Disorders of Consciousness and COVID-19: David Fischer, MD

WATCH TIME: 3 minutes

“Medical teams and families wanted to know if life-sustaining treatment should be continued or not, basically asking how long they could expect these disorders of consciousness to continue, and we really didn’t know. We didn’t really know how COVID was affecting the brain.”

A recent prospective study investigated patients with COVID-19 and disorders of consciousness (COVID-DoC), which has been identified as a serious complication of the virus. As prognosis and pathophysiology of the condition are not yet fully understood, an added layer or complications arose in terms of the decision to continue life-sustaining treatment. 

Led by David Fischer, MD, neurocritical care fellow at Massachusetts General Hospital and Brigham and Women’s Hospital, investigators enrolled 12 patients with COVID-DoC, 11 of whom recovered consciousness after 0-25 days (median, 7 [5-14.5]) after stopping continuous intravenous sedation—excluding 1 patient who died following enrollment. We sat down with Fischer to learn more about study findings, the most surprising of which was the recovery of significant neurologic function and minimal disability by 9 surviving patients upon returning home.  

Speaking with NeurologyLive^®, Fischer outlined motivations for the study, which was prompted by questions from families and medical teams regarding admitted patients with severe COVID-19 infections and DoC that were not waking up. This generated issues for clinicians, Fischer said, as they were unable to provide informed advice to families and medical teams regarding withdrawal of life-sustaining treatment. 

REFERENCE
Fischer D, Snider SB, Barra ME, et al. Disorders of consciousness associated with COVID-19: A prospective, multimodal study of recovery and brain connectivity. Neurology. Published online December 3, 2021. doi:10.1212/WNL.0000000000013067