Patients admitted to hospital due to a severe COVID-19 infection exhibit no evidence of brain damage caused by the disease. This is the conclusion of an extensive study led by Maastricht University. The patients in the study did not appear to have more neurological symptoms or cognitive disfunction than other groups of seriously ill patients. However, more than half of them suffered from a variety of long-term complaints, such as fatigue, concentration problems, forgetfulness or reduced quality of life. The cause of their symptoms is unclear. Precisely for this reason, the researchers say, these patients should receive ongoing attention, care and support.

Brain damage

The reason for the study was the neurological symptoms that doctors regularly observed in intensive care patients during the first COVID-19 wave in the spring of 2020. It was thought that the symptoms experienced by many former COVID-19 patients might be related. To investigate this, the researchers followed two groups of COVID-19 patients: 104 patients who had been admitted to the regular nursing ward due to a coronavirus infection and 101 who had been taken into intensive care at a total of six large Dutch hospitals. Around 9 months after the patients had been discharged, the researchers conducted MRI scans and comprehensive cognitive tests, looking not only for brain damage but also for consequences of such damage, such as memory impairment.

They also considered symptoms the patients actually experienced, such as fatigue. ‘We expected that people from the group of intensive care patients, who were after all the most seriously ill, would also have the most brain damage and experience more symptoms,’ says Caroline van Heugten, Professor of Clinical Neuropsychology at Maastricht University and head of the Limburg Brain Injury Center. ‘But that turned out not to be the case. The MRI scans of the brain were largely comparable, except that we saw more microbleeds on the MRI scans of the intensive care patients. However, patients with such microbleeds didn’t suffer from more disorders or complaints.’

Cognitive symptoms

The cognitive tests and patient questionnaires also revealed no difference between the two groups of patients in terms of cognitive functioning or mental well-being. However, more than half of the patients in the study suffered from a variety of complaints, such as fatigue, forgetfulness, concentration problems or reduced quality of life. As yet, the cause is unknown.

‘Long-term symptoms such as fatigue and forgetfulness also occur in people who were less seriously ill and who didn’t require hospitalisation,’ says Van Heugten. ‘Also in this group, the cause of the symptoms is not yet known. It may be that for the intensive care patients, not only the serious illness plays a role, but also the isolated nursing care combined with fear and stress, as well as the fear that was widely felt in society during the first COVID-19 wave. Similar symptoms have been observed before in intensive care survivors and are therefore not specific to COVID-19.’