Researchers have found that people hospitalised with Covid-19 and neurological problems, including stroke and confusion have a higher risk of dying than other coronavirus affected patients.
The findings, published in the journal Neurology, have the potential to identify and focus treatment efforts on individuals most at risk and could decrease Covid-19 deaths.
"This study is the first to show that the presence of neurological symptoms, particularly stroke and confused or altered thinking, may indicate a more serious course of illness, even when pulmonary problems aren't severe," said study author David Altschul from the Albert Einstein College of Medicine in the US.
"Hospitals can use this knowledge to prioritize treatment and, hopefully, save more lives during this pandemic," Altschul added.
The study looked at data from 4,711 Covid-19 patients who were admitted to Montefiore during the six-week period between March 1, 2020, and April 16, 2020.
Of those patients, 581 (12 per cent) had neurological problems serious enough to warrant brain imaging.
These individuals were compared with 1,743 non-neurological Covid-19 patients of similar age and disease severity who were admitted during the same period.
Among people who underwent brain imaging, 55 were diagnosed with stroke and 258 people exhibited confusion or altered thinking ability.
The findings showed that individuals with stroke were twice as likely to die (49 per cent mortality) compared with their matched controls (24 per cent mortality) -- a statistically significant difference.
People with confusion had a 40 per cent mortality rate compared with 33 per cent for their matched controls -- also statistically significant.
Also, more than half the stroke patients in the study did not have hypertension or other underlying risk factors for stroke.
"This highly unusual finding agrees with other studies of people with Covid-19 in suggesting that infection with the novel coronavirus is itself a risk factor for stroke," Altschul noted.