Strokes, brain inflammation, psychosis and dementia-like symptoms could be linked to COVID-19, researchers have said.

A trial, led by the University of Liverpool, identified 153 people from hospitals across the UK who were all very unwell with COVID-19 and had also developed a neurological or psychiatric condition.

Clinical data was available for 125 of those people and the most common brain complication among the participants was stroke, reported in 77 people. Of these, 57 had an ischaemic stroke which is caused by a blood clot in the brain. Nine people experienced a stroke caused by a brain haemorrhage, and one person had a stroke caused by inflammation in the blood vessels of the brain.

Previous research has found COVID-19 can cause inflammation and blood clots in the lungs and elsewhere in the body.

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The findings also discovered 39 people showed signs of confusion or changes in behaviour reflecting an altered mental state. Seven of them ended up with encephalitis, which is a type of inflammation of the brain.

The remaining 23 people who had experienced an altered mental state were diagnosed with psychiatric conditions, including psychosis, a dementia-like syndrome and mood disorders.

Lead author Dr Benedict Michael said: “Whilst an altered mental state was being reported by some clinicians, we were surprised to identify quite so many cases, particularly in younger patients, and by the breadth of clinical syndromes ranging from brain inflammation (encephalitis) through to psychosis and catatonia.

“Clinicians should be alert to the possibility of patients with COVID-19 developing these complications and, conversely, of the possibility of COVID-19 in patients presenting with acute neurological and psychiatric syndromes.”

Co-author Professor Tom Soloman, Director of the National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections at the University of Liverpool added: “This study provides a great snapshot of the spectrum of COVID-19 associated neurological disease in the UK.

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“Now we can recognise these problems, we need to understand in more detail why some patients are developing these complications, and what we can do to stop it. It will also be interesting to see how these data compare with other countries.”

The study findings have been published in the Lancet Psychiatry journal.

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