PT  - JOURNAL ARTICLE
AU  - Romero-Sánchez, Carlos Manuel
AU  - Díaz-Maroto, Inmaculada
AU  - Fernández-Díaz, Eva
AU  - Sánchez-Larsen, Álvaro
AU  - Layos-Romero, Almudena
AU  - García-García, Jorge
AU  - González, Esther
AU  - Redondo-Peñas, Inmaculada
AU  - Perona-Moratalla, Ana Belén
AU  - Del Valle-Pérez, José Antonio
AU  - Gracia-Gil, Julia
AU  - Rojas-Bartolomé, Laura
AU  - Feria-Vilar, Inmaculada
AU  - Monteagudo, María
AU  - Palao, María
AU  - Palazón-García, Elena
AU  - Alcahut-Rodríguez, Cristian
AU  - Sopelana-Garay, David
AU  - Moreno, Yóscar
AU  - Ahmad, Javaad
AU  - Segura, Tomás
TI  - Neurologic manifestations in hospitalized patients with COVID-19
AID  - 10.1212/WNL.0000000000009937
DP  - 2020 Aug 25
TA  - Neurology
PG  - e1060--e1070
VI  - 95
IP  - 8
4099  - http://n.neurology.org/content/95/8/e1060.short
4100  - http://n.neurology.org/content/95/8/e1060.full
SO  - Neurology2020 Aug 25; 95
AB  - Objective The coronavirus disease 2019 (COVID-19) has spread worldwide since December 2019. Neurologic symptoms have been reported as part of the clinical spectrum of the disease. We aimed to determine whether neurologic manifestations are common in hospitalized patients with COVID-19 and to describe their main characteristics.Methods We systematically reviewed all patients diagnosed with COVID-19 admitted to the hospital in a Spanish population during March 2020. Demographic characteristics, systemic and neurologic clinical manifestations, and complementary tests were analyzed.Results Of 841 patients hospitalized with COVID-19 (mean age 66.4 years, 56.2% men), 57.4% developed some form of neurologic symptom. Nonspecific symptoms such as myalgias (17.2%), headache (14.1%), and dizziness (6.1%) were present mostly in the early stages of infection. Anosmia (4.9%) and dysgeusia (6.2%) tended to occur early (60% as the first clinical manifestation) and were more frequent in less severe cases. Disorders of consciousness occurred commonly (19.6%), mostly in older patients and in severe and advanced COVID-19 stages. Myopathy (3.1%), dysautonomia (2.5%), cerebrovascular diseases (1.7%), seizures (0.7%), movement disorders (0.7%), encephalitis (n = 1), Guillain-Barré syndrome (n = 1), and optic neuritis (n = 1) were also reported, but less frequent. Neurologic complications were the main cause of death in 4.1% of all deceased study participants.Conclusions Neurologic manifestations are common in hospitalized patients with COVID-19. In our series, more than half of patients presented some form of neurologic symptom. Clinicians need to maintain close neurologic surveillance for prompt recognition of these complications. The mechanisms and consequences of severe acute respiratory syndrome coronavirus type 2 neurologic involvement require further studies.ACE2=angiotensin-converting enzyme receptor 2; ACEI=angiotensin-converting enzyme inhibitors; AIDP=acute inflammatory demyelinating polyneuropathy; ARB=angiotensin II receptor blockers; BBB=blood–brain barrier; CI=confidence interval; CK=creatine kinase; CKD=chronic kidney disease; COVID-19=coronavirus disease 2019; CRP=C-reactive protein; ICH=intracranial hemorrhage; ICU=intensive care unit; IgG=immunoglobulin G; IgM=immunoglobulin M; LMWH=low-molecular-weight heparin; OR=odds ratio; PNS=peripheral nervous system; rt-PCR=real-time reverse transcription–polymerase chain reaction; SARS-CoV-2=severe acute respiratory syndrome coronavirus type 2