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. 2020 Aug;41(8):2029-2031.
doi: 10.1007/s10072-020-04525-z. Epub 2020 Jul 2.

Early neurological manifestations of hospitalized COVID-19 patients

Veria Vacchiano  1 , P Riguzzi  2 , L Volpi  2 , M Tappatà  2 , P Avoni  2   3 , G Rizzo  2   3 , L Guerra  4 , S Zaccaroni  4 , P Cortelli  2   3 , R Michelucci  2 , R Liguori  2   3
Affiliations

Early neurological manifestations of hospitalized COVID-19 patients

Veria Vacchiano et al. Neurol Sci. 2020 Aug.

Abstract

Introduction: Neurological manifestations can occur during coronavirus disease 19 (COVID-19). Several pathogenic mechanisms have been hypothesized, without conclusive results. In this study, we evaluated the most frequent neurological symptoms in a cohort of hospitalized COVID-19 patients, and also investigated the possible relationship between plasmatic inflammatory indices and olfactory disorders (ODs) and between muscle pain and creatine kinase (CK).

Methods: We consecutively enrolled hospitalized COVID-19 patients. A structured questionnaire concerning typical and neurological symptoms, focusing on headache, dizziness, ODs, taste disorders (TDs), and muscle pain, was administrated by telephone interviews.

Results: Common neurological symptoms were reported in the early phase of the disease, with a median onset ranging from 1 to 3 days. Headache showed tension-type features and was more frequently associated with a history of headache. Patients with ODs less frequently needed oxygen therapy. Inflammatory indices did not significantly differ between patients with and without ODs. Muscle pain did not show any association with CK level but was more frequently associated with arthralgia and headache.

Conclusion: In our cohort, ODs were an early symptom of COVID-19, more frequently reported by patients with milder forms of disease. Headache in association with arthralgia and muscle pain seems to reflect the common symptoms of the flu-like syndrome, and not COVID-19 infection-specific.

Keywords: COVID-19; Headache; Muscle pain; Neurological manifestations; Test and smell disorders.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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