Introduction

Neurological manifestations can occur during coronavirus disease 19 (COVID-19). Several pathogenic mechanisms have been hypothesized, without conclusive results. In this study, we evaluated the most frequent neurological symptoms in a cohort of hospitalized COVID-19 patients, and also investigated the possible relationship between plasmatic inflammatory indices and olfactory disorders (ODs) and between muscle pain and creatine kinase (CK).

Methods

We consecutively enrolled hospitalized COVID-19 patients. A structured questionnaire concerning typical and neurological symptoms, focusing on headache, dizziness, ODs, taste disorders (TDs), and muscle pain, was administrated by telephone interviews.

Results

Common neurological symptoms were reported in the early phase of the disease, with a median onset ranging from 1 to 3 days. Headache showed tension-type features and was more frequently associated with a history of headache. Patients with ODs less frequently needed oxygen therapy. Inflammatory indices did not significantly differ between patients with and without ODs. Muscle pain did not show any association with CK level but was more frequently associated with arthralgia and headache.

Conclusion

In our cohort, ODs were an early symptom of COVID-19, more frequently reported by patients with milder forms of disease. Headache in association with arthralgia and muscle pain seems to reflect the common symptoms of the flu-like syndrome, and not COVID-19 infection-specific.

中文翻译：

---

住院 COVID-19 患者的早期神经系统表现。

介绍

在冠状病毒病 19 (COVID-19) 期间可能会出现神经系统表现。已经假设了几种致病机制，但没有确凿的结果。在这项研究中，我们评估了一组 COVID-19 住院患者中最常见的神经系统症状，并研究了血浆炎症指数与嗅觉障碍 (OD) 以及肌肉疼痛与肌酸激酶 (CK) 之间的可能关系。

方法

我们连续招募了住院的 COVID-19 患者。通过电话采访进行了一份关于典型和神经系统症状的结构化问卷，重点关注头痛、头晕、ODs、味觉障碍 (TDs) 和肌肉疼痛。

结果

在疾病的早期阶段报告了常见的神经系统症状，中位发病时间为 1 至 3 天。头痛表现出紧张型特征，并且更常与头痛病史相关。ODs 患者较少需要氧疗。有和没有 OD 的患者之间的炎症指数没有显着差异。肌肉疼痛与 CK 水平没有任何关联，但更常与关节痛和头痛相关。

结论

在我们的队列中，ODs 是 COVID-19 的早期症状，更常见于病情较轻的患者。与关节痛和肌肉疼痛相关的头痛似乎反映了流感样综合征的常见症状，而不是 COVID-19 感染特异性。