当前位置: X-MOL 学术J. Neurol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Neurologic manifestations in 1760 COVID-19 patients admitted to Papa Giovanni XXIII Hospital, Bergamo, Italy
Journal of Neurology ( IF 6 ) Pub Date : 2020-10-07 , DOI: 10.1007/s00415-020-10251-5
Nicola Rifino 1 , Bruno Censori 2, 3 , Emanuela Agazzi 2 , Dario Alimonti 1, 2 , Virginio Bonito 2 , Giorgia Camera 2 , Marta Zaffira Conti 2 , Camillo Foresti 2 , Barbara Frigeni 2 , Simonetta Gerevini 4 , Maria Grimoldi 2 , Sara La Gioia 2 , Tania Partziguian 2 , Stefano Quadri 2 , Riccardo Riva 2 , Maria Cristina Servalli 2 , Manlio Sgarzi 2 , Benedetta Storti 1 , Marcella Vedovello 2 , Elisabetta Venturelli 2 , Martina Viganò 1 , Annapaola Callegaro 5 , Marco Arosio 5 , Maria Sessa 2
Affiliation  

Objectives

Evidences from either small series or spontaneous reporting are accumulating that SARS-CoV-2 involves the Nervous Systems. The aim of this study is to provide an extensive overview on the major neurological complications in a large cohort of COVID-19 patients.

Methods

Retrospective, observational analysis on all COVID-19 patients admitted from February 23rd to April 30th, 2020 to ASST Papa Giovanni XXIII, Bergamo, Italy for whom a neurological consultation/neurophysiological assessment/neuroradiologic investigation was requested. Each identified neurologic complication was then classified into main neurologic categories.

Results

Of 1760 COVID-19 patients, 137 presented neurologic manifestations that manifested after COVID-19 symptoms in 98 pts and was the presenting symptom in 39. Neurological manifestations were classified as: (a) cerebrovascular disease [53 pts (38.7%)] including 37 ischemic and 11 haemorrhagic strokes, 4 transient ischemic attacks, 1 cerebral venous thrombosis; (b) peripheral nervous system diseases [31 (22.6%)] including 17 Guillain–Barrè syndromes; (c) altered mental status [49 (35.8%)] including one necrotizing encephalitis and 2 cases with RT-PCR detection of SARS-Cov-2 RNA in CSF; (d) miscellaneous disorders, among whom 2 patients with myelopathy associated with Ab anti-SARS-CoV-2 in CSF. Patients with peripheral nervous system involvement had more frequently severe ARDS compared to patients with cerebrovascular disease (87.1% vs 42%; difference = 45.1% 95% CI 42.0–48.2; χ2= 14.306; p < 0.0002) and with altered mental status (87.1% vs 55.6%; difference = 31.5% 95% CI 27.5–37.5%; χ2= 7.055; p < 0.01).

Conclusion

This study confirms that involvement of nervous system is common in SARS-CoV-2 infection and offers clinicians useful information for prevention and prompt identification in order to set the adequate therapeutic strategies.



中文翻译:

意大利贝加莫 Papa Giovanni XXIII 医院收治的 1760 名 COVID-19 患者的神经系统表现

目标

来自小型系列或自发报告的证据正在积累,表明 SARS-CoV-2 涉及神经系统。本研究的目的是对大量 COVID-19 患者的主要神经系统并发症提供广泛的概述。

方法

对 2020 年 2 月 23 日至 4 月 30 日在意大利贝加莫的 ASST Papa Giovanni XXIII 住院的所有 COVID-19 患者进行回顾性观察分析,要求进行神经学会诊/神经生理学评估/神经放射学调查。然后将每个确定的神经系统并发症分类为主要的神经系统类别。

结果

在 1760 名 COVID-19 患者中,137 名在 98 名患者出现 COVID-19 症状后出现神经系统表现,其中 39 名患者出现症状。神经系统表现被分类为:(a) 脑血管疾病 [53 名 (38.7%)] 包括 37 名缺血性和出血性中风 11 次,短暂性脑缺血发作 4 次,脑静脉血栓形成 1 次;(b) 周围神经系统疾病 [31 (22.6%)] 包括 17 种格林-巴雷综合征;(c) 精神状态改变 [49 (35.8%)] 包括 1 例坏死性脑炎和 2 例 RT-PCR 检测脑脊液中 SARS-Cov-2 RNA 的病例;(d) 其他疾病,其中 2 名脊髓病患者与脑脊液中的抗 SARS-CoV-2 抗体相关。与脑血管疾病患者相比,周围神经系统受累患者更频繁地出现严重 ARDS(87.1% vs 42%;χ 2 = 14.306;p  < 0.0002)和精神状态改变(87.1% vs 55.6%;差异 = 31.5% 95% CI 27.5–37.5%;χ 2 = 7.055;p  < 0.01)。

结论

该研究证实,神经系统受累在 SARS-CoV-2 感染中很常见,并为临床医生提供有用的预防信息和及时识别,以便制定适当的治疗策略。

更新日期:2020-10-07
down
wechat
bug