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. 2022 Dec 15:443:120485.
doi: 10.1016/j.jns.2022.120485. Epub 2022 Nov 9.

Frequency and burden of neurological manifestations upon hospital presentation in COVID-19 patients: Findings from a large Brazilian cohort

Milena Soriano Marcolino  1 , Fernando Anschau  2 , Luciane Kopittke  3 , Magda Carvalho Pires  4 , Izabela Guimarães Barbosa  5 , Daniella Nunes Pereira  6 , Lucas Emanuel Ferreira Ramos  7 , Luís Fernando Israel Assunção  8 , André Soares de Moura Costa  9 , Matheus Carvalho Alves Nogueira  10 , Helena Duani  11 , Karina Paula Medeiros Prado Martins  12 , Leila Beltrami Moreira  13 , Carla Thais Cândida Alves da Silva  14 , Neimy Ramos de Oliveira  15 , Patricia Klarmann Ziegelmann  16 , Milton Henriques Guimarães-Júnior  17 , Mauro Oscar Soares de Souza Lima  18 , Rubia Laura Oliveira Aguiar  19 , Luanna Silva Monteiro Menezes  20 , Talita Fischer Oliveira  21 , Maíra Dias Souza  22 , Bárbara Lopes Farace  23 , Christiane Corrêa Rodrigues Cimini  24 , Amanda de Oliveira Maurílio  25 , Silvana Mangeon Mereilles Guimarães  26 , Silvia Ferreira Araújo  27 , Guilherme Fagundes Nascimento  28 , Daniel Vitório Silveira  29 , Karen Brasil Ruschel  30 , Thainara Conceição de Oliveira  31 , Alexandre Vargas Schwarzbold  32 , Luiz Antônio Nasi  33 , Maiara Anschau Floriani  34 , Veridiana Baldon Dos Santos  35 , Carolina Marques Ramos  36 , Joice Coutinho de Alvarenga  37 , Ana Luiza Bahia Alves Scotton  38 , Euler Roberto Fernandes Manenti  39 , Gabriela Petry Crestani  40 , Joanna d'Arc Lyra Batista  41 , Daniela Ponce  42 , Juliana Machado-Rugolo  43 , Adriana Falangola Benjamin Bezerra  44 , Petrônio José de Lima Martelli  45 , Heloisa Reniers Vianna  46 , Luís César de Castro  47 , Cássia Regina Gotler Medeiros  48 , Giovanna Grunewald Vietta  49 , Elayne Crestani Pereira  50 , José Miguel Chatkin  51 , Mariana Frizzo de Godoy  52 , Polianna Delfino-Pereira  53 , Antonio Lucio Teixeira  54
Affiliations

Frequency and burden of neurological manifestations upon hospital presentation in COVID-19 patients: Findings from a large Brazilian cohort

Milena Soriano Marcolino et al. J Neurol Sci. .

Abstract

Background: Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection and outcomes in the Brazilian population.

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.

Keywords: COVID-19; Delirium; Neurologic manifestations; Prognosis.

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Conflict of interest statement

Declaration of Competing Interest The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Flowchart of COVID-19 patients included in the study.
See this image and copyright information in PMC

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