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Artikel ; Online: Subarachnoid hemorrhage due to intradural cerebral aneurysm and simultaneous spinal subdural hematoma: illustrative case.

Hernández-Fernández, Francisco / Cámara-González, Noemí / Pedrosa-Jiménez, María José / Alcahut-Rodríguez, Cristian

Journal of neurosurgery. Case lessons

2021 Band 1, Heft 20, Seite(n) CASE21123

Abstract: Background: Spontaneous spinal subdural hematomas (SSDHs) are unusual. Among their probable etiologies, an association with ruptured brain aneurysms has been described in an extraordinary way. The underlying pathophysiological mechanism is not ... ...

Abstract	Background: Spontaneous spinal subdural hematomas (SSDHs) are unusual. Among their probable etiologies, an association with ruptured brain aneurysms has been described in an extraordinary way. The underlying pathophysiological mechanism is not conclusively described in the literature. Observations: The authors reported an exceptional case of a 59-year-old woman admitted for a condition that included sudden headache, stiff neck, and vomiting associated with pain in the left flank area that radiated to the leg. Computed tomography (CT) of the brain evidenced acute subarachnoid hemorrhage distributed in the bilateral posterior parieto-occipital fossa and occipital horns of the ventricles. CT angiography detected a dissecting aneurysm in the left vertebral artery (V4) that was treated urgently via the endovascular route. In the next hours, the patient's symptoms worsened, with paraplegia of the lower extremities. Magnetic resonance imaging showed SSDH at T4-6 and extensive associated myelopathy. Lessons: The origin of the spinal hematoma may be the rupture of the aneurysm of the V4 segment in the dura mater of the foramen magnum and subsequent rostrocaudal migration of the hemorrhage to the spinal subdural space, enhanced by an intracranial pressure increase. This hypothesis is discussed, as is a brief literature review.
Sprache	Englisch
Erscheinungsdatum	2021-05-17
Erscheinungsland	United States
Dokumenttyp	Case Reports
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE21123
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Symptoms timeline and outcomes in amyotrophic lateral sclerosis using artificial intelligence.

Segura, Tomás / Medrano, Ignacio H / Collazo, Sergio / Maté, Claudia / Sguera, Carlo / Del Rio-Bermudez, Carlos / Casero, Hugo / Salcedo, Ignacio / García-García, Jorge / Alcahut-Rodríguez, Cristian / Taberna, Miren

Scientific reports

2023 Band 13, Heft 1, Seite(n) 702

Abstract: Amyotrophic lateral sclerosis (ALS) is a fatal, neurodegenerative motor neuron disease. Although an early diagnosis is crucial to provide adequate care and improve survival, patients with ALS experience a significant diagnostic delay. This study aimed to ...

Abstract	Amyotrophic lateral sclerosis (ALS) is a fatal, neurodegenerative motor neuron disease. Although an early diagnosis is crucial to provide adequate care and improve survival, patients with ALS experience a significant diagnostic delay. This study aimed to use real-world data to describe the clinical profile and timing between symptom onset, diagnosis, and relevant outcomes in ALS. Retrospective and multicenter study in 5 representative hospitals and Primary Care services in the SESCAM Healthcare Network (Castilla-La Mancha, Spain). Using Natural Language Processing (NLP), the clinical information in electronic health records of all patients with ALS was extracted between January 2014 and December 2018. From a source population of all individuals attended in the participating hospitals, 250 ALS patients were identified (61.6% male, mean age 64.7 years). Of these, 64% had spinal and 36% bulbar ALS. For most defining symptoms, including dyspnea, dysarthria, dysphagia and fasciculations, the overall diagnostic delay from symptom onset was 11 (6-18) months. Prior to diagnosis, only 38.8% of patients had visited the neurologist. In a median post-diagnosis follow-up of 25 months, 52% underwent gastrostomy, 64% non-invasive ventilation, 16.4% tracheostomy, and 87.6% riluzole treatment; these were more commonly reported (all Ps < 0.05) and showed greater probability of occurrence (all Ps < 0.03) in bulbar ALS. Our results highlight the diagnostic delay in ALS and revealed differences in the clinical characteristics and occurrence of major disease-specific events across ALS subtypes. NLP holds great promise for its application in the wider context of rare neurological diseases.
Mesh-Begriff(e)	Humans ; Male ; Middle Aged ; Female ; Amyotrophic Lateral Sclerosis/therapy ; Amyotrophic Lateral Sclerosis/drug therapy ; Retrospective Studies ; Artificial Intelligence ; Delayed Diagnosis ; Disease Progression
Sprache	Englisch
Erscheinungsdatum	2023-01-13
Erscheinungsland	England
Dokumenttyp	Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-27863-2
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Stroke-associated pneumonia according to mCDC criteria: impact on prognosis and antibiotic therapy.

Frontiers in neurology

2024 Band 15, Seite(n) 1358628

Abstract: Objective: The modified Centers for Disease Control and Prevention (mCDC) criteria have been proposed for diagnosing and managing stroke-associated pneumonia (SAP). The objective was to investigate the impact of SAP on stroke outcome depending on ... ...

Abstract	Objective: The modified Centers for Disease Control and Prevention (mCDC) criteria have been proposed for diagnosing and managing stroke-associated pneumonia (SAP). The objective was to investigate the impact of SAP on stroke outcome depending on whether or not it conforms to mCDC criteria. Our secondary objective was to identify the responsible factors for antibiotic initiation in stroke patients. Methods: We conducted a prospective, multicenter, observational study of ischemic stroke patients with moderate to severe stroke (NIHSS≥4) admitted within 24 h. For 7 days, mCDC criteria were assessed daily, and infections and antibiotics were recorded. Pneumonias were divided into those fulfilling mCDC criteria (mCDC-SAP) or not (other pneumonias, OPn). The effect of each type of pneumonia on 3-month outcome was evaluated in separated logistic regression models. Factors associated with antibiotic initiation were explored using a random forest analysis. Results: Of the 342 patients studied, infections were diagnosed in 72 (21.6%), including 39 (11.7%) cases of pneumonia. Of them, 25 (7.5%) fulfilled mCDC criteria. Antibiotics were used in 92% of mCDC-SAP and 64.3% of OPn. In logistic regression analysis, mCDC-SAP, but not OPn, was an independent predictor of poor outcome [OR, 4.939 (1.022-23.868)]. The random forest analysis revealed that fever had the highest importance for antibiotic initiation. Interpretation: The mCDC criteria might be useful for detecting clinically relevant SAP, which is associated with poor outcomes. Isolated signs of infection were more important for antibiotic initiation than compliance with pre-defined criteria. Therefore, adherence to mCDC criteria might result in antibiotic saving without compromising clinical outcome.
Sprache	Englisch
Erscheinungsdatum	2024-02-28
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2024.1358628
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Influence of the COVID-19 outbreak in people with epilepsy: Analysis of a Spanish population (EPICOVID registry).

Sanchez-Larsen, Alvaro / Gonzalez-Villar, Esther / Díaz-Maroto, Inmaculada / Layos-Romero, Almudena / Martínez-Martín, Álvaro / Alcahut-Rodriguez, Cristian / Grande-Martin, Alberto / Sopelana-Garay, David

Epilepsy & behavior : E&B

2020 Band 112, Seite(n) 107396

Abstract: Background: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current ... ...

Abstract	Background: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. Methods: This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. Results: One hundred patients were included, 52% women, mean age 42.4 years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; p = 0.008) and a prior higher seizure frequency (OR: 12.4; p = 0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; p = 0.03) and recent adjustment of antiepileptics (OR: 0.07; p = 0.01) acted as protecting factors. Conclusions: A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.
Mesh-Begriff(e)	Adolescent ; Adult ; Anticonvulsants/therapeutic use ; Anxiety/physiopathology ; Anxiety/psychology ; Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Depression/physiopathology ; Depression/psychology ; Disease Progression ; Epilepsy/drug therapy ; Epilepsy/physiopathology ; Epilepsy/psychology ; Exercise ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; Recurrence ; Registries ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Seizures/physiopathology ; Sleep Deprivation/physiopathology ; Spain ; Status Epilepticus/physiopathology ; Stress, Psychological/physiopathology ; Stress, Psychological/psychology
Chemische Substanzen	Anticonvulsants
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-09-07
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Observational Study
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2020.107396
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description.

Hernández-Fernández, Francisco / Sandoval Valencia, Hernán / Barbella-Aponte, Rosa Angélica / Collado-Jiménez, Rosa / Ayo-Martín, Óscar / Barrena, Cristina / Molina-Nuevo, Juan David / García-García, Jorge / Lozano-Setién, Elena / Alcahut-Rodriguez, Cristian / Martínez-Martín, Álvaro / Sánchez-López, Antonio / Segura, Tomás

Brain : a journal of neurology

2020 Band 143, Heft 10, Seite(n) 3089–3103

Abstract: Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, ... ...

Abstract	Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on co-morbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4-6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012-2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.
Mesh-Begriff(e)	Age Factors ; Aged ; Betacoronavirus ; Brain/diagnostic imaging ; Brain/pathology ; Brain Ischemia/diagnostic imaging ; Brain Ischemia/epidemiology ; Brain Ischemia/pathology ; COVID-19 ; Cerebral Hemorrhage/blood ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/epidemiology ; Cerebral Hemorrhage/pathology ; Comorbidity ; Coronavirus Infections/blood ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/epidemiology ; Coronavirus Infections/pathology ; Female ; Ferritins/blood ; Humans ; Incidence ; Leukoencephalopathies/diagnostic imaging ; Leukoencephalopathies/epidemiology ; Leukoencephalopathies/pathology ; Magnetic Resonance Imaging ; Male ; Neuroimaging ; Pandemics ; Pneumonia, Viral/blood ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/pathology ; SARS-CoV-2 ; Spain/epidemiology ; Tomography, X-Ray Computed
Chemische Substanzen	Ferritins (9007-73-2)
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-07-09
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	80072-7
ISSN	1460-2156 ; 0006-8950
ISSN (online)	1460-2156
ISSN	0006-8950
DOI	10.1093/brain/awaa239
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Influence of the COVID-19 outbreak in people with epilepsy: Analysis of a Spanish population (EPICOVID registry)

Epilepsy Behav

Abstract: BACKGROUND: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current ... ...

Abstract	BACKGROUND: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. METHODS: This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. RESULTS: One hundred patients were included, 52% women, mean age 42.4â¯years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; pâ¯=â¯0.008) and a prior higher seizure frequency (OR: 12.4; pâ¯=â¯0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; pâ¯=â¯0.03) and recent adjustment of antiepileptics (OR: 0.07; pâ¯=â¯0.01) acted as protecting factors. CONCLUSIONS: A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.
Schlagwörter	covid19
Verlag	WHO
Dokumenttyp	Artikel
Anmerkung	WHO #Covidence: #745902
Datenquelle	COVID19

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Artikel ; Online: Influence of the COVID-19 outbreak in people with epilepsy

Epilepsy & Behavior

Analysis of a Spanish population (EPICOVID registry)

2020 Band 112, Seite(n) 107396

Schlagwörter	Behavioral Neuroscience ; Neurology ; Clinical Neurology ; covid19
Sprache	Englisch
Verlag	Elsevier BV
Erscheinungsland	us
Dokumenttyp	Artikel ; Online
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2020.107396
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel: Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description

Brain

Abstract	Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on co-morbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4-6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012-2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.
Schlagwörter	covid19
Verlag	WHO
Dokumenttyp	Artikel
Anmerkung	WHO #Covidence: #636181
Datenquelle	COVID19

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Artikel ; Online: Cerebrovascular disease in patients with COVID-19

Brain

neuroimaging, histological and clinical description

2020 Band 143, Heft 10, Seite(n) 3089–3103

Abstract: Abstract Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, ... ...

Abstract	Abstract Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on co-morbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4–6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012–2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.
Schlagwörter	Clinical Neurology ; covid19
Sprache	Englisch
Verlag	Oxford University Press (OUP)
Erscheinungsland	uk
Dokumenttyp	Artikel ; Online
ZDB-ID	80072-7
ISSN	0006-8950
ISSN	0006-8950
DOI	10.1093/brain/awaa239
Datenquelle	BASE - Bielefeld Academic Search Engine (Lebenswissenschaftliche Auswahl)

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Artikel ; Online: Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry.

Romero-Sánchez, Carlos Manuel / Díaz-Maroto, Inmaculada / Fernández-Díaz, Eva / Sánchez-Larsen, Álvaro / Layos-Romero, Almudena / García-García, Jorge / González, Esther / Redondo-Peñas, Inmaculada / Perona-Moratalla, Ana Belén / Del Valle-Pérez, José Antonio / Gracia-Gil, Julia / Rojas-Bartolomé, Laura / Feria-Vilar, Inmaculada / Monteagudo, María / Palao, María / Palazón-García, Elena / Alcahut-Rodríguez, Cristian / Sopelana-Garay, David / Moreno, Yóscar /

Ahmad, Javaad / Segura, Tomás

Neurology

2020 Band 95, Heft 8, Seite(n) e1060–e1070

Abstract: 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 ... ...

Abstract	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.
Mesh-Begriff(e)	Aged ; Betacoronavirus/pathogenicity ; COVID-19 ; Comorbidity ; Coronavirus Infections/epidemiology ; Coronavirus Infections/psychology ; Female ; Humans ; Male ; Nervous System Diseases/epidemiology ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/psychology ; Registries ; SARS-CoV-2 ; Spain/epidemiology
Schlagwörter	covid19
Sprache	Englisch
Erscheinungsdatum	2020-06-01
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	207147-2
ISSN	1526-632X ; 0028-3878
ISSN (online)	1526-632X
ISSN	0028-3878
DOI	10.1212/WNL.0000000000009937
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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