Hypertension, diabetes common in COVID-19 patients with life-threatening brain complications

The novel coronavirus is commonly known for attacking the lungs, but new research has pinpointed specific factors that may increase an individual’s risk for developing life-threatening neurological complications.

That study—set to be presented next month at RSNA’s annual meeting—found abnormalities like brain bleeding and stroke occurred more often in patients with diabetes and hypertension. While the investigation is ongoing, it’s yet another indication the virus can attack multiple areas of the body.

“COVID-19’s effects extend far beyond the chest,” lead author Colbey W. Freeman, MD, chief resident in the Department of Radiology at Penn Medicine, said on Wednesday. “While complications in the brain are rare, they are an increasingly reported and potentially devastating consequence of COVID-19 infection.”

For their study, Freeman and colleagues analyzed COVID-19 patients who received head CT and/or MR imaging at their health system between January and April. During those four months, 1,357 patients were admitted and 81 underwent a brain scan. Most received their exam due to an altered mental state and speech and vision problems.

Overall, 1 in 5 of these individuals had emergency or critical findings, including stroke, brain bleed or blocked blood vessels. What’s more, at least half had preexisting high blood pressure and/or type 2 diabetes. Three patients with emergent findings died in the hospital, the authors noted.

“COVID-19 is associated with neurologic manifestations, and hypertension and type 2 diabetes mellitus are common in individuals who develop these manifestations,” Freeman added. “These populations may be at higher risk for neurologic complications and should be monitored closely.”

The researchers also found that two-thirds of critical patients included in the study were African American, indicating these individuals may need closer monitoring.

Freeman said his team plans to continue publishing results as the study progresses. In the near-term, they’re investigating cases of brain complications in COVID-19 patients with extracorporeal membrane oxygenation, a pump system that circulates and replenishes oxygen in the blood. Many of the study participants have needed the device during their hospital stay, he noted.