Neurological symptoms of COVID-19 infection; a cross-sectional study on hospitalized COVID-19 patients in Iran

Abstract

Background Coronavirus disease 2019 (COVID-19), a global issue now, can have a variety of clinical manifestations. Hundreds of articles have discussed different aspects of this infectious disease, such as physiopathology, epidemiology, clinical manifestations and treatment protocols. Recently, neurological manifestations of the disease have been found to be pretty common among COVID-19 patients. Here, neurological symptoms of COVID-19 infection with a focus on non-cerebrovascular complications are discussed in a large study population. Methods Neurological symptoms of 891hospitalized COVID-19 patients from March to June 2020 in a major Hospital, Tehran, Iran, were reviewed. Demographic characteristics and neurological manifestations were analyzed. Results Among 891 hospitalized COVID-19 patients, the following symptoms were observed: headache(63.9%),sleeping problems(51.3%), hyposmia/anosmia(46%), dizziness(45.4%), hypogeusia (42.1%),memory issues(31.5%), auditory disturbances(17.5%), paralysis(3.7%) and seizures(1.7%). In 29.7% of the patients, a neurological symptom was the initiating symptoms of the infection. Females were more likely to show headache and dizziness compared to males (p value<0.05). Headache intensity was also higher in females compared to males (p value<0.05). Headache prevalence was lower in older patients (p value<0.05), while memory loss and impaired consciousness were higher by increasing age (p values= 0.002 and 0.001, respectively). Conclusion Neurological manifestations were common among COVID-19 patients under study. Headache, as the most common neurological symptom among COVID-19 patients, was the most prevalent and intense among the female population. Headache, dizziness, sleeping problems, hyposmia/anosmia and hypogeusia were common COVID-19 neurological manifestations, while memory issues, auditory disturbances, paralysis, and seizures were less common.

Neurological symptoms and signs associated with COVID-19 in pediatric patients: a single-center experience

“…Notably, neurological findings are more common in obese patients in the literature. [6,9–12,15,23,26,53–55]…”

“…[6,[9][10][11][12]15,23,26,[53][54][55] Reports show that seizures are observed more frequently in patients with underlying neurological disease and/or hospitalised for severe illness. [6,[9][10][11][12]15,23,26,[53][54][55] Unlike the literature, in our study, the number of boys (n:13, 37.1%) was slightly smaller than the number of girls (n:22, 62.9%) in Group 1. Most studies have reported that there is no gender difference in terms of neurological findings among children.…”

“…The frequency of seizures in children with COVID-19 varies between 0.7% and 52.9%. [6,9–12,15,23,26,53–55] Reports show that seizures are observed more frequently in patients with underlying neurological disease and/or hospitalised for severe illness. [6,9–12,15,23,26,53–55]…”

“…Unlike the literature, in our study, the number of boys (n:13, 37.1%) was slightly smaller than the number of girls (n:22, 62.9%) in Group 1. [6–26] Most studies have reported that there is no gender difference in terms of neurological findings among children. [6–26] However, 1 study reported that headache was more common in girls.…”

Patterns of COVID-19-related headache: A cross-sectional study

“…Few studies have investigated COVID-19-related headache [19] , [20] . Uygun et al described the headaches as bilateral, lasting longer than 72 h, resistant to analgesics, occurring more in males, and associated with mostly gastrointestinal (GI) symptoms and a loss of smell or taste [21] .…”