Neurological presentations of COVID-19: Findings from the Spanish Society of Neurology neuroCOVID-19 registry

Abstract

Objective We report the findings from the Spanish Society of Neurology's NeuroCOVID-19 Registry. Methods We performed a multicentre study of patients with neurological manifestations of COVID-19. Participating physicians reported demographic, clinical, and paraclinical data and judged the involvement of COVID-19 in causing neurological symptoms. Results A total of 233 cases were submitted, including 74 different combinations of manifestations. The most frequently reported were stroke (27%), neuromuscular symptoms (23.6%), altered mental status (23.6%), anosmia (17.6%), headache (12.9%), and seizures (11.6%). The mean age of patients was 61.1 years, with 42.1% being women; a higher proportion of women was recorded among patients with altered mental status, anosmia, and headache. The onset of symptoms differed within categories. Onset of anosmia occurred a mean (standard deviation) of 2.9 (2.5) days after the first general symptom, whereas neuromuscular symptoms appeared after 13.9 (10.1) days. Neurological symptoms were persistent in 33% of patients. General symptoms were present in 97.7% of patients, and results from general laboratory studies were abnormal in 99.4% of patients. Cerebrospinal fluid analysis findings were abnormal in 62.7% of the cases in which this test was performed ( n = 51), but positive results for SARS-CoV-2 were only found in one case. Conclusions The neurological manifestations of COVID-19 are diverse. Anosmia, myalgia, and headache occur earlier in the course of the disease. Altered mental status, neuromuscular symptoms, and stroke are associated with greater severity. COVID-19 must be incorporated into most clinical and radiological differential diagnoses. COVID-19 may cause persistent and disabling neurological symptoms.

Epilepsy and the risk of severe coronavirus disease 2019 outcomes: A systematic review, meta-analysis, and meta-regression

“…Eleven article were excluded after the assessment because the outcomes outlined in seven of the articles did not meet the criteria of the present study, three articles had no information on a control group, and one article was not published in English. Thus, 13 studies [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , which included a total of 67,131 patients with COVID-19, were included in the analysis ( Figure 1 ). Of the 13 studies, eight were retrospective cohort studies, three were case-control studies, and two were case-series studies.…”

Is loss of smell an early predictor of COVID-19 severity: a systematic review and meta-analysis

“…In total, 34 studies provided information on the severity of COVID-19 disease. Of them, four studies were preprints (Al Harthi et al 2020 ; Bertlich et al 2020 ; Papizadeh et al 2020 ; Patel et al 2020 ), and 30 articles were published studies (Aggarwal et al 2020 ; Alasia et al 2021 ; Alizadehsani et al 2021 ; Allenbach et al 2020 ; Amanat et al 2021 ; Borobia et al 2020 ; Delorme et al 2021 ; Elimian et al 2020 ; Ermis et al 2021 ; García-Azorín et al 2021 ; Ghaffari et al 2021 ; Goyal et al 2021 ; Izquierdo et al 2020 ; Kadiane-Oussou et al 2020 ; Kocayığıt et al 2021 ; Lechien et al 2021 ; Liotta et al 2020 ; Mao et al 2020 ; McElvaney et al 2020 ; Muñoz-Rodríguez et al 2021 ; Printza et al 2021 ; Romero-Sánchez et al 2020 ; Salepci et al 2021 ; Sobhani et al 2021 2021 ; Song et al 2021 ; Studart-Neto et al 2020 ; Sun et al 2021 ; Tomlins et al 2020 ; Vaira et al 2020 ; Vial et al 2020 ). The OD were present in 482 severely ill and 2640 non-severely ill patients with COVID-19.…”

Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions

“…Ongoing (neuro)COVID registries [ 62 – 64 ], data banks [ 65 ] and surveillance systems [ 66 ] with active follow-up (including the upcoming WHO follow-up tool) ( https://www.who.int/publications/i/item/global-covid-19-clinical-platform-case-report-form-(crf)-for-post-covid-conditions-(post-covid-19-crf -) can provide useful information for the identification of incident neurological manifestations (types and frequency) in large cohorts of patients enrolled during the acute phase of the disease. In these registries and surveillance modules, the ascertainment of COVID-19 complications during follow-up should be made using accurate measures, valid and reliable diagnostic criteria, and standardised methods for the characterisation of any signs or symptoms.…”