September 15, 2020; 95 (11) Article
New onset neurologic events in people with COVID-19 in 3 regions in China
View ORCID ProfileWeixi Xiong, View ORCID ProfileJie Mu, View ORCID ProfileJian Guo, View ORCID ProfileLu Lu, View ORCID ProfileDan Liu, View ORCID ProfileJianfei Luo, Nian Li, View ORCID ProfileJing Liu, View ORCID ProfileDan Yang, View ORCID ProfileHui Gao, Yingying Zhang, Mintao Lin, View ORCID ProfileSisi Shen, View ORCID ProfileHesheng Zhang, Lei Chen, Gang Wang, Fengming Luo, Weimin Li, View ORCID ProfileShengli Chen, Li He, View ORCID ProfileJosemir W. Sander, View ORCID ProfileDong Zhou
First published June 17, 2020, DOI: https://doi.org/10.1212/WNL.0000000000010034
Weixi Xiong
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Jie Mu
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Jian Guo
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Lu Lu
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Dan Liu
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Jianfei Luo
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Nian Li
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Jing Liu
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Dan Yang
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Hui Gao
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Yingying Zhang
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Mintao Lin
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Sisi Shen
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Hesheng Zhang
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Lei Chen
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Gang Wang
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Fengming Luo
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Weimin Li
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Shengli Chen
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Li He
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Josemir W. Sander
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
Dong Zhou
From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
New onset neurologic events in people with COVID-19 in 3 regions in China
Weixi Xiong, Jie Mu, Jian Guo, Lu Lu, Dan Liu, Jianfei Luo, Nian Li, Jing Liu, Dan Yang, Hui Gao, Yingying Zhang, Mintao Lin, Sisi Shen, Hesheng Zhang, Lei Chen, Gang Wang, Fengming Luo, Weimin Li, Shengli Chen, Li He, Josemir W. Sander, Dong Zhou
Neurology Sep 2020, 95 (11) e1479-e1487; DOI: 10.1212/WNL.0000000000010034
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- Figure 1 Flowchart of study enrollment
COVID-19 = coronavirus disease 2019.
- Figure 2 CT brain scans of patients with COVID-19 with cerebrovascular accidents
(A, B) Images of patient 1 showing multifocal ischemic stroke in both hemispheres. (C) Image of patient 1 taken 10 days after the images in panels A and B, showing the onset of intraventricular bleeding. (D) Image of patient 8 showing ischemic stroke of right temporal occipital junction and parahippocampal gyrus. (E–G) Images of patient 2 showing multifocal cerebral watershed infarction. (H) Unremarkable image of patient 4, taken 2 days before fatal stroke. (I–K) Scans of patient 3 showing bilateral multifocal stroke, hemorrhagic lesions, and large hemispheric infarction on the left side. (L, M) Scans of patient 9 showing previous lesions of stroke. (N–P) Images of the new-onset subdural hematoma (arrow) in the follow-up scans 4, 11, and 16 days after images in panels L and M.
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