Northwestern Medicine

First-of-its-kind Study Examines the Frequency and Severity of Neurologic Manifestations in Patients Hospitalized with COVID-19 in the United States

Northwestern Memorial Hospital October 05, 2020

Of the 509 patients who were studied, 82% had neurological manifestations during the course of COVID-19, such as muscle pain, headaches, dizziness, alteration of mental function and disorder of taste and smell

Chicago, IL – A new Northwestern Medicine study published in the Annals of Clinical and Translational Neurology* analyzed 509 COVID-19 hospitalized patients and discovered neurologic manifestations happened 82% at any time during the course of the disease. The study conducted by the Northwestern Medicine Neuro COVID-19 research group outlined the frequency and severity of neurologic signs and symptoms in patients hospitalized throughout the Chicago-based health system.

“This is the first study of its kind in the United States,” says Igor Koralnik, MD, chief of neuro-infectious diseases and global neurology in the Ken & Ruth Davee Department of Neurology at Northwestern Medicine, who also oversees the Neuro COVID-19 Clinic at Northwestern Memorial Hospital. “There are only two other published papers describing the prevalence of neurological manifestations in hospitalized COVID-19 patients in China and Europe. Our research group spent the summer performing chart reviews on the first 509 patients hospitalized for COVID-19 within the Northwestern Medicine health system, and our findings show neurological manifestations are very common in these patients.”

Of the 509 hospitalized patients with COVID-19:

- 42% had neurological manifestations at the time of initial symptom onset
- 63% at time of hospitalization
- 82% at any time during the course of the disease

Dr. Koralnik says, the most frequent neurological symptoms were:

-  Muscle pain (44.8%)
-  Headaches (37.7%)
-  Encephalopathy (31.8%)
-  Dizziness (29.7%)
-  Disorder of taste (15.9%)
-  Disorder of smell (11.4%)

“Encephalopathy, which is characterized by altered mental function ranging from mild confusion to coma, is the most severe neurologic manifestation of COVID-19,” explains Dr. Koralnik.

Upon discharge from the hospital, only 32.1% of patients with encephalopathy were able to care for their own affairs, compared to 89.3% of those who did not develop encephalopathy. There was also higher mortality in patients with encephalopathy (21.7%) compared to 3.2% of those without.

“We are now looking to characterize the long-term neurologic effects of COVID-19 and the cognitive outcomes in patients with COVID-19-associated encephalopathy,” says Dr. Koralnik. “We’re studying this in patients who are discharged from the hospital, as well as in COVID-19 ‘long-haulers,’ who have never been hospitalized but also suffer from a similar range of neurological problems, including brain fog.”

Long-haulers from all over the United States have scheduled appointments with Dr. Koralnik and the Neuro COVID-19 Clinic team at Northwestern Memorial Hospital. The team’s extensive knowledge of infectious diseases that affect the nervous system helps them determine what is causing a patient’s symptoms. Dr. Koralnik says, the use of telehealth technology makes it easier and safer for patients who are recovering from COVID-19 to receive care.

“The Neuro COVID-19 Clinic’s unique approach, along with this new study, will help shape long-term care for people who suffer from neurological complications of COVID-19,” adds Dr. Koralnik. “Patients and clinicians need to be aware of the high frequency of neurologic manifestations of COVID-19 and the severity of altered mental function associated with this disease.”

The study was published on Monday, Oct. 5, in Annals of Clinical and Translational Neurology*.

B-roll and photos of the Neuro COVID-19 Clinic and lab are available on Dropbox*, including soundbites from Dr. Igor Koralnik, chief of neuro-infectious diseases and global neurology at Northwestern Medicine.

Media Contact

Jenny Nowatzke
Senior Specialist, Media Relations
Northwestern Memorial Hospital jenny.nowatzke@nm.org 312.926.2131
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