Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry
2020
OBJECTIVE: The coronavirus disease 2019 (COVID-19) has spread worldwide since December 2019 Neurological symptoms have been reported as part of the clinical spectrum of the disease We aim to determine whether neurological manifestations are common in hospitalized COVID-19 patients and to describe their main characteristics METHODS: We systematically review all patients diagnosed with COVID-19 admitted to hospital in a Spanish population during March 2020 Demographic characteristics, systemic and neurological clinical manifestations, and complementary tests were analyzed RESULTS: Of 841 patients hospitalized with COVID-19 (mean age 66 4 years, 56 2% men) 57 4% developed some form of neurological symptom Nonspecific symptoms such as myalgias (17 2%), headache (14 1%), and dizziness (6 1%) were present mostly in the early stages of infection Anosmia (4 9%) and dysgeusia (6 2%) tended to occur early (60% as the first clinical manifestation) and were more frequent in less severe cases Disorders of consciousness occurred commonly (19 6%), mostly in older patients and in severe and advanced COVID-19 stages Myopathy (3 1%), dysautonomia (2 5%), cerebrovascular diseases (1 7%), seizures (0 7%), movement disorders (0 7%), encephalitis (n=1), Guillain-Barr� syndrome (n=1), and optic neuritis (n=1) were also reported, but less frequent Neurological complications were the main cause of death in 4 1% of all deceased study subjects CONCLUSIONS: Neurological manifestations are common in hospitalized COVID-19 patients In our series, more than half of patients presented some form of neurological symptom Clinicians need to maintain close neurological surveillance for prompt recognition of these complications The investigation of the mechanisms and emerging consequences of SARS-CoV-2 neurological involvement require further studies
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