tetano
Editor, Senior Moderator
PLoS One
. 2021 Apr 8;16(4):e0247433.
doi: 10.1371/journal.pone.0247433. eCollection 2021.
Neurologic manifestations in hospitalized patients with COVID-19 in Mexico City
Fernando Daniel Flores-Silva[SUP] 1 [/SUP], Miguel Garc?a-Grimshaw[SUP] 1 [/SUP], Sergio Iv?n Vald?s-Ferrer[SUP] 1 2 [/SUP], Alma Poema Vigueras-Hern?ndez[SUP] 1 [/SUP], Rogelio Dom?nguez-Moreno[SUP] 1 [/SUP], Dioselina Panam? Trist?n-Samaniego[SUP] 1 [/SUP], Anaclara Michel-Ch?vez[SUP] 1 [/SUP], Alejandra Gonz?lez-Duarte[SUP] 1 [/SUP], Felipe A Vega-Boada[SUP] 1 [/SUP], Isael Reyes-Melo[SUP] 1 [/SUP], Amado Jim?nez-Ruiz[SUP] 3 [/SUP], Oswaldo Alan Ch?vez-Mart?nez[SUP] 1 [/SUP], Daniel Rebolledo-Garc?a[SUP] 1 [/SUP], Osvaldo Alexis March?-Fern?ndez[SUP] 1 [/SUP], Samantha S?nchez-Torres[SUP] 1 [/SUP], Guillermo Garc?a-Ramos[SUP] 1 [/SUP], Carlos Cant?-Brito[SUP] 1 [/SUP], Erwin Chiquete[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease 2019 (COVID-19) is a systemic entity that frequently implies neurologic features at presentation and complications during the disease course. We aimed to describe the characteristics and predictors for developing in-hospital neurologic manifestations in a large cohort of hospitalized patients with COVID-19 in Mexico City.
Methods: We analyzed records from consecutive adult patients hospitalized from March 15 to June 30, 2020, with moderate to severe COVID-19 confirmed by reverse transcription real-time polymerase chain reaction (rtRT-PCR) for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurologic syndromes were actively searched by a standardized structured questionnaire and physical examination, confirmed by neuroimaging, neurophysiology of laboratory analyses, as applicable.
Results: We studied 1,072 cases (65% men, mean age 53.2?13 years), 71 patients had pre-existing neurologic diseases (diabetic neuropathy: 17, epilepsy: 15, history of ischemic stroke: eight, migraine: six, multiple sclerosis: one, Parkinson disease: one), and 163 (15.2%) developed a new neurologic complication. Headache (41.7%), myalgia (38.5%), dysgeusia (8%), and anosmia (7%) were the most common neurologic symptoms at hospital presentation. Delirium (13.1%), objective limb weakness (5.1%), and delayed recovery of mental status after sedation withdrawal (2.5%), were the most common new neurologic syndromes. Age, headache at presentation, preexisting neurologic disease, invasive mechanical ventilation, and neutrophil/lymphocyte ratio ?9 were independent predictors of new in-hospital neurologic complications.
Conclusions: Even after excluding initial clinical features and pre-existing comorbidities, new neurologic complications in hospitalized patients with COVID-19 are frequent and can be predicted from clinical information at hospital admission.
. 2021 Apr 8;16(4):e0247433.
doi: 10.1371/journal.pone.0247433. eCollection 2021.
Neurologic manifestations in hospitalized patients with COVID-19 in Mexico City
Fernando Daniel Flores-Silva[SUP] 1 [/SUP], Miguel Garc?a-Grimshaw[SUP] 1 [/SUP], Sergio Iv?n Vald?s-Ferrer[SUP] 1 2 [/SUP], Alma Poema Vigueras-Hern?ndez[SUP] 1 [/SUP], Rogelio Dom?nguez-Moreno[SUP] 1 [/SUP], Dioselina Panam? Trist?n-Samaniego[SUP] 1 [/SUP], Anaclara Michel-Ch?vez[SUP] 1 [/SUP], Alejandra Gonz?lez-Duarte[SUP] 1 [/SUP], Felipe A Vega-Boada[SUP] 1 [/SUP], Isael Reyes-Melo[SUP] 1 [/SUP], Amado Jim?nez-Ruiz[SUP] 3 [/SUP], Oswaldo Alan Ch?vez-Mart?nez[SUP] 1 [/SUP], Daniel Rebolledo-Garc?a[SUP] 1 [/SUP], Osvaldo Alexis March?-Fern?ndez[SUP] 1 [/SUP], Samantha S?nchez-Torres[SUP] 1 [/SUP], Guillermo Garc?a-Ramos[SUP] 1 [/SUP], Carlos Cant?-Brito[SUP] 1 [/SUP], Erwin Chiquete[SUP] 1 [/SUP]
Affiliations
- PMID: 33831042
- DOI: 10.1371/journal.pone.0247433
Abstract
Background: The coronavirus disease 2019 (COVID-19) is a systemic entity that frequently implies neurologic features at presentation and complications during the disease course. We aimed to describe the characteristics and predictors for developing in-hospital neurologic manifestations in a large cohort of hospitalized patients with COVID-19 in Mexico City.
Methods: We analyzed records from consecutive adult patients hospitalized from March 15 to June 30, 2020, with moderate to severe COVID-19 confirmed by reverse transcription real-time polymerase chain reaction (rtRT-PCR) for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neurologic syndromes were actively searched by a standardized structured questionnaire and physical examination, confirmed by neuroimaging, neurophysiology of laboratory analyses, as applicable.
Results: We studied 1,072 cases (65% men, mean age 53.2?13 years), 71 patients had pre-existing neurologic diseases (diabetic neuropathy: 17, epilepsy: 15, history of ischemic stroke: eight, migraine: six, multiple sclerosis: one, Parkinson disease: one), and 163 (15.2%) developed a new neurologic complication. Headache (41.7%), myalgia (38.5%), dysgeusia (8%), and anosmia (7%) were the most common neurologic symptoms at hospital presentation. Delirium (13.1%), objective limb weakness (5.1%), and delayed recovery of mental status after sedation withdrawal (2.5%), were the most common new neurologic syndromes. Age, headache at presentation, preexisting neurologic disease, invasive mechanical ventilation, and neutrophil/lymphocyte ratio ?9 were independent predictors of new in-hospital neurologic complications.
Conclusions: Even after excluding initial clinical features and pre-existing comorbidities, new neurologic complications in hospitalized patients with COVID-19 are frequent and can be predicted from clinical information at hospital admission.