Some COVID-19 patients have brain complications, study suggests

Authors: Mary Van Beusekom | News Writer | CIDRAP News  | Jun 26, 2020

Some COVID-19 patients, including those younger than 60 years old, appear to develop neurologic and neuropsychiatric complications such as stroke, brain inflammation, psychosis, and dementia-like symptoms, according to a study published yesterday in The Lancet Psychiatry.

The early-stage study of 153 hospitalized patients with confirmed, probable, or possible COVID-19 in the United Kingdom (UK) from Apr 2 to 26 identified 125 patients with complete data, of whom 77 (62%) had a stroke.

Of 125 patients, 114 (92%) had confirmed coronavirus infection, 5 (4%) had probable infection, and 5 (4%) were classified as possibly infected.

Stroke, encephalopathy, psychiatric diagnoses

Fifty-seven of 77 stroke patients (74%) had an ischemic stroke caused by a blood clot in the brain, 9 (12%) had a stroke caused by a brain hemorrhage, and 1 (1%) had a stroke caused by inflammation in the brain’s blood vessels. Sixty-one of the 77 stroke patients for whom age was available (82%) were older than 60 years.

Thirty-nine of 125 patients (31%) had behavioral changes indicative of an altered mental state, of whom 9 (23%) had unspecified brain dysfunction known as encephalopathy, and 7 (18%) had brain inflammation, or encephalitis.

The remaining 23 patients with altered mental states had psychiatric diagnoses, including 10 with new-onset psychosis, 7 with depression or anxiety, and 6 with a dementia-like syndrome. Only 2 patients (9%) had exacerbations of a chronic mental illness, although the authors noted that they cannot exclude the possibility that cases classified as new were simply undiagnosed before the pandemic.

Of the 37 of 39 COVID-19 patients with an altered mental state for whom age was available, 18 (49%) were younger than 60 years, which could be because they were more likely to be referred to a psychiatrist or other specialist, while physicians may be likely to attribute confusion or behavioral changes in older patients to delirium without further investigation, the authors said.

Altered mental states in younger patients

While altered mental states are not uncommon in hospitalized patients with infections, especially those requiring intensive care, they occur most often in older patients.

“In this study, we observed a disproportionate number of neuropsychiatric presentations in younger patients and a predominance of cerebrovascular complications in older patients, which might reflect the state of health of the cerebral vasculature and associated risk factors, exacerbated by critical illness in older patients,” the authors said.

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Stress-Related Growth in Adolescents Returning to School After COVID-19 School Closure

Authors: Lea Waters,1,*Kelly-Ann Allen,1,2 and Gökmen Arslan3,4


The move to remote learning during COVID-19 has impacted billions of students. While research shows that school closure, and the pandemic more generally, has led to student distress, the possibility that these disruptions can also prompt growth in is a worthwhile question to investigate. The current study examined stress-related growth (SRG) in a sample of students returning to campus after a period of COVID-19 remote learning (n = 404, age = 13–18). The degree to which well-being skills were taught at school (i.e., positive education) before the COVID-19 outbreak and student levels of SRG upon returning to campus was tested via structural equation modeling. Positive reappraisal, emotional processing, and strengths use in students were examined as mediators. The model provided a good fit [χ2 = 5.37, df = 3, p = 0.146, RMSEA = 0.044 (90% CI = 0.00–0.10), SRMR = 0.012, CFI = 99, TLI = 0.99] with 56% of the variance in SRG explained. Positive education explained 15% of the variance in cognitive reappraisal, 7% in emotional processing, and 16% in student strengths use during remote learning. The results are discussed using a positive education paradigm with implications for teaching well-being skills at school to foster growth through adversity and assist in times of crisis.


Novel coronavirus (COVID-19) spread rapidly across the globe in 2020, infecting more than 70 million people and causing more than 1.5 million deaths at the time of submitting this paper (December 8, 2020; World Health Organization, 2020a). The restrictions and disruptions stemming from this public health crisis have compromised the mental health of young people (Hawke et al., 2020UNICEF, 2020Yeasmin et al., 2020Zhou et al., 2020). A review assessing the mental health impact of COVID-19 on 6–21-year-olds (n = 51 articles) found levels of depression and anxiety ranging between 11.78 and 47.85% across China, the United States of America, Europe, and South America (Marques de Miranda et al., 2020). Researchers have also identified moderate levels of post-traumatic stress disorder (PTSD) in youth samples during the COVID-19 pandemic (Guo et al., 2020Liang et al., 2020Wang et al., 2020).

Adolescence is a critical life stage for identity formation (Allen and McKenzie, 2015Crocetti, 2017) where teenagers strive for mastery and autonomy (Featherman et al., 2019), individuate from their parents (Levpuscek, 2006), and gravitate toward their peer groups to have their social and esteem needs met (Allen and Loeb, 2015). The pandemic has drastically curtailed the conditions for teens to meet their developmental needs (Loades et al., 2020). Gou et al. (2020, p. 2) argue that adolescents are “more vulnerable than adults to mental health problems, in particular during a lockdown, because they are in a transition phase… with increasing importance of peers, and struggling with their often brittle self-esteem.”

In addition to the researching psychological distress arising from COVID-19, it is also important to identify positive outcomes that may arise through this pandemic. Dvorsky et al. (2020) caution that research focused only on distress may create a gap in knowledge about the resilience processes adopted by young people. In line with this, Bruining et al. (2020, p. 1) advocate for research to keep “an open scientific mind” and include “positive hypotheses.” Waters et al. (2021) argue that researching distress during COVID-19 need not come at the expense of investigating how people can be strengthened through the pandemic. Hawke et al. (2020), for example, found that more than 40% of their teen and early adult sample reported improved social relationships, greater self-reflection, and greater self-care.

Focusing on adolescents and adopting positive hypotheses, the current study will examine the degree to which a positive education intervention taught at school prior to the COVID-19 outbreak had an influence on three coping approaches during remote learning (i.e., positive reappraisal, emotional processing, and strengths use) and on student levels of stress-related growth (SRG) upon returning to school.

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Psychological Impact of COVID-19 on Children and Adolescents: A Systematic Review

Authors: Nishtha Chawla,1Ashlyn Tom,1Mahadev Singh Sen,1 and Rajesh Sagar1


Background and aims:

The outbreak of COVID-19 led to a significant psychological impact on individuals, particularly those belonging to vulnerable groups. This study aimed to synthesize literature on the psychological impact of COVID-19 among children and adolescents.


Electronic search engines were used to identify studies till March 2021 that reported symptoms of psychological origin in children and adolescents. Information was extracted using a predefined template, and qualitative analysis was conducted using STROBE.


One hundred and two relevant papers were identified. Most of the studies were conducted online or telephonically. The study designs were primarily single group cross-sectional, though a few prospective/retrospective designs were also identified. Studies assessing emotional distress showed variable levels of anxiety and depressive symptoms in the study population, with greater severity of anxiety symptoms among females and older adolescents. Reduced physical activity; delayed sleep time; increased sleep duration, screen time, internet use, and sedentary habits, poor quality of life were other notable findings, often correlating with anxiety/depression. Efforts to address bias, discussion on generalizability of their results, and sample size calculation were not reported in most studies.


Psychological impact on children/adolescents is significant, either due to the fear of the illness or social isolation related to COVID-19. One may focus on improving sleep habits and physical activity and regulating internet use for maintaining psychological well-being.

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Individual differences in adolescent mental health during COVID-19: The importance of peer relationship quality

By DocWire News Featured Reading -August 11, 2021

Neuron. 2021 Aug 9:S0896-6273(21)00571-7. doi: 10.1016/j.neuron.2021.07.027. Online ahead of print.


Lockdowns and school closures deprive adolescents of typical social interactions. In this NeuroView, we explore how the quality of existing peer relationships might moderate-both positively and negatively-the impact of these restrictions on adolescent mental health, and we highlight the importance of individual differences.

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Children born during pandemic have lower IQs, US study finds

Authors: Natalie Grover Science correspondent

Children born during the coronavirus pandemic have significantly reduced verbal, motor and overall cognitive performance compared with children born before, a US study suggests.

The first few years of a child’s life are critical to their cognitive development. But with Covid-19 triggering the closure of businesses, nurseries, schools and playgrounds, life for infants changed considerably, with parents stressed and stretched as they tried to balance work and childcare.

With limited stimulation at home and less interaction with the world outside, pandemic-era children appear to have scored shockingly low on tests designed to assess cognitive development, said lead study author Sean Deoni, associate professor of paediatrics (research) at Brown University.

In the decade preceding the pandemic, the mean IQ score on standardised tests for children aged between three months and three years of age hovered around 100, but for children born during the pandemic that number tumbled to 78, according to the analysis, which is yet to be peer-reviewed.

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Top Ten COVID-19 Anxiety Reduction Strategies

Authors: Ken Goodman, LCSW

To stop the spread of COVID-19, we’ve had to practice social distancing. But to stop the spread of anxiety, we must distance ourselves from the media. All anxiety stems from uncertainty and an active imagination which produces catastrophic thoughts. The media, which is 24/7 Coronavirus and virtually all negative, is the driver of those thoughts. My patients who are the most anxious about the Coronavirus are those who are consuming the most news from social media, online, and traditional outlets. The more anxious you feel, the more you should distance from the media. And if you are extremely fearful, stop altogether. Do no Google or research. Stop checking the latest news about the virus. Any vital information you need to know, you will find out.

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Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations☆

Authors: Shweta Singh,a Deblina Roy,b,⁎ Krittika Sinha,c Sheeba Parveen,c Ginni Sharma,c and Gunjan Josh

COVID-19 pandemic and lockdown has brought about a sense of fear and anxiety around the globe. This phenomenon has led to short term as well as long term psychosocial and mental health implications for children and adolescents. The quality and magnitude of impact on minors is determined by many vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection.


This paper is aimed at narratively reviewing various articles related to mental-health aspects of children and adolescents impacted by COVID-19 pandemic and enforcement of nationwide or regional lockdowns to prevent further spread of infection.

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COVID-19 and mental health: A review of the existing literature

Author: Ravi Philip Rajkumar

The COVID-19 pandemic is a major health crisis affecting several nations, with over 720,000 cases and 33,000 confirmed deaths reported to date. Such widespread outbreaks are associated with adverse mental health consequences. Keeping this in mind, existing literature on the COVID-19 outbreak pertinent to mental health was retrieved via a literature search of the PubMed database. Published articles were classified according to their overall themes and summarized. Preliminary evidence suggests that symptoms of anxiety and depression (16–28%) and self-reported stress (8%) are common psychological reactions to the COVID-19 pandemic, and may be associated with disturbed sleep. A number of individual and structural variables moderate this risk. In planning services for such populations, both the needs of the concerned people and the necessary preventive guidelines must be taken into account. The available literature has emerged from only a few of the affected countries, and may not reflect the experience of persons living in other parts of the world. In conclusion, subsyndromal mental health problems are a common response to the COVID-19 pandemic. There is a need for more representative research from other affected countries, particularly in vulnerable populations.

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