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Background and purpose: The aim was to investigate the neurological complications associated with coronavirus disease 19 (COVID‐19) during the 2022 Omicron wave. Methods and analysis: The medical records of a cohort of people admitted to neurological wards of three participating tertiary centres in Sichuan from 12 December 2022 to 12 January 2023 were reviewed. Demographics and clinical data were obtained and analysed with an interest in COVID‐19‐related new‐onset or worse neurological symptoms. The current data were also compared in two centres with similar data from the same period 12 months earlier. Results: In all, 790 people were enrolled, of whom 436 were positive for COVID‐19. Ninety‐nine had new onset COVID‐related neurological problems, or their known neurological condition deteriorated during the wave. There was a significant difference in demographics from the findings amongst admissions 12 months earlier as there was an increase in the average age, the incidence of encephalitis and encephalopathy, and mortality rates. One hundred and one received COVID‐specific antivirals, intravenous glucocorticoids and intravenous immunoglobulin therapy. No differences were seen between these and those who did not use them. Conclusion: New‐onset neurological conditions, particularly encephalitis and encephalopathy, increased significantly during this period. Deterioration of existing neurological conditions, such as seizure exacerbation, was also observed. A large‐scale treatment trial of people with COVID‐19 infection presenting with neurological disorders is still needed. [ABSTRACT FROM AUTHOR]