The possibility of predicting the occurrence of neurological complications in patients with COVID-19

Abstract

Background. The problem of coronavirus disease (COVID-19) remains relevant due to high morbidity and mortality. There are various lesions of the nervous system in the setting of COVID-19 that significantly affect the course of the disease. Predicting the development of neurological complications requires further research. The aim of the study is to analyze the state of blood gas composition, coagulogram and acute phase of inflammation in patients with COVID-19 depending on the severity of their state and the presence of neurological complications. Materials and methods. We examined 96 patients with confirmed coronavirus disease with pneumonia and no history of neurological diseases. Group I included 43 (44.79 %) individuals with moderate COVID-19, and group II — 53 (55.21 %) patients with severe condition. Blood saturation, blood gas composition and acid-base balance, coagulogram, levels of interleukin-6 (IL-6), ferritin, and C-reactive protein (CRP) in the blood serum were evaluated. The control group consisted of 25 healthy donors. Results. A comparative analysis was performed of the clinical manifestations of nervous system damage and neurological complications, blood gas composition, acid-base balance, acute phase of inflammation, coagulogram in patients with COVID-19 depending on the severity of the disease. Conclusions. In patients with COVID-19, the incidence of neurological symptoms, the degree of changes in blood gas composition, acid-base balance, coagulogram, levels of CRP, ferritin and IL-6 depend on the severity of the disease. Neurological complications in the form of acute cerebrovascular accident, cerebral edema, and transient ischemic attack occur in 16.67 % of patients with moderate to severe COVID-19. The risk of developing these complications is associated with more severe hypercapnia (p < 0.001), respiratory acidosis (p < 0.001), signs of hypercoagulability (p < 0.001), changes in IL-6 (p < 0.01) and CRP (p < 0.001).