CNS and COVID-19: Neurological symptoms of hospitalized patients with coronavirus in Iraq: A surveying case sequences study

ABSTRACTOBJECTIVETo study the neurological manifestations of patients with coronavirus disease 2019 (COVID-19).DESIGNRetrospective case seriesSETTINGThree designated COVID-19 care hospitals of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China.PARTICIPANTSTwo hundred fourteen hospitalized patients with laboratory confirmed diagnosis of severe acute respiratory syndrome from coronavirus 2 (SARS-CoV-2) infection. Data were collected from 16 January 2020 to 19 February 2020.MAIN OUTCOME MEASURESClinical data were extracted from electronic medical records and reviewed by a trained team of physicians. Neurological symptoms fall into three categories: central nervous system (CNS) symptoms or diseases (headache, dizziness, impaired consciousness, ataxia, acute cerebrovascular disease, and epilepsy), peripheral nervous system (PNS) symptoms (hypogeusia, hyposmia, hypopsia, and neuralgia), and skeletal muscular symptoms. Data of all neurological symptoms were checked by two trained neurologists.RESULTSOf 214 patients studied, 88 (41.1%) were severe and 126 (58.9%) were non-severe patients. Compared with non-severe patients, severe patients were older (58.7 ± 15.0 years vs 48.9 ± 14.7 years), had more underlying disorders (42 [47.7%] vs 41 [32.5%]), especially hypertension (32 [36.4%] vs 19 [15.1%]), and showed less typical symptoms such as fever (40 [45.5%] vs 92 [73%]) and cough (30 [34.1%] vs 77 [61.1%]). Seventy-eight (36.4%) patients had neurologic manifestations. More severe patients were likely to have neurologic symptoms (40 [45.5%] vs 38 [30.2%]), such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]) and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]).CONCLUSIONCompared with non-severe patients with COVID-19, severe patients commonly had neurologic symptoms manifested as acute cerebrovascular diseases, consciousness impairment and skeletal muscle symptoms.

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Three-month outcomes in hospitalized COVID-19 patients

10.1101/2020.10.16.20211029 ◽

2020 ◽

Author(s):

Jude PJ Savarraj ◽

Angela B Burkett ◽

Sarah N Hinds ◽

Atzhiry S Paz ◽

Andres Assing ◽

...

Keyword(s):

Public Health ◽

Hospitalized Patients ◽

Neurological Symptoms ◽

Cognitive Symptoms ◽

Neurologic Outcomes ◽

Pain Symptoms

AbstractCOVID-19 is an ongoing pandemic with a devastating impact on public health. Acute neurological symptoms have been reported after a COVID-19 diagnosis, however there is no data available on the long-term neurological symptoms. Using a prospective registry of hospitalized COVID-19 patients, we assessed the neurological assessments (including functional, cognitive and psychiatric assessments) of several hospitalized patients at 3 months. Our main finding is that 71% of the patients still experienced neurological symptoms at 3 months and the most common symptoms being fatigue (42%) and PTSD (29%). 64% of the patients report pain symptoms we well. Cognitive symptoms were found in 12%. Our preliminary findings suggests the importance of investigating long-term and rationalizes the need for further studies investigating the neurologic outcomes after COVID-19.

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Frequency and burden of neurological manifestations in hospitalized patients with COVID-19: findings from a large Brazilian cohort

10.21203/rs.3.rs-1231708/v1 ◽

2022 ◽

Author(s):

Milena Soriano Marcolino ◽

Fernando Anschau ◽

Luciane Kopittke ◽

Magda Carvalho Pires ◽

Izabela Guimarães Barbosa ◽

...

Keyword(s):

Underlying Disease ◽

Scientific Data ◽

Hospitalized Patients ◽

Neurological Symptoms ◽

Self Report ◽

Neurological Manifestations ◽

Neurological Syndrome ◽

Common Diagnosis ◽

Lower Oxygen ◽

Latin America Countries

Abstract Background Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection in the Brazilian population and its association with patient outcomes, such as in-hospital mortality. Methods This study is part of the Brazilian COVID-19 Registry, a multicentric COVID-19 cohort, including data from 37 Brazilian hospitals. For the analysis, patients were grouped according to the presence of self-reported vs. clinically-diagnosed neurological manifestations and matched with patients without neurological manifestations by age, sex, number of comorbidities, hospital, and whether or not patients ha neurological underlying disease. Results From 7,232 hospitalized patients with COVID-19, 27.8% presented self-reported neurological manifestations, 9.9% were diagnosed with a clinically-defined neurological syndrome and 1.2% did not show any neurological symptoms. In patients with self-reported symptoms, the most common ones were headache (19.3%), ageusia (10.4%) and anosmia (7.4%). Meanwhile, in the group with clinically-defined neurological syndromes, acute encephalopathy was the most common diagnosis (10.5%), followed by coma (0.6%1) and seizures (0.4%). Men and younger patients were more likely to self-report neurological symptoms, while women and older patients were more likely to develop a neurological syndrome. Patients with clinically-defined neurological syndromes presented a higher prevalence of comorbidities, as well as lower oxygen saturation and blood pressure at hospital admission. In the paired analysis, it was observed that patients with clinically-defined neurological syndromes were more likely to require ICU admission (46.9 vs. 37.9%), mechanical ventilation (33.4 vs. 28.2%), to develop acute heart failure (5.1 vs. 3.0%, p=0.037) and to die (40.7 vs. 32.3%, p<0.001) when compared to controls. Conclusion Neurological manifestations are an important cause of morbidity in COVID-19 patients. More specifically, patients with clinically defined neurological syndromes presented a poorer prognosis for the disease when compared to matched controls.

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COVID-19 in Brazilian children and adolescents: findings from 21 hospitals

10.1101/2021.08.08.21261510 ◽

2021 ◽

Author(s):

Priscila Menezes Ferri Liu ◽

Maria do Carmo Barros de Melo ◽

Lilian Martins Oliveira Diniz ◽

Cristiane dos Santos Dias ◽

Andre Soares de Moura Costa ◽

...

Keyword(s):

Children And Adolescents ◽

Clinical Laboratory ◽

Intensive Therapy ◽

Case Series ◽

Hospitalized Patients ◽

Neurological Symptoms ◽

Hospital Length Of Stay ◽

X Rays ◽

Reference Limit ◽

Initial Symptoms

Introduction: Children and adolescents with Covid-19 have been shown lower mortality less intense symptoms when compared to adults, but studies in Brazil have been based on the compulsory notifying system only. Objective: To analyse clinical, laboratory, radiological characteristics and outcomes of hospitalized patients under 20 years with Covid-19. Methods: Cases series of hospitalized patients with confirmed Covid-19 under 20 years, obtained from a cohort study in 37 hospitals from five states of Brazil. Results: From 36 patients, 20 (55.5%) were adolescentes, 20 (55.5%) were male, 18 (50.0%) had comorbidities, 2 were pregnant and in 7 (19.4%), initial symptoms occurred during hospitalization for other causes, of whom 3 were possibly infected in the hospital. Fever (61.1%), dyspnea (33.3%) and neurological symptoms (33.0%) were the most common complaints. C-reactive protein was higher than 50mg/L in 16.7% and D-dimer was above the reference limit in 22.2%. Chest X-rays were performed in 20 (55.5%) patients, 9 had abnormalities, and chest tomography in 5. Hospital length of stay ranged from 1-40 days (median 5 [interquartile range 3-10]), 16 (44.4%) needed intensive therapy, 6 (16.7%) required mechanical ventilation and one patient (2.8%) died. Conclusion: In case series patients under 20 years from hospitals from 5 states of Brazil, comorbidities were frequent, and most common symptoms were fever, dyspnea and neurological symptoms. Forty-four percent required intensive therapy, showing that the disease was not as mild as it was expected, and one patient died.

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Pain and Other Neurological Symptoms Are Present at 3 Months After Hospitalization in COVID-19 Patients

Frontiers in Pain Research ◽

10.3389/fpain.2021.737961 ◽

2021 ◽

Vol 2 ◽

Author(s):

Jude P. J. Savarraj ◽

Angela B. Burkett ◽

Sarah N. Hinds ◽

Atzhiry S. Paz ◽

Andres Assing ◽

...

Keyword(s):

Public Health ◽

Neurological Function ◽

Hospitalized Patients ◽

Neurological Symptoms ◽

Cognitive Symptoms ◽

Long Term Outcomes ◽

Neurologic Outcomes ◽

Pain Symptoms

COVID-19 is an ongoing pandemic with a devastating impact on public health. Acute neurological symptoms have been reported after a COVID-19 diagnosis, however, the long-term neurological symptoms including pain is not well established. Using a prospective registry of hospitalized COVID-19 patients, we assessed pain and neurological function (including functional, cognitive and psychiatric assessments) of several hospitalized patients at 3 months. Our main finding is that 60% of the patients report pain symptoms. 71% of the patients still experienced neurological symptoms at 3 months and the most common symptoms being fatigue (42%) and PTSD (25%). Cognitive symptoms were found in 12%. Our preliminary findings suggests the importance of investigating long-term outcomes and rationalizes the need for further studies investigating the neurologic outcomes and symptoms of pain after COVID-19.

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