Surveillance study of acute neurological manifestations among 439 Egyptian patients with COVID-19 in Assiut and Aswan university hospitals

Khedr, Eman M.; Abo-Elfetoh, Noha; Daef, Enas; Hassan, Hebatallah M.; Amin, Mariam; Soliman, Radwa K.; Attia, Alaa A; Zarzour, Amro A.; Zain, Mohamed E.; Mohamed-Hussein, Aliae; Hashem, Maiada K.; Hassany, Sahar M.; Aly, Ahmed; Shoap, Ahmed; Saber, Mostafa

doi:10.1101/2020.10.28.20221879

Cited by 7 publications

(30 citation statements)

References 34 publications

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“…These papers were appropriate for systematic review and entered into data extraction. Eighteen of these clinical studies used various methods, such as brain CT, MRI, EGG, and CSF for the diagnosis of neurological manifestations 8,10,11,18–32 . However, two other studies performed only clinical neurological exams 4,33 .…”

Section: Resultsmentioning

confidence: 99%

Neurological manifestations in patients with COVID‐19: A systematic review and meta‐analysis

Ari

Mohamadi

Mehr

et al. 2022

Clinical Laboratory Analysis

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Introduction The intensification of coronavirus disease 2019 (COVID‐19) complications, severe symptoms, and high mortality rate has led researchers to focus on this significant issue. While respiratory and cardiac complications have been described as high‐risk manifestations in patients with COVID‐19, neurological complications can also enhance mortality. This study aimed to evaluate the prevalence of neurological complications arises from SARS‐CoV‐2 and assess the mortality rate from neurological complications. Material and Methods Literature review was conducted by searching in PubMed/Medline, Web of Sciences, and Embase. After performing search strategies with relevant terms, a number of articles were excluded, including review articles, systematic review or meta‐analysis, duplicate publication of same researchers, congress abstracts, animal studies, case reports, case series, and articles reporting a history of neurological features prior to COVID‐19 infection. After retrieving the data, statistical analysis was performed using the STATA Version 14 software. Results From 4455 retrieved publications, 20 articles were selected for further analysis. Among 18,258 included patients, 2791 showed neurological symptoms, which were classified into different groups. Headache, confusion, and fatigue were reported as the most non‐specific neurological features in confirmed COVID‐19 patients. Psychiatric symptoms, CNS disorders, cerebrovascular disorders, CNS inflammatory disorders, PNS disorders, neuromuscular disorders, etc., were defined as specific neurological manifestations. The pooled prevalence of neurological manifestations and mortality rate of COVID‐19 patients with neurological features were estimated to be 23.0% (95% CI: 17.8–29.2) and 29.1% (95% CI: 20.3–39.8), respectively. Conclusion Neurological manifestations may commonly happen in patients with COVID‐19. This study reported a high prevalence of neurological complications and mortality rates in COVID‐19 patients. Therefore, patients with COVID‐19 who indicated neurological symptoms should be taken seriously and should receive early treatment to prevent undesirable events.

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Section: Resultsmentioning

confidence: 99%

Neurological manifestations in patients with COVID‐19: A systematic review and meta‐analysis

Ari

Mohamadi

Mehr

et al. 2022

Clinical Laboratory Analysis

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“…Patients with suspected COVID-19 were admitted from June 1 to August 10, 2020, to two university hospitals in Upper Egypt (Assiut and Aswan), which served as quarantine areas ( 11 ). Then, all patients with COVID-19 infection, whom presented with acute CVD, were transferred to the intensive care unit (ICU) of the Neurology, Neurosurgery Hospital of Assiut and the ICU in Aswan University hospital.…”

Section: Methodsmentioning

confidence: 99%

Clinical and Radiological Characteristics of Acute Cerebrovascular Diseases Among Egyptian Patients With COVID-19 in Upper Egypt

et al. 2021

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Background and Purpose: There is little information on the acute cerebrovascular complications of coronavirus disease 2019 (COVID-19) in Egypt. The aim of this study was to estimate the proportion of acute cerebrovascular disease (CVD) among COVID-19 patients and evaluate their clinical and radiological characteristics in comparison with non-COVID-19 CVD.Materials and Methods: In a retrospective study, COVID-19 patients whom presented with CVD in Assiut and Aswan University Hospitals were compared with non-COVID-19, CVD patients, admitted to Qena University Hospital, prior to the pandemic. The following data were collected: clinical history and presentation, risk factors, comorbidities, brain imaging (MRI or CT), chest CT, and some laboratory investigations.Results: Fifty-five (12.5%) of the 439 patients with COVID-19 had acute CVD. Of them, 42 (9.6%) had ischemic stroke while 13 patients (2.9%) had hemorrhagic CVD. In the 250 cases of the non-COVID-19 group, 180 had ischemic stroke and 70 had hemorrhagic stroke. A large proportion of patients with COVID-19 who presented with ischemic stroke had large vessel occlusion (LVO), which was significantly higher than in non-COVID-19 patients with CVD (40 vs. 7.2%, P < 0.001). Comorbidities were recorded in 44 (80%) cases. In COVID-19 ischemic stroke patients, risk factors [hypertension and ischemic heart disease (IHD)] and comorbidities (hepatic and renal) were significantly higher than those in non–COVID-19 patients. In addition, 23.5% had hemorrhagic CVD, and six patients with LVO developed hemorrhagic transformation.Conclusion: Acute CVD among patients with COVID-19 was common in our study. LVO was the commonest. Hypertension, IHD, and anemia are the most common risk factors and could contribute to the worsening of clinical presentation. Comorbidities were common among patients with CVD, although a large number had elevated liver enzymes and creatinine that were partially due to COVID-19 infection itself. The current results begin to characterize the spectrum of CVD associated with COVID-19 in patients in Upper Egypt.Registration ID: The ID number of this study is IRB no: 17300470.

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“…An increasing body of literature, including cohort studies, [1][2][3][4][5][6][7][8][9] has linked COVID-19 to the development peripheral nervous system (PNS) diseases. However, findings are divergent due to methodological differences and largely variable sample sizes.…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 and the peripheral nervous system. A 2‐year review from the pandemic to the vaccine era

Taga

Lauria

2022

J Peripheral Nervous Sys

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Increasing literature has linked COVID‐19 to peripheral nervous system (PNS) diseases. In addition, as we move from the pandemic to the vaccination era, literature interest is shifting towards the potential association between COVID‐19 vaccines and PNS manifestations. We reviewed published literature on COVID‐19, COVID‐19 vaccines and PNS manifestations between 1 January 2020 and 1 December 2021. For Guillain‐Barré syndrome (GBS), isolated cranial neuropathy (ICN) and myositis associated with COVID‐19, the demographic, clinical, laboratory, electrophysiological and imaging features were included in a narrative synthesis. We identified 169 studies on COVID‐19‐associated complications, including 63 papers (92 patients) on GBS, 29 papers (37 patients) on ICN and 11 papers (18 patients) on myositis. Additional clinical phenotypes included chronic inflammatory demyelinating polyneuropathy, vasculitic neuropathies, neuralgic amyotrophy, critical care‐related complications, and myasthenia gravis. PNS complications secondary to COVID‐19 vaccines have been reported during randomized clinical trials, in real‐world case reports, and during large‐scale surveillance programs. These mainly include cases of GBS, Bell's palsy, and cases of neuralgic amyotrophy. Based on our extensive review of the literature, any conclusion about a pathophysiological correlation between COVID‐19 and PNS disorders remains premature, and solely supported by their temporal association, while epidemiological and pathological data are insufficient. The occurrence of PNS complications after COVID‐19 vaccines seems limited to a possible higher risk of facial nerve palsy and GBS, to a degree that widespread access to the ongoing vaccination campaign should not be discouraged, while awaiting for more definitive data from large‐scale surveillance studies.

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Surveillance study of acute neurological manifestations among 439 Egyptian patients with COVID-19 in Assiut and Aswan university hospitals

Cited by 7 publications

References 34 publications

Neurological manifestations in patients with COVID‐19: A systematic review and meta‐analysis

Neurological manifestations in patients with COVID‐19: A systematic review and meta‐analysis

Clinical and Radiological Characteristics of Acute Cerebrovascular Diseases Among Egyptian Patients With COVID-19 in Upper Egypt

COVID‐19 and the peripheral nervous system. A 2‐year review from the pandemic to the vaccine era

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