As the novel coronavirus continues to spread around the U.S., research continues to evolve around the potential symptoms and warning signs of COVID-19, the disease the virus causes.

Encephalopathy should be on the list of potential warning signs of the disease, especially for older patients, according to a new paper published on March 21 in Cureus.

COVID-19 is a respiratory illness typified by a range of symptoms, from acute respiratory symptoms to severe pneumonia. The CDC currently warns to watch for a cough, shortness of breath, and fever, plus other possible disease indicators.

New research suggests there may be a neurological link to detecting COVID-19, especially among older patients. According to the new paper, “Neurology Complications of Coronavirus Disease (COVID-19): Encephalopathy,” COVID-19 patients have presented symptoms such as:

  • Acute stroke
  • Consciousness impairment
  • Skeletal muscle injury

The paper, written by Asia Filatov, Pamraj Sharma, Fawzi Hindi, and Patricio S. Espinosa, focuses on a case study of a 74-year-old male who presented neurological symptoms. The patient was found “encephalopathic, nonverbal, and unable to follow any commands,” according to the study, and later tested positive for COVID-19.

Prior to that diagnosis, a CT scan of the patient’s head showed no acute abnormalities. The EEG, however, showed “bilateral slowing and focal slowing in the left temporal region with sharply countered waves,” according to the case study.

At the time of publication, the patient remained in the ICU in critical condition.

The authors of the paper warned that neurologists should be wary of presentation of encephalopathy in the ER or during a hospital stay. Consulting neurologists in these cases should be aware of the potential link to COVID-19.

“Elderly patients with chronic conditions are at an increased risk of altered mental status in the setting of acute infections,” the authors concluded. “Since COVID-19 affects more of the elderly and those with preexisting conditions, patients with prior neurological conditions and acute respiratory symptoms are at an increased risk of encephalopathy on initial presentation.”

As for March 30, the John Hopkins University Coronavirus Resource Center was reported 153,246 confirmed COVID-19 cases in the U.S. and 2,828 deaths in the country from the disease.