Neurological Symptoms and Complications of COVID-19 Among Patients in a Tertiary Hospital in Saudi Arabia

Abstract

Objectives In this study, we aimed to determine the frequency of neurological signs, symptoms, and complications in coronavirus disease 2019 (COVID-19) patients. We also sought to explore the general characteristics of stroke patients in particular. Methods A retrospective cohort study was conducted among COVID-19 patients who were hospitalized between April-September 2020 at the Al-Noor Specialist Hospital in Makkah city, Saudi Arabia. The study included patients who were aged ≥18 years and presented with or were reported to have any neurological manifestations and/or complications secondary to COVID-19 infection. Results A total of 79 patients were included. The mean age of the cohort was 63.6 years, with a significant male predominance (67.1%). The most commonly reported neurological signs and symptoms were altered level of consciousness (45.9%), dizziness (11.5%), and focal neurological deficit (10.4%). Acute ischemic stroke was seen in 18 patients. Most of them were males (66.7%). Most strokes were in the right middle cerebral artery territory (MCA) (50.0%). Diabetic patients were four times more at risk to develop stroke [odds ratio (OR)=3.76; 95% confidence interval (CI): 1.1-29.9]. Patients with respiratory failure were 21 times more likely to have a stroke (OR=21.3; 95% CI: 2.2-54.6). Patients with acute respiratory distress syndrome recorded a three-fold increased risk for developing stroke (OR=2.96; 95% CI: 1.25-37.3). Critically ill patients had double the risk of stroke (OR=1.8; 95% CI: 1.1-6.9). Other neurological complications were hemorrhagic stroke (3.3%), subacute/chronic infarction (23.3%), meningitis (10%), and brain mass lesion (3.3%). Conclusions Neurological symptoms and complications are not uncommon among COVID-19 patients. Most of these patients had poor outcomes. Acute ischemic stroke was the most common finding on neuroimaging.

Long COVID, neuropsychiatric disorders, psychotropics, present and future

“…Acute ischaemic stroke was seen in 18 of the 79 patients. Diabetic patients were 4 times more at risk to develop stroke while patients with respiratory failure were 21 times more likely to have a stroke (Tawakul et al, 2021).…”

Intracranial hemorrhages in patients with COVID-19: a systematic review of the literature, regarding six cases in an Amazonian population

“…In general, the most common neurological symptoms described in COVID-19 patients are headache, altered level of consciousness (ALC), dizziness, ageusia and anosmia, while other less common symptoms reported include visual impairment, CVD, seizures, occipital neuralgia, ataxia, tremor, and tics. 4,5,27 Severe infections were more likely in the presence of CVD and ALC 27 and to be reported in hypertensive patients, who were older, had fewer typical symptoms, and were more likely to develop neurological manifestations, especially acute CVD. 4 Several of the articles reported the time between admission and neuroimaging, with mean values ranging from 11 to 29 days.…”

Olive Leaves as a Potential Phytotherapy in the Treatment of COVID-19 Disease; A Mini-Review

“…Unlike other coronaviruses that caused several respiratory diseases, SARS-CoV-2 infection is not only a respiratory but also a systematic infection that exhibited severe immune response and resulted in multiorgan dysfunction and finally death ( da Rosa Mesquita et al, 2021 ). The main symptoms of COVID-19 disease are fever, headache, fatigue, malaise, dry cough, and dyspnea with progression to pneumonia, diarrhea, back pain, and loss of smell and taste ( da Rosa Mesquita et al, 2021 ; Zhou et al, 2020 ; Kabrah et al, 2021 ; Tawakul et al, 2021 ). The symptoms vary among patients depending on the viral load and virus strain ( da Rosa Mesquita et al, 2021 ).…”