Incidence of neurological manifestations and complications in patients with COVID-19 infection: a propensity score matching analysis

Ir J Med Sci. 2024 Apr;193(2):967-972. doi: 10.1007/s11845-023-03541-0. Epub 2023 Oct 12.

Abstract

Background: The novel coronavirus, SARS-CoV-2, can lead to potential neurological complications in COVID-19 patients. This study aims to assess the prevalence and associated risk factors of these complications among Thai individuals.

Methods: We conducted a retrospective study on hospitalized adults with COVID-19 at Thammasat University Hospital from April 2020 to September 2021, totaling 990 patients. We used propensity score matching and logistic regression to determine associated risk factors.

Results: Of the patients, 21.7% (215 individuals) manifested neurological complications, categorized as follows: Skeletal muscle injury: 16.3% Acute cerebrovascular disease: 0.8% Delirium: 2.4% Impaired consciousness: 2.6% Seizures: 0.5% Post-matching revealed risk factors significantly associated with neurological complications: overweight status, hypertension, diabetes mellitus, dyslipidemia, and severe infection. However, in a multivariable analysis, only severe infection remained significant (adjusted OR 3.71; p = 0.010). The presence of neurological complications was linked with an elevated mortality risk (OR 1.77, p = 0.005).

Conclusions: In the Thai COVID-19 patient cohort, roughly 22% experienced neurological complications, with severe infection standing out as a major risk factor. This underscores the importance of closely monitoring neurological symptoms in COVID-19 patients.

Keywords: COVID-19; Neurological complications; Neurological manifestations; Risk factors.

MeSH terms

  • Adult
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Humans
  • Incidence
  • Nervous System Diseases* / epidemiology
  • Nervous System Diseases* / etiology
  • Propensity Score
  • Retrospective Studies
  • SARS-CoV-2