The Frequency of Neurological Symptoms in COVID-19 Patients at a Tertiary Care Hospital in Pakistan

Makda, Aamir; Kumar, Sagar Suresh; Kumar, Amit; Kumar, Vinesh; Rizwan, Amber

doi:10.7759/cureus.10360

Cited by 26 publications

(26 citation statements)

References 23 publications

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“…The prevalence of strokes in our cohort was not inconsistent with previous studies (4,5,12,28,(38)(39)(40). Additionally, we found a similar distribution of stroke types as those reported previously by (41).…”

Section: Discussionsupporting

confidence: 89%

The Common Neurological Presentations and Clinical Outcomes of Coronavirus Disease 2019 in Saudi Arabia

et al. 2021

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Background: Neurological manifestations have increasingly become recognized in COVID-19. People from different ethnic backgrounds are experiencing different outcomes related to SARS-CoV-2 infection. Several cohort studies reported the common neurological manifestations and complications associated with COVID-19 disease around the world however, the prevalence of neurological complications associated with SARS-CoV-2 infection in the Arab countries and Saudi Arabia is still unknown.Objective: To study the prevalence, risk factors, and characteristics of the neurological complications associated with COVID-19 and their relationship with clinical outcomes.Methods: We conducted a prospective, single-center, observational, cohort study of consecutive hospitalized adults COVID-19 patients with and without neurological manifestation admitted between March 2020 until the end of December 2020. Data was collected prospectively using electronic medical records; Cases and controls were observed until they either get discharged from the hospital or died. The primary outcomes were death, survival, and survival with sequalae.Results: Among 497 patients with COVID-19, 118 patients (23.7%) had neurological complications, 94 patients (18.9%) had encephalopathy, and 16 patients (3.2%) had cerebrovascular accidents (CVA). Patients with COVID-19-related neurological complications were older and more likely to have a pre-existing neurological disease. The most common neurological syndrome associated with COVID-19 were encephalopathy (18.9%) and headache (13.7%). Pre-existing neurological disease and an elevated neutrophil count were the strongest predictors of developing any neurological complications. Death form COVID-19 was associated with age (OR 1.06, 95% CI 1.02–1.10, P = 0.001), invasive ventilation (OR 37.12, 95% CI 13.36–103.14), COVID-19-related-neurological complications (OR 3.24, 95% CI 1.28–8.21, P = 0.01), and elevated CRP level (OR 1.01, 95% CI 1.00–1.01, P = 0.01).Conclusions: COVID-19 is associated with a wide range of neurological manifestations in people living in Saudi Arabia, with older individuals and those with underlying neurological disorders being most at risk. The presence of neurological complications was associated with increased mortality and poor outcomes.

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Section: Discussionsupporting

confidence: 89%

The Common Neurological Presentations and Clinical Outcomes of Coronavirus Disease 2019 in Saudi Arabia

et al. 2021

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“…12 studies performed regression analyses adjusted for demographic and clinical variables. OGD were found to be associated with COVID+ after adjustment for demographic 104 , 105 , 106 , 91 , 107 , 108 , 109 , 110 , 111 , clinical 104 , 105 , 106 , 91 , 107 109 , 110 and laboratoristic 106 variables. Interestingly, a preprint published by the Global Consortium for Chemosensory Research (GCCR) demonstrated how a continuous rating of current olfactory ability on a 0 to 10 rating scale was the best predictor of SARS-CoV-2 infection in a sample of 4148 COVID+ and 546 COVID-; ratings ≤ 2 were associated with OR ≥ 2 50 .…”

Section: Resultsmentioning

confidence: 94%

Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review

Boscutti

Delvecchio

Pigoni

et al. 2021

Brain, Behavior, & Immunity - Health

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Background Among Coronavirus Disease 2019 (COVID-19) manifestations, Olfactory (OD) and Gustatory (GD) Dysfunctions (OGD) have drawn considerable attention, becoming a sort of hallmark of the disease. Many have speculated on the pathogenesis and clinical characteristics of these disturbances; however, no definite answers have been produced on the topic. With this systematic review, we aimed to collect all the available evidence regarding the prevalence of OGD, the timing of their onset and their resolution, their rate of recovery and their role as diagnostic and prognostic tools for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Methods A systematic review comprising all the observational studies that reported the prevalence and/or the longitudinal trajectories of OGD in COVID-19 patients, as self-reported by patients or measured through objective psychophysical tests. Results After the selection process, 155 studies were included, with a total of 70920 patients and 105291 not-infected individuals. Prevalence reports were extremely variable across studies, with wide ranges for OD (0% - 98%) and GD (0-89%) prevalence. OGD occurred early during the disease course and only rarely preceded other symptoms; out of 30 studies with a follow-up time of at least 20 days, only in 5 studies OGD fully resolved in more than 90% of patients. OGD had low sensitivity and high specificity for SARS-CoV-2 infection; accuracy of OD and GD for infection identification was higher than 80% in 10 out of 33 studies and in 8 out of 22 studies considered, respectively. 28 out of 30 studies that studied the association between OGD and disease severity found how OGD were associated with lower rates of severe pneumonia, hospitalization and mortality. Conclusions OGD seem to be highly prevalent in SARS-CoV-2 infection. They occur early, concomitantly with other symptoms and often persist after recovery, in some cases for months; whether a full recovery eventually occurs in all cases is not clear yet. OGD are good predictors of SARS-CoV-2 infection and are associated with a milder disease course.

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“…van Ofwegen-Hanekamp MD PhD 2 , Richard C.J.M. Donders MD PhD 3 , D. Martijn O. Pruijsen MD PhD 3 , Rik S. Hermanides MD PhD 4 , Hortence, E. Haerkens-Arends MD 5 , Rutger L. Anthonio MD 6 , Mireille E. Emans MD PhD 7 , René A. Tio MD PhD 8 , Jur M. ten Berg MD PhD 9,10 , Björn E. Groenemeijer MD PhD 11 , Ron Pisters MD PhD 12 , P. Marc van der Zee MD PhD 13 , Hans-Marc J. Siebelink MD PhD 14 Derk O. Verschure MD PhD 15 , Matthijs F.L. Meijs MD PhD 16 1.…”

Section: The Capacity-covid Collaborative Consortiummentioning

confidence: 99%

Risk, clinical course and outcome of ischemic stroke in patients hospitalized with COVID-19: a multicenter cohort study

Sluis

Linschoten

Biesbroek

et al. 2021

Preprint

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Background and purpose The frequency of ischemic stroke in patients with COVID-19 varies in the current literature, and risk factors are unknown. We assessed the incidence, risk factors, and outcomes of acute ischemic stroke in hospitalized patients with COVID-19. Methods We included patients with a laboratory confirmed SARS-CoV-2 infection admitted in 16 hospitals participating in the international CAPACITY-COVID registry between March 1st and August 1st, 2020. Patients were screened for the occurrence of acute ischemic stroke. We calculated the cumulative incidence of ischemic stroke and compared risk factors, cardiovascular complications, and in-hospital mortality in patients with and without ischemic stroke. Results We included 2147 patients with COVID-19, of whom 586 (27.3%) needed treatment at an intensive care unit (ICU). Thirty-eight patients (1.8%) had an ischemic stroke. Patients with stroke were older, but did not differ in sex or cardiovascular risk factors. Median time between onset of COVID-19 symptoms and diagnosis of stroke was two weeks. The incidence of ischemic stroke was higher among patients who were treated at an ICU (16/586; 2.7% versus 22/1561; 1.4%; p=0.039). Pulmonary embolism was more common in patients with (8/38; 21.1%) than in those without stroke (160/2109; 7.6%; adjusted RR: 2.08; 95%CI:1.52-2.84). Twenty-seven patients with ischemic stroke (71.1%) died during admission or were functional dependent at discharge and in-hospital mortality. Patients with ischemic stroke were at a higher risk of in-hospital mortality (adjusted RR 1.56; 95%CI:1.13-2.15) than patients without stroke. Conclusions In this multicenter cohort study, the cumulative incidence of acute ischemic stroke in hospitalized patients with COVID-19 was approximately 2%, with a higher risk in patients treated at an ICU. The majority of stroke patients had a poor outcome. The association between ischemic stroke and pulmonary embolism warrants further investigation.

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The Frequency of Neurological Symptoms in COVID-19 Patients at a Tertiary Care Hospital in Pakistan

Cited by 26 publications

References 23 publications

The Common Neurological Presentations and Clinical Outcomes of Coronavirus Disease 2019 in Saudi Arabia

The Common Neurological Presentations and Clinical Outcomes of Coronavirus Disease 2019 in Saudi Arabia

Olfactory and gustatory dysfunctions in SARS-CoV-2 infection: A systematic review

Risk, clinical course and outcome of ischemic stroke in patients hospitalized with COVID-19: a multicenter cohort study

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