Abstract

Objective

The purpose of this study was to investigate the occurrence of neurologic symptoms with a focus on altered mental status in a sample of deaths due to COVID-19.

Methods

We reviewed neurologic symptoms in 71 deaths due to COVID-19 at the first US hospital with reported cases, of which 66 (93%) had medical comorbidities, 47 (66%) came from assisted living facilities or nursing homes and 35 (49%) had baseline dementia.

Results

Sixty-one patients (86%) demonstrated neurologic symptoms at hospital admission. Altered mental status was seen in 47 patients (66%) and represented the most common neurologic symptom. Seven patients (10%) were comatose at hospital admission and 5 (7%) presented with altered mental status without respiratory symptoms. Three patients had seizures and two had strokes. Hypertension (61%), cardiovascular disease (59%), and dementia (49%) were the most common comorbidities associated with death due to COVID-19 in our sample.

Conclusions

Neurologic symptoms, particularly altered mental status, are very common in COVID-19 patients with high risk of mortality. In a small subset of patients, altered mental status is the defining feature of disease presentation. A mental status examination should be incorporated in the medical assessment of COVID-19.

中文翻译：

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由于 COVID-19 导致 71 人死亡的精神状态改变

摘要

客观的

本研究的目的是调查神经系统症状的发生，重点关注 COVID-19 死亡样本中精神状态的改变。

方法

我们回顾了美国第一家有报告病例的医院因 COVID-19 导致的 71 例死亡的神经系统症状，其中 66 例 (93%) 患有合并症，47 例 (66%) 来自辅助生活设施或疗养院，35 例 (49% ) 患有基线痴呆症。

结果

61 名患者 (86%) 在入院时表现出神经系统症状。47 名患者 (66%) 出现精神状态改变，是最常见的神经系统症状。7 名患者 (10%) 入院时昏迷，5 名 (7%) 出现精神状态改变而没有呼吸道症状。三名患者癫痫发作，两名中风。在我们的样本中，高血压 (61%)、心血管疾病 (59%) 和痴呆 (49%) 是与 COVID-19 死亡相关的最常见合并症。

结论

神经系统症状，特别是精神状态改变，在死亡风险高的 COVID-19 患者中非常常见。在一小部分患者中，精神状态改变是疾病表现的决定性特征。精神状态检查应纳入 COVID-19 的医学评估。