Neurological Manifestations in a Prospective Unselected Series of Hospitalized COVID-19 patients

ABSTRACT Objective: Increasing number of neurological problems are being described in COVID-19 disease, but their frequency and type have not been defined. In this study we sought to determine the extent of neurological manifestations of COVID-19 in a prospective series of unselected patients admitted to the general medicine wards of our hospitals due to COVID-19 and who were examined by a team of neurologists. Methods: Eight neurologists provided medical attention to patients hospitalized for COVID-19 to provide medical support to other hospital units tasked with the care of an increasingly larger influx of COVID-19 patients. A series of 100 consecutive, unselected patients were evaluated systematically, including a questionnaire that collected medical information derived from the initial exam and the medical history. Results: Eighty-eight percent of the patients had one neurological manifestation associated with COVID-19 during hospitalization. Most common were anosmia-dysgeusia and headache (44% each), myalgias (43%), and dizziness (36%). Less frequent were encephalopathy (8%), syncope (7%), seizures (2%), and ischemic stroke during the period of hospitalization (2%). Anosmia and headache associated with younger patients with less severe disease, and both were associated with each other and with serum inflammatory markers. Encephalopathy was associated with fever and syncope and with markers of inflammation. Conclusions: Neurological disturbances are common in COVID-19 patients, particularly if patients are evaluated by neurologists. There is a wide variety of neurological conditions, some of them severe, in the spectrum of COVID-19 disease that will benefit from an evaluation by practicing neurologists.