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. 2021 Mar;177(3):275-282.
doi: 10.1016/j.neurol.2021.01.004. Epub 2021 Feb 11.

Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series

L Cleret de Langavant  1 , A Petit  1 , Q T R Nguyen  1 , T Gendre  2 , J Abdelhedi  2 , A Djellaoui  2 , L Seddik  2 , L Lim  2 , F Faugeras  1 , H Salhi  2 , A Wahab  2 , L Fechtenbaum  2 , A Dormeuil  1 , H Hosseini  3 , K Youssov  1 , G Fénelon  1 , B Bapst  4 , P Brugières  4 , T Tuilier  4 , E Kalsoum  4 , M-B Matignon  5 , J Oniszczuk  5 , S Gallien  6 , W Vindrios  6 , G Melica  6 , A-L Scain  7 , R Esser  7 , L Rostain  8 , C Guillaud  9 , G Dubos-Lascu  9 , N Saada  9 , H Guillet  10 , M Khellaf  9 , B Bardel  11 , S S Ayache  11 , J-P Lefaucheur  11 , J-M Pawlotsky  12 , S Fourati  12 , A-C Bachoud-Lévi  1
Affiliations

Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series

L Cleret de Langavant et al. Rev Neurol (Paris). 2021 Mar.

Abstract

Background: Neurological disorders associated with SARS-CoV-2 infection represent a clinical challenge because they encompass a broad neurological spectrum and may occur before the diagnosis of COVID-19.

Methods: In this monocentric retrospective case series, medical records from patients with acute neurological disorders associated with SARS-CoV-2 infection from medicine departments of an academic center in Paris area were collected between March 15th and May 15th 2020. Diagnosis of SARS-CoV-2 was ascertained through specific RT-PCR in nasopharyngeal swabs or based on circulating serum IgG antibodies.

Results: Twenty-six patients diagnosed with SARS-CoV-2 infection presented with neurological disorders: encephalitis (N=8), encephalopathy (N=6), cerebrovascular events (ischemic strokes N=4 and vein thromboses N=2), other central nervous system (CNS) disorders (N=4), and Guillain-Barré syndrome (N=2). The diagnosis of SARS-CoV-2 was delayed on average 1.6 days after the onset of neurological disorder, especially in case of encephalitis 3.9 days, encephalopathy 1.0 day, and cerebrovascular event 2.7 days.

Conclusions: Our study confirms that COVID-19 can yield a broad spectrum of neurological disorders. Because neurological presentations of COVID-19 often occur a few days before the diagnosis of SARS-COV-2 infection, clinicians should take preventive measures such as patient isolation and masks for any new admission to avoid nosocomial infections. Anti-SARS-CoV2 antibody detection in RT-PCR SARS CoV-2 negative suspected cases is useful to confirm a posteriori the diagnosis of atypical COVID-19 presentations.

Keywords: Amyotrophic Lateral Sclerosis; Diaphragmatic ultrasonography; Phrenic nerve conduction; Pulmonary function tests.

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