tetano
Editor, Senior Moderator
Front Neurol
. 2020 Jul 10;11:806.
doi: 10.3389/fneur.2020.00806. eCollection 2020.
Neurological Manifestations in Critically Ill Patients With COVID-19: A Retrospective Study
Siyuan Fan[SUP] 1 [/SUP], Meng Xiao[SUP] 2 [/SUP], Fei Han[SUP] 1 [/SUP], Peng Xia[SUP] 3 [/SUP], Xiaoyin Bai[SUP] 4 [/SUP], Huan Chen[SUP] 5 [/SUP], Hongmin Zhang[SUP] 5 [/SUP], Xin Ding[SUP] 5 [/SUP], Hua Zhao[SUP] 5 [/SUP], Jing Zhao[SUP] 6 [/SUP], Xuefeng Sun[SUP] 6 [/SUP], Wei Jiang[SUP] 7 [/SUP], Chunyao Wang[SUP] 7 [/SUP], Wei Cao[SUP] 8 [/SUP], Fan Guo[SUP] 9 [/SUP], Ran Tian[SUP] 9 [/SUP], Peng Gao[SUP] 9 [/SUP], Wei Wu[SUP] 9 [/SUP], Jie Ma[SUP] 3 [/SUP], Dong Wu[SUP] 4 [/SUP], Zhengyin Liu[SUP] 8 [/SUP], Xiang Zhou[SUP] 5 [/SUP], Jinglan Wang[SUP] 6 [/SUP], Tianjia Guan[SUP] 10 [/SUP], Yan Qin[SUP] 3 [/SUP], Taisheng Li[SUP] 8 [/SUP], Yingchun Xu[SUP] 2 [/SUP], Dong Zhang[SUP] 2 [/SUP], Yu Chen[SUP] 2 [/SUP], Jing Xie[SUP] 2 [/SUP], Yongzhe Li[SUP] 2 [/SUP], Xiaowei Yan[SUP] 9 [/SUP], Yicheng Zhu[SUP] 1 [/SUP], Bin Peng[SUP] 1 [/SUP], Liying Cui[SUP] 1 [/SUP], Shuyang Zhang[SUP] 9 [/SUP], Hongzhi Guan[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The complications of coronavirus disease 2019 (COVID-19) involved multiple organs or systems, especially in critically ill patients. We aim to investigate the neurological complications in critically ill patients with COVID-19. Methods: This retrospective single-center case series analyzed critically ill patients with COVID-19 at the intensive care unit of Tongji Hospital, Wuhan, China from February 5 to April 2, 2020. Demographic data, clinical and laboratory findings, comorbidities and treatments were collected and analyzed. Results: Among 86 patients with confirmed COVID-19, 54 patients (62.8%) were male, and the mean (SD) age was 66.6 (11.1) years. Overall, 65% patients presented with at least one neurological symptom. Twenty patients (23.3%) had symptoms involving the central nervous system, including delirium, cerebrovascular diseases and hypoxic-ischemic brain injury, while 6 patients (7%) had neuromuscular involvement. Seven of 86 patients exhibited new stroke and 6 (7%) cases were ischemic. A significantly higher prevalence of antiphospholipid antibodies was observed in patients with ischemic stroke than in those without stroke (83.3 vs. 26.9%, p < 0.05). Patients with ischemic stroke were more likely to have a higher myoglobulin level, and a lower hemoglobin level. Conclusions: The clinical spectrum of neurological complications in critically ill patients with COVID-19 was broad. Stroke, delirium and neuromuscular diseases are common neurological complications of COVID-19. Physicians should pay close attention to neurological complications in critically ill patients with COVID-19.
Keywords: COVID-19; critically ill; neurological manifestations; neuromuscular diseases; stroke.
. 2020 Jul 10;11:806.
doi: 10.3389/fneur.2020.00806. eCollection 2020.
Neurological Manifestations in Critically Ill Patients With COVID-19: A Retrospective Study
Siyuan Fan[SUP] 1 [/SUP], Meng Xiao[SUP] 2 [/SUP], Fei Han[SUP] 1 [/SUP], Peng Xia[SUP] 3 [/SUP], Xiaoyin Bai[SUP] 4 [/SUP], Huan Chen[SUP] 5 [/SUP], Hongmin Zhang[SUP] 5 [/SUP], Xin Ding[SUP] 5 [/SUP], Hua Zhao[SUP] 5 [/SUP], Jing Zhao[SUP] 6 [/SUP], Xuefeng Sun[SUP] 6 [/SUP], Wei Jiang[SUP] 7 [/SUP], Chunyao Wang[SUP] 7 [/SUP], Wei Cao[SUP] 8 [/SUP], Fan Guo[SUP] 9 [/SUP], Ran Tian[SUP] 9 [/SUP], Peng Gao[SUP] 9 [/SUP], Wei Wu[SUP] 9 [/SUP], Jie Ma[SUP] 3 [/SUP], Dong Wu[SUP] 4 [/SUP], Zhengyin Liu[SUP] 8 [/SUP], Xiang Zhou[SUP] 5 [/SUP], Jinglan Wang[SUP] 6 [/SUP], Tianjia Guan[SUP] 10 [/SUP], Yan Qin[SUP] 3 [/SUP], Taisheng Li[SUP] 8 [/SUP], Yingchun Xu[SUP] 2 [/SUP], Dong Zhang[SUP] 2 [/SUP], Yu Chen[SUP] 2 [/SUP], Jing Xie[SUP] 2 [/SUP], Yongzhe Li[SUP] 2 [/SUP], Xiaowei Yan[SUP] 9 [/SUP], Yicheng Zhu[SUP] 1 [/SUP], Bin Peng[SUP] 1 [/SUP], Liying Cui[SUP] 1 [/SUP], Shuyang Zhang[SUP] 9 [/SUP], Hongzhi Guan[SUP] 1 [/SUP]
Affiliations
- PMID: 32754114
- PMCID: PMC7365850
- DOI: 10.3389/fneur.2020.00806
Abstract
Background: The complications of coronavirus disease 2019 (COVID-19) involved multiple organs or systems, especially in critically ill patients. We aim to investigate the neurological complications in critically ill patients with COVID-19. Methods: This retrospective single-center case series analyzed critically ill patients with COVID-19 at the intensive care unit of Tongji Hospital, Wuhan, China from February 5 to April 2, 2020. Demographic data, clinical and laboratory findings, comorbidities and treatments were collected and analyzed. Results: Among 86 patients with confirmed COVID-19, 54 patients (62.8%) were male, and the mean (SD) age was 66.6 (11.1) years. Overall, 65% patients presented with at least one neurological symptom. Twenty patients (23.3%) had symptoms involving the central nervous system, including delirium, cerebrovascular diseases and hypoxic-ischemic brain injury, while 6 patients (7%) had neuromuscular involvement. Seven of 86 patients exhibited new stroke and 6 (7%) cases were ischemic. A significantly higher prevalence of antiphospholipid antibodies was observed in patients with ischemic stroke than in those without stroke (83.3 vs. 26.9%, p < 0.05). Patients with ischemic stroke were more likely to have a higher myoglobulin level, and a lower hemoglobin level. Conclusions: The clinical spectrum of neurological complications in critically ill patients with COVID-19 was broad. Stroke, delirium and neuromuscular diseases are common neurological complications of COVID-19. Physicians should pay close attention to neurological complications in critically ill patients with COVID-19.
Keywords: COVID-19; critically ill; neurological manifestations; neuromuscular diseases; stroke.