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Article ; Online: Neurological manifestations of COVID-19 in confirmed and probable cases: A descriptive study from a large tertiary care center.

Yuksel, Hatice / Gursoy, Gorkem Tutal / Dirik, Ebru Bilge / Kenar, Safiye Gul / Bektas, Hesna / Yamanel, Levent / Guner, Hatice Rahmet

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2021  Volume 86, Page(s) 97–102

Abstract: ... in both confirmed (43.9% vs. 6.2%) and probable cases (47.3% vs. 6.9%) (for both p:0.001). The frequency of seizure ... attacks was 13.2% in confirmed and 17.5% in probable cases (p:0.321). The mortality rate was higher ... classified as "confirmed cases" or "probable cases" based on confirmatory tests, including ...

Abstract During the early phase of the COVID-19 pandemic, it was thought that virus affects only the respiratory system. However, now it is clear that it can affect other systems too, particularly the nervous system. We aimed to identify the most common neurological symptoms and findings of COVID-19 in hospitalized patients and investigate the relationship between these symptoms and clinical, radiological, and laboratory findings. A total of 307 patients, including 125 women and 182 men, were included in the study. They were classified as "confirmed cases" or "probable cases" based on confirmatory tests, including polymerase chain reaction testing of a nasopharyngeal sample or validated antibody test. All medical records, including medical history, clinical course, laboratory data, and radiographic studies, were evaluated by two expert neurologists. Altered mental status (AMS) is the most common neurological finding in both confirmed (68.1%) and probable cases (71.8%). Pre-existing neurological diseases were detected as an independent risk factor for AMS. The mortality rate of patients with AMS was dramatically higher than normal mental status in both confirmed (43.9% vs. 6.2%) and probable cases (47.3% vs. 6.9%) (for both p:0.001). The frequency of seizure attacks was 13.2% in confirmed and 17.5% in probable cases (p:0.321). The mortality rate was higher in patients with a seizure attack in both groups. We conclude that AMS was one of the most common neurological manifestations in this cohort of COVID-19 patients. The development of mental deterioration increases mortality dramatically. Also, the existence of seizure attacks was associated with a high mortality rate.
MeSH term(s) Aged ; COVID-19/complications ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Nervous System Diseases/epidemiology ; Nervous System Diseases/virology ; SARS-CoV-2 ; Tertiary Care Centers ; Turkey/epidemiology
Language English
Publishing date 2021-01-22
Publishing country Scotland
Document type Journal Article
ZDB-ID 1193674-5
ISSN 1532-2653 ; 0967-5868
ISSN (online) 1532-2653
ISSN 0967-5868
DOI 10.1016/j.jocn.2021.01.002
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