RT Journal Article
SR Electronic
T1 Neurologic manifestations in hospitalized patients with COVID-19
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e1060
OP e1070
DO 10.1212/WNL.0000000000009937
VO 95
IS 8
A1 Romero-Sánchez, Carlos Manuel
A1 Díaz-Maroto, Inmaculada
A1 Fernández-Díaz, Eva
A1 Sánchez-Larsen, Álvaro
A1 Layos-Romero, Almudena
A1 García-García, Jorge
A1 González, Esther
A1 Redondo-Peñas, Inmaculada
A1 Perona-Moratalla, Ana Belén
A1 Del Valle-Pérez, José Antonio
A1 Gracia-Gil, Julia
A1 Rojas-Bartolomé, Laura
A1 Feria-Vilar, Inmaculada
A1 Monteagudo, María
A1 Palao, María
A1 Palazón-García, Elena
A1 Alcahut-Rodríguez, Cristian
A1 Sopelana-Garay, David
A1 Moreno, Yóscar
A1 Ahmad, Javaad
A1 Segura, Tomás
YR 2020
UL http://n.neurology.org/content/95/8/e1060.abstract
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