Mao et.al study finds that 36.4% of the COVID-19 patients surveyed presented neurologic symptoms, such as acute cerebrovascular events, impaired consciousness and skeletal muscle injury. Neurologists conducted a study (Jan. 16 - Feb. 19) (n=214, from 3 designated Wuhan hospitals) by retrospectively reviewing patient charts. Nervous system symptoms were found to be more prevalent in severe patients, affecting them disproportionately to their counterparts with regards to CNS function and muscle injury.

Increased neurologic symptoms in severely infected COVID-19 patients

Invasive aspergillosis is a well‐known complication of severe influenza pneumonia with acute respiratory distress syndrome (ARDS). However, recent studies are reporting emergence of aspergillosis in severe COVID‐19 pneumonia, named as COVID‐19‐associated pulmonary aspergillosis (CAPA). A study done by researchers in Pakistan show that invasive aspergillosis is a complication in moderate to severe COVID‐19 patients, but the study also highlights the need for comparative studies to establish whether there really is an association of CAPA and COVID‐19. 

COVID‐19‐associated pulmonary aspergillosis (CAPA)

- Pneumonia,
- Hypoxemic respiratory failure/ARDS,
- Sepsis and septic shock,
- Cardiomyopathy and arrhythmia,
- Acute kidney injury,
- Complications from prolonged hospitalization including:
   - Secondary bacterial infections,
   - Thromboembolism,
   - Gastrointestinal bleeding,
   - Critical illness polyneuropathy/myopathy.
- Neurological Symptoms (acute cerbrovascular diseases, impaired consciousness, skeletal muscle injury)
- COVID‐19‐associated pulmonary aspergillosis (CAPA)


University of Michigan - Ann Arbor

Columbia University

Michigan State University

Severe COVID-19 is a medical emergency and requires immediate hospitalization.

1. Severe dyspnea

2. Hypoxia

3. Serious dehydration

4. P/F ration < 300

5. New bilateral infiltrated on imaging

6. Altered level of consciousness (e.g., confusion, delirium, lethargy)*

*If this symptom is present, emergency medical attention should be sought right away, even if other symptoms are absent. Often times, this is the only severe symptom and can be present even when other "classic" COVID symptoms are absent. Even if this doesn't indicate COVID infection, it should still be treated as a medical emergency.


Severe COVID-19 symptoms

Centers for Disease Control and Prevention. (n.d.). Centers for Disease control and Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/. 

Centers for Disease Control and Prevention

Severe COVID-19 Case Complications

In addition to the milder situation treatments, it often requires hospitalization and advanced ventilatory support.

Treatment of Severe COVID-19

- NOTE: Some people (especially elderly people or people with serious underlying conditions) develop confusion/delirium, even though they don't have any of the typical COVID-19 symptoms. Although they may not be "screened" for COVID, they NEED immediate medical attention. 
- Altered mental status can be an independent predictor of mortality, even when other symptoms are not severe.
- Even if something other than COVID-19 caused the patient to have an altered mental status, emergency medical attention is still NEEDED.
-Sources: https://www.medpagetoday.com/infectiousdisease/covid19/90354; https://pubmed.ncbi.nlm.nih.gov/33566314/; https://www.cidrap.umn.edu/news-perspective/2020/11/delirium-fairly-common-older-covid-19-patients

Learn Before

Related

Learn After