Patients with COVID-19 who have disorders of consciousness (COVID-DoC) are highly likely to reawaken and recover from disability, US neurologists say.
Their study of 12 hospitalised COVID-19 patients in comas, vegetative or minimally conscious states saw 11 regain consciousness within 25 days of continuous intravenous sedation cessation.
All eight discharged patients were cognitively impaired and needed significant assistance upon leaving the hospital, yet, five were out of inpatient rehabilitation facilities with normal or nearly normal cognition and mild weakness and pain-related disability in under three months and six were home with normal cognition and minimal or no disability at six months.
Two remained in inpatient care for more constant support after their recovery was hindered by severe polyneuropathy, the authors wrote in Neurology.
The findings are positive despite radiological signs of white matter and neuronal activity depletion, with the cohort’s structural connectivity mirroring that of patients with severe traumatic brain injuries.
Though small and somewhat limited, the study provides critical information that could help justify life-sustaining treatment in un- or minimally-conscious COVID patients, the authors suggested.
“Among the countless tragedies of the COVID-19 pandemic, COVID-DoC has presented unique and profound challenges,” they wrote.
“Rendering patients unable to communicate, and with uncertain prospects for recovery, COVID-DoC has forced families and clinicians to decide whether to continue life-sustaining treatment with little data available for guidance.”