RT Journal Article
SR Electronic
T1 New onset neurologic events in people with COVID-19 in 3 regions in China
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e1479
OP e1487
DO 10.1212/WNL.0000000000010034
VO 95
IS 11
A1 Weixi Xiong
A1 Jie Mu
A1 Jian Guo
A1 Lu Lu
A1 Dan Liu
A1 Jianfei Luo
A1 Nian Li
A1 Jing Liu
A1 Dan Yang
A1 Hui Gao
A1 Yingying Zhang
A1 Mintao Lin
A1 Sisi Shen
A1 Hesheng Zhang
A1 Lei Chen
A1 Gang Wang
A1 Fengming Luo
A1 Weimin Li
A1 Shengli Chen
A1 Li He
A1 Josemir W. Sander
A1 Dong Zhou
YR 2020
UL http://n.neurology.org/content/95/11/e1479.abstract
AB Objective To investigate new-onset neurologic impairments associated with coronavirus disease 2019 (COVID-19).Methods A retrospective multicenter cohort study was conducted between January 18 and March 20, 2020, including people with confirmed COVID-19 from 56 hospitals officially designated in 3 Chinese regions; data were extracted from medical records. New-onset neurologic events as assessed by neurology consultants based on manifestations, clinical examination, and investigations were noted, in which critical events included disorders of consciousness, stroke, CNS infection, seizures, and status epilepticus.Results We enrolled 917 people with average age 48.7 years and 55% were male. The frequency of new-onset critical neurologic events was 3.5% (32/917) overall and 9.4% (30/319) among those with severe or critical COVID-19. These were impaired consciousness (n = 25) or stroke (n = 10). The risk of critical neurologic events was highly associated with age above 60 years and previous history of neurologic conditions. Noncritical events were seen in fewer than 1% (7/917), including muscle cramp, unexplained headache, occipital neuralgia, tic, and tremor. Brain CT in 28 people led to new findings in 9. Findings from lumbar puncture in 3 with suspected CNS infection, unexplained headache, or severe occipital neuralgia were unremarkable.Conclusions People with COVID-19 aged over 60 and with neurologic comorbidities were at higher risk of developing critical neurologic impairment, mainly impaired consciousness and cerebrovascular accidents. Brain CT should be considered when new-onset brain injury is suspected, especially in people under sedation or showing an unexplained decline in consciousness. Evidence of direct acute insult of severe acute respiratory syndrome coronavirus 2 to the CNS is lacking.COVID-19=coronavirus disease 2019; GCS=Glasgow Coma Scale; ICU=intensive care unit; IMV=invasive mechanical ventilation; NIPPV=noninvasive positive-pressure ventilation; SARS-CoV-2=severe acute respiratory syndrome coronavirus 2