tetano
Editor, Senior Moderator
BMC Neurol
. 2021 Mar 16;21(1):116.
doi: 10.1186/s12883-021-02152-5.
Neurological manifestations as the predictors of severity and mortality in hospitalized individuals with COVID-19: a multicenter prospective clinical study
Man Amanat[SUP] 1 [/SUP], Nima Rezaei[SUP] 2 3 4 [/SUP], Mehrdad Roozbeh[SUP] 5 [/SUP], Maziar Shojaei[SUP] 6 [/SUP], Abbas Tafakhori[SUP] 7 [/SUP], Anahita Zoghi[SUP] 6 [/SUP], Ilad Alavi Darazam[SUP] 8 [/SUP], Mona Salehi[SUP] 1 [/SUP], Ehsan Karimialavijeh[SUP] 9 [/SUP], Behnam Safarpour Lima[SUP] 6 [/SUP], Amir Garakani[SUP] 10 11 [/SUP], Alexander Vaccaro[SUP] 12 [/SUP], Mahtab Ramezani[SUP] 13 [/SUP]
Affiliations
Abstract
Backgrounds: The reports of neurological symptoms are increasing in cases with coronavirus disease 2019 (COVID-19). This multi-center prospective study was conducted to determine the incidence of neurological manifestations in hospitalized cases with COVID-19 and assess these symptoms as the predictors of severity and death.
Methods: Hospitalized males and females with COVID-19 who aged over 18 years were included in the study. They were examined by two neurologists at the time of admission. All survived cases were followed for 8 weeks after discharge and 16 weeks if their symptoms had no improvements.
Results: We included 873 participants. Of eligible cases, 122 individuals (13.97%) died during hospitalization. The most common non-neurological manifestations were fever (81.1%), cough (76.1%), fatigue (36.1%), and shortness of breath (27.6%). Aging, male gender, co-morbidity, smoking, hemoptysis, chest tightness, and shortness of breath were associated with increased odds of severe cases and/or mortality. There were 561 (64.3%) cases with smell and taste dysfunctions (hyposmia: 58.6%; anosmia: 41.4%; dysguesia: 100%). They were more common among females (69.7%) and non-smokers (66.7%). Hyposmia/anosmia and dysgeusia were found to be associated with reduced odds of severe cases and mortality. Myalgia (24.8%), headaches (12.6%), and dizziness (11.9%) were other common neurological symptoms. Headaches had negative correlation with severity and death due to COVID-19 but myalgia and dizziness were not associated. The cerebrovascular events (n = 10) and status epilepticus (n = 1) were other neurological findings. The partial or full recovery of smell and taste dysfunctions was found in 95.2% after 8 weeks and 97.3% after 16 weeks. The parosmia (30.9%) and phantosmia (9.0%) were also reported during 8 weeks of follow-up. Five cases with mild headaches and 5 cases with myalgia were reported after 16 weeks of discharge. The demyelinating myelitis (n = 1) and Guillain-Barr? syndrome (n = 1) were also found during follow-up.
Conclusion: Neurological symptoms were found to be prevalent among individuals with COVID-19 disease and should not be under-estimated during the current pandemic outbreak.
Keywords: Anosmia; Headache; Neurology; SARS-CoV-2; Seizure; Stroke.
. 2021 Mar 16;21(1):116.
doi: 10.1186/s12883-021-02152-5.
Neurological manifestations as the predictors of severity and mortality in hospitalized individuals with COVID-19: a multicenter prospective clinical study
Man Amanat[SUP] 1 [/SUP], Nima Rezaei[SUP] 2 3 4 [/SUP], Mehrdad Roozbeh[SUP] 5 [/SUP], Maziar Shojaei[SUP] 6 [/SUP], Abbas Tafakhori[SUP] 7 [/SUP], Anahita Zoghi[SUP] 6 [/SUP], Ilad Alavi Darazam[SUP] 8 [/SUP], Mona Salehi[SUP] 1 [/SUP], Ehsan Karimialavijeh[SUP] 9 [/SUP], Behnam Safarpour Lima[SUP] 6 [/SUP], Amir Garakani[SUP] 10 11 [/SUP], Alexander Vaccaro[SUP] 12 [/SUP], Mahtab Ramezani[SUP] 13 [/SUP]
Affiliations
- PMID: 33726699
- DOI: 10.1186/s12883-021-02152-5
Abstract
Backgrounds: The reports of neurological symptoms are increasing in cases with coronavirus disease 2019 (COVID-19). This multi-center prospective study was conducted to determine the incidence of neurological manifestations in hospitalized cases with COVID-19 and assess these symptoms as the predictors of severity and death.
Methods: Hospitalized males and females with COVID-19 who aged over 18 years were included in the study. They were examined by two neurologists at the time of admission. All survived cases were followed for 8 weeks after discharge and 16 weeks if their symptoms had no improvements.
Results: We included 873 participants. Of eligible cases, 122 individuals (13.97%) died during hospitalization. The most common non-neurological manifestations were fever (81.1%), cough (76.1%), fatigue (36.1%), and shortness of breath (27.6%). Aging, male gender, co-morbidity, smoking, hemoptysis, chest tightness, and shortness of breath were associated with increased odds of severe cases and/or mortality. There were 561 (64.3%) cases with smell and taste dysfunctions (hyposmia: 58.6%; anosmia: 41.4%; dysguesia: 100%). They were more common among females (69.7%) and non-smokers (66.7%). Hyposmia/anosmia and dysgeusia were found to be associated with reduced odds of severe cases and mortality. Myalgia (24.8%), headaches (12.6%), and dizziness (11.9%) were other common neurological symptoms. Headaches had negative correlation with severity and death due to COVID-19 but myalgia and dizziness were not associated. The cerebrovascular events (n = 10) and status epilepticus (n = 1) were other neurological findings. The partial or full recovery of smell and taste dysfunctions was found in 95.2% after 8 weeks and 97.3% after 16 weeks. The parosmia (30.9%) and phantosmia (9.0%) were also reported during 8 weeks of follow-up. Five cases with mild headaches and 5 cases with myalgia were reported after 16 weeks of discharge. The demyelinating myelitis (n = 1) and Guillain-Barr? syndrome (n = 1) were also found during follow-up.
Conclusion: Neurological symptoms were found to be prevalent among individuals with COVID-19 disease and should not be under-estimated during the current pandemic outbreak.
Keywords: Anosmia; Headache; Neurology; SARS-CoV-2; Seizure; Stroke.