<p><strong>Background: </strong>The main feature of COVID-19 is symptoms of respiratory system disorder, however, there has been an increase in reports of neurological symptoms that appear in COVID-19 patients. Several previous studies have linked SARS-CoV-2 with nervous system damage. Research studying neurological complaints in confirmed COVID-19 patients in Indonesia is still lacking</p><p><strong>Aim: </strong>To identify neurological, laboratory, and imaging findings in COVID-19 patients with neurological symptoms.</p><p><strong>Methods: </strong>This study was a cross-sectional observational study conducted at Siloam Hospitals Mampang, a COVID-19 referral hospital in South Jakarta. We analyzed medical records of confirmed COVID-19 patients during the period of April - July 2020. The data collected included demographic data, comorbidities, neurological manifestations, laboratory examinations, and neuroimaging.</p><p><strong>Results: </strong>There were 22 confirmed COVID-19 patients with neurological complaints referred to a neurologist. The mean age of patients was 60.4 (SD 15.8) years. The most common neurological complaints were altered mental status (50%), hemiparesis (27.3%), and tremors (22.7%). More than half of the patients (81.8%) had a comorbid condition or past history related to neurological symptoms. Laboratory examination results showed increased NLR (neutrophil-lymphocyte ratio) (50%), anemia (45.5%), and leukocytosis (40.1%). The most common neuroimaging feature was infarct (50%) in the brain CT scan.</p><p><strong>Conclusion: </strong>The neurological complaints in COVID-19 patients are mostly associated with exacerbation of pre-existing comorbidities as a result of the severe inflammatory process triggered by COVID-19. Further research is needed to establish the mechanism of nervous system dysfunction in COVID-19.</p>
IntroductionMultiple sclerosis (MS) is a demyelinating disorder of the CNS which is an emerging neurological problem in Sri Lanka. We looked at treatment responses and disability outcomes of a cohort of 100 Sri Lankan patients with confirmed MS in terms of their EDSS, annualized relapse rates (ARR) and time to first relapse (TTFR) ObjectiveTo determine the disability outcomes and overall prognosis of Sri Lankan MS patients in terms of their demographic, clinical, radiological and treatment status. Methods 100 confirmed MS patients (McDonald 2010 & MAGNIMS 2016) attending the MS clinic at the National Hospital of Sri Lanka were randomly assessed using direct interviews and patient registries. AQP4-IgG and MOG-IgG serology was negative in all. ResultsMajority were females (63%). Average age at onset was 29Y. Predominantly RRMS (75%). Mean EDSS 2.8 (Mean duration of follow-up 7.9y) with 81% having EDSSb3.5. EDSS was worse with longer disease duration (p=0.072) and significantly better in those without cerebellar lesions (EDSS 2.5vs3.7; p=0.004), brain stem lesions (EDSS 2.6vs3.2;p=0.05) and 5 or less MRI lesions (EDSS 2.3vs3.3;p= 0.0127). Those with a higher ARR were more likely to be on Disease-modifying-Treatment (DMT) but it didn't influence EDSS. ARR reduced with increasing disease duration but TTFR didn't. The number of brain lesions had no influence on ARR or TTFR. Out of 58% patients initiated on DMTs, 83% had no relapse thereafter. ConclusionMS patients in Sri Lanka had reasonably good outcomes in terms of disability and progression perhaps due to early diagnosis and treatment.
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