Evaluation of Biomarkers and Clinical Course in Patients Developing Neurologic Disorders due to COVID-19

Abstract

COVID-19 is a highly contagious and deadly disease. It may present with neurologic symptoms as well as respiratory symptoms. In this study, the existence of different biomarkers in the development and evaluation of neurologic symptoms and complications in patients with COVID-19 and the relationship between clinical course and neurologic disorders were investigated. In this prospective randomized study, the study group included 133 patients with a diagnosis of COVID-19 who were admitted to the neurology clinic and intensive care unit managed by expert neurologists during the pandemic period. Patients were classified as those without neurological disorders associated with COVID-19, those with mild neurologic disorders, and those with severe neurological disorders. The demographic characteristics, laboratory values, lung tomography, and clinical features of these patients were examined and the relationship between them was investigated. Of the patients, 54.9% were male, 45.1% were female, and the mean age was 60.85±18.38 (min-max: 19-91) years. As the age increased, a moderately significant positive correlation was found between the presence of neurologic disorders and disease severity. Myalgia (39.1%) and headache (34.6%) were the most common neurologic symptoms. In patients with severe neurologic disorders, the most common neurologic symptom was unconsciousness (n=22, 64.7%). Hemoglobin levels, hematocrit, lymphocyte counts, and procalcitonin levels were decreased (p=0.010, p=0.018, p=0.001, and p=0.021, respectively) in patients with neurologic disorders, neutrophil count, C-reactive protein, D-dimer, and interleukin-6 levels were increased (p=0.039, p=0.020, p<0.001, and p=0.001, respectively). An increase in the presence and severity of neurologic disorders was observed in patients in parallel with an increase in lung computed tomography scores and O2 requirement (p<0.001 and p<0.001, respectively). As the severity of the neurologic disorders of the patients increased, the rate of discharge decreased (p<0.001). Our results suggested that some biomarkers associated with the severity of the disease could also be shown in patients with neurologic disorders, and patients with COVID-19 had severe disease in the presence of neurologic disorders. To define the existence of an independent biomarker, there is a need for large-scale studies in which neurologic disorders are handled separately.