Recently, an Italian study found that altered state of consciousness and stroke are the most common neurological symptoms in patients with new coronary pneumonia. The author believes that this discovery may help clarify the effect of the new coronavirus on the central nervous system.

Of the 725 patients with neocoronal pneumonia in the study, 108 (15%) had severe neurological symptoms. Among them, 64 patients (59%) reported altered mental status (AMS, which refers to clinical symptoms such as cognitive impairment, attention deficit, arousal disorder, and decreased consciousness level), and 31% of patients experienced ischemic stroke In addition, there were symptoms such as headache (12%), epilepsy (9%) and dizziness (4%).

Abdelkader Mahammedi, the study ’s first author and assistant professor of radiology at the University of Cincinnati, said that the medical community currently knows very little about the neurological symptoms of patients with new coronary pneumonia, “regardless of these symptoms Is it caused by a critical illness or caused by the new coronavirus directly affecting the central nervous system “, further research is needed to provide better interventions.

The phenomenon that the new crown virus affects the nervous system of patients has attracted increasing attention. Two articles have been published in the academic journal “The Lancet · Neurology” calling for the establishment of the Global New Coronary Pneumonia Neural Research Alliance 2. Collect evidence that the new coronavirus affects the nervous system. Previously, on April 10, a study published in the Journal of the American Medical Association (JAMA) by the research team of Tongji Medical College of Huazhong University of Science and Technology and St. Joseph Hospital in the United States also analyzed the effect of the new crown on the nervous system and found that 24.8% of patients appeared Central nervous system symptoms.

In this regard, the above Italian study pointed out that compared with the Wuhan experience, the Italian study has a lower prevalence of central nervous symptoms (15% vs. 24.8%), but lacks The prevalence of blood stroke is higher (31% vs. 11%).

This study was completed in collaboration with institutions such as the University of Cincinnati in the United States and the University of Cagliari in Italy, entitled “Neurological Disease Imaging of Inpatients with New Coronary Pneumonia: An Italian “Imaging in Neurological Disease of Hospitalized COVID-19 Patients: An Italian Multicenter Retrospective Observational Study” was published online on May 21 in the international radiology journal Radiology.


Figure 1: A 60-year-old male with new history of epilepsy who has no history of seizures has convulsion / div> Researchers conducted a large-scale investigation of neuroimaging and neurological symptoms in Italian patients with new coronary pneumonia, and collected neuroimaging of 725 inpatients. These patients were diagnosed with new coronary pneumonia from February 29 to April 4, 2020.

Of the 725 patients, 108 (15%) had severe neurological symptoms and received brain or spine imaging. Most patients (99%) underwent CT scan (Computed Tomography), 16% underwent CT scan of head and neck, and 18% underwent MRI scan (Magnetic Resonance Imaging). ).

Figure 2: Clinical characteristics of inpatients with new coronary pneumonia

Of the 108 patients, 31 patients (29%) have no previous medical history, and 77 patients have chronic diseases, such as coronary artery disease (23%), Cerebrovascular disease (14%), hypertension (51%) and diabetes (28%).

31 (29%) patients with no previous medical history range from 16 to 62 years old. Ten of them had symptoms of stroke, and two had cerebral hemorrhage.

Figure 3: Neuroimaging characteristics of hospitalized patients with new neurological symptoms after infection with a new crown
< div class = "contheight"> Of the 108 patients, 71 (66%) had no acute symptoms on CT of the brain, and 7 (35%) had acute abnormalities on the brain MRI.

Researchers also found that there is a statistically significant correlation between the probability of a patient ’s state of consciousness changing and age.

The paper concludes that the neuroimaging characteristics of hospitalized patients with new coronary pneumonia are variable, there is no specific pattern, and the main change is consciousness and stroke. The authors suggest that more and more evidence indicates that some patients with severe new pneumonia may have cytokine storm syndrome, “this syndrome may be a trigger for ischemic stroke.”