Frequency and burden of neurological manifestations upon hospital presentation in COVID-19 patients: Findings from a large Brazilian cohort.
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Marcolino Milena Soriano, Anschau Fernando, Kopittke Luciane, Pires Magda Carvalho, Barbosa Izabela Guimarães, Pereira Daniella Nunes, Ramos Lucas Emanuel Ferreira, Assunção Luís Fernando Israel, Costa André Soares de Moura, Nogueira Matheus Carvalho Alves, Duani Helena, Martins Karina Paula Medeiros Prado, Moreira Leila Beltrami, Silva Carla Thais Cândida Alves da, Oliveira Neimy Ramos de, Ziegelmann Patricia Klarmann, Guimarães-Júnior Milton Henriques, Lima Mauro Oscar Soares de Souza, Aguiar Rubia Laura Oliveira, Menezes Luanna Silva Monteiro, Oliveira Talita Fischer, Souza Maíra Dias, Farace Bárbara Lopes, Cimini Christiane Corrêa Rodrigues, Maurílio Amanda de Oliveira, Guimarães Silvana Mangeon Mereilles, Araújo Silvia Ferreira, Nascimento Guilherme Fagundes, Silveira Daniel Vitório, Ruschel Karen Brasil, Oliveira Thainara Conceição de, Schwarzbold Alexandre Vargas, Nasi Luiz Antônio, Floriani Maiara Anschau, Santos Veridiana Baldon Dos, Ramos Carolina Marques, Alvarenga Joice Coutinho de, Scotton Ana Luiza Bahia Alves, Manenti Euler Roberto Fernandes, Crestani Gabriela Petry, Batista Joanna d'Arc Lyra, Ponce Daniela, Machado-Rugolo Juliana, Bezerra Adriana Falangola Benjamin, Martelli Petrônio José de Lima, Vianna Heloisa Reniers, Castro Luís César de, Medeiros Cássia Regina Gotler, Vietta Giovanna Grunewald, Pereira Elayne Crestani, Chatkin José Miguel, Godoy Mariana Frizzo de, Delfino-Pereira Polianna, Teixeira Antonio Lucio
Аннотация
METHODS: This study is part of the Brazilian COVID-19 Registry, a multicentric cohort, including data from 37 hospitals. For the present analysis, patients were grouped according to the presence of reported symptoms (i.e., headache; anosmia and ageusia; syncope and dizziness) vs. clinically-diagnosed neurological manifestations (clinically-defined neurological syndrome: neurological signs or diagnoses captured by clinical evaluation) and matched with patients without neurological manifestations by age, sex, number of comorbidities, hospital of admission, and whether or not patients had underlying neurological disease.
RESULTS: From 6,635 hospitalized patients with COVID-19, 30.8% presented reported neurological manifestations, 10.3% were diagnosed with a neurological syndrome and 60.1% did not show any neurological manifestations. In patients with reported symptoms, the most common ones were headache (20.7%), ageusia (11.1%) and anosmia (8.0%). In patients with neurological syndromes, acute encephalopathy was the most common diagnosis (9.7%). In the matched analysis, patients with neurological syndromes presented more cases of septic shock (17.0 vs. 13.0%, p = 0.045), intensive care unit admission (45.3 vs. 38.9%, p = 0.023), and mortality (38.7 vs. 32.6%, p = 0.026; and 39.2 vs. 30.3%, p < 0.001) when compared to controls.
CONCLUSION: COVID-19 in-hospital patients with clinically defined neurological syndromes presented a higher incidence of septic shock, ICU admission and death when compared to controls.