mean anywhere on the spectrum of needing 9 hours of sleep a night to not even being able to walk to your mail box. What I'm also interested in is how long these side effects last. I'm assuming this study is based on their first wave that happened in February - March. If so, this may indicate that some feel the side effects for at least 6 months. As time goes on, I hope they follow-up with these individuals. Not being able to go out for a walk or hang out with friends for more than say a few minutes at a time would be some tough restrictions on life.