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Diabetes and Hypertension May Increase risk of Neurological Complications in Patients with COVID-19

NEUROLOGICAL complication risk in patients with coronavirus disease (COVID-19) may be increased in those with a history of hypertension and Type 2 diabetes mellitus, according to new research from Penn Medicine, Philadelphia, Pennsylvania, USA.

It has been established that COVID-19 is a disease that primarily affects the respiratory system leading to inflammation of the lungs. However, the impact of the virus on other body systems has also been recognised. “While complications in the brain are rare, they are an increasingly reported and potentially devastating consequence of COVID-19 infection,” stated Dr Colbey W. Freeman, Department of Radiology, Penn Medicine.

In their study, Dr Freeman and colleagues from the Perelman School of Medicine, University of Pennsylvania, investigated 81 patients, in their health system from January to April 2020, with COVID-19 who underwent head CT and/or MRI. Of the 81 patients, 18 had findings considered critical including strokes, brain haemorrhage, and blocked blood vessels. The findings also revealed that approximately one-half of the patients had a pre-existing history of hypertension and/or Type 2 diabetes mellitus.

“COVID-19 is associated with neurologic manifestations, and hypertension and Type 2 diabetes mellitus are common in individuals who develop these manifestations,” Dr Freeman noted, while emphasising the importance of closely monitoring these populations as they may be at an increased risk of neurological complications. Currently, the exact mechanisms of the neurological effects associated with COVID-19 are not fully understood, but it is speculated that the inflammation associated with the infection is the primary cause. In their study, the researchers also witnessed increased levels of inflammatory blood markers in patients with critical results. Dr Freeman further highlighted that in an inflammatory state, the body secretes cytokines to regulate an inflammatory response. “Unfortunately, if cytokines are overproduced, the immune response actually starts doing damage,” he added.

As more data come in, the researchers will continue to publish findings from the ongoing study. Currently, the team is also investigating the prevalence of neurological complications in patients with COVID-19 on extracorporeal membrane oxygenation as several patients in their study required the pump system. Dr Freeman concluded: “We have plans to initiate a larger prospective study evaluating delayed, long-term, and chronic neurologic manifestations that may not be known in this early period in the pandemic.”