Neurological manifestations of patients with mild-to-moderate COVID-19 attending a public hospital in Lima, Peru

Abstract

Objective To determine the prevalence and characteristics of the most common neurological manifestations in Peruvian patients with mild-to-moderate COVID-19. Methods We conducted a single-center prospective, cross-sectional study at an isolation center functioning as a public acute-care hospital during the COVID-19 pandemic in Lima, the capital city of Peru. This was a convenience sample of patients with acute COVID-19 infection and mild-to-moderate respiratory symptoms who presented for hospital admission between September 25 and November 25, 2020. We interviewed participants and collected demographic, medical history and clinical presentation data; all participants underwent a complete physical and neurological examination. Descriptive statistics and prevalence ratios (PR) with corresponding 95% confidence intervals and p-values were calculated to explore between-groups differences. Results Of 199 patients with mild-to-moderate COVID-19 enrolled in this study, 83% presented with at least one neurological symptom (mean symptom duration 8 +/- 6 days). The most common neurological symptoms were headache (72%), hypogeusia or ageusia (41%), hyposmia or anosmia (40%) and dizziness (34%). Only 2.5% of the cohort had an abnormal neurological examination. The majority (42%) had no prior comorbidities. Presence of at least 1 neurological symptom was independently associated with fever, dyspnea, cough, poor appetite, sore throat, chest tightness or diarrhea, but not with comorbid conditions. Conclusions This cross-sectional study found that headaches, and smell and taste dysfunction are common among patients presenting with mild-to-moderate acute COVID-19 in Lima, Peru. International longitudinal studies are needed to determine the long-term neurological sequelae of COVID-19 during the acute and post-infectious period.

A review of neurological health disparities in Peru

“…The COVID-19 pandemic increased rates of migraine more directly as well. In the previously mentioned cross-sectional study that investigated neurological symptoms in mild-to-moderate COVID-19 patients in Peru, headache was the most commonly reported symptom with a response rate of 72% (52). Compared to other studies with similar investigations in different countries, Peruvian patients recorded some of the highest rates of headache (52).…”

“…In addition to increasing the overall burden of disease, the COVID-19 pandemic has worsened the already growing burden of neurological diseases harming Peru. A recent cross-sectional study of Peruvian patients with mild-to-moderate COVID-19 found that 83% of patients reported at least one neurological symptom (52). Other studies found that stroke caused by COVID-19 infection led to remarkably high rates of mortality among Peruvian patients hospitalized with the disease (53,54).…”

“…In the previously mentioned cross-sectional study that investigated neurological symptoms in mild-to-moderate COVID-19 patients in Peru, headache was the most commonly reported symptom with a response rate of 72% (52). Compared to other studies with similar investigations in different countries, Peruvian patients recorded some of the highest rates of headache (52). This may reflect the fact that the country experienced some of the highest rates of COVID-19 cases throughout the pandemic, in addition to the socioeconomic and system-based disparities previously mentioned.…”