Covid-19: Involvement of the nervous system. Identifying neurological predictors defining the course of the disease

J Neurol Sci. 2021 Jun 15:425:117438. doi: 10.1016/j.jns.2021.117438. Epub 2021 Apr 8.

Abstract

The main objective of this study was to analyse neurological symptoms during a Covid-19 infection and determine the pattern of symptoms by comparing outpatients with inpatients. A further goal was to identify possible predictors, such as pre-existing conditions and neurological symptoms. We recorded the clinical data of 40 inpatients and 42 outpatients in this retrospective, cross sectional study. Of them, 68 patients (83%), evenly distributed between the two groups, suffered from neurological symptoms. We identified the onset of neurological symptoms and the related time ranges in 41 patients (36 outpatients and 5 inpatients). Of these, 63.4% reported neurological symptoms on the first or second day of illness. 49 patients (72%) showed combinations of at least two to a maximum of seven different neurological symptoms. A more severe course of disease was correlated with age and male sex, but age was not identified as a predictor for the occurrence of neurological symptoms. Women suffered from central and neuromuscular symptoms more often than men (p = 0,004). The most common symptoms were fatigue (54%), headache (31%), loss of taste (31%), and loss of smell (27%). Pre-existing dementia was associated with increased lethality; similarly, pre-existing stroke was associated with a more severe course of Covid-19 infection. Hallucinations and confusion were related to an increased likelihood of death. The present data demonstrate the importance of comprehensive neurological support of inpatients and outpatients affected by Covid-19.

Keywords: Covid-19; Inpatient; Neurological symptom; Outpatient; Pre-existing neurological condition; Predictor of severity; SARS-CoV-2.

MeSH terms

  • COVID-19*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Nervous System
  • Retrospective Studies
  • SARS-CoV-2