Background

COVID-19 disease affects the nervous system and led to an increase in neurological consults for patients at admission and through the period of hospitalization during the peak of the pandemic.

Methods

Patients with clinical and laboratory diagnosis of COVID-19 that required a neurologic consultation or those who presented with neurological problems on admission that led to a diagnosis of SARS-CoV-2 infection during a 2-month period at the peak of the pandemic were included in this study. Demographic and clinical variables were analyzed.

Results

Thirty-five patients were included. The presenting neurologic manifestations on admission led to the diagnosis of COVID-19 in 14 patients (40%). The most common reasons for consultation during the hospitalization period were stroke (11), encephalopathy (7), seizures (6), and neuropathies (5) followed by a miscellaneous of syncope (2), migraine (1), anosmia (1), critical illness myopathy (1), and exacerbation of residual dysarthria (1). The most common neurological disturbances were associated with severe disease except for neuropathies. Patients with encephalopathies and seizures had markedly increased D-dimer and ferritin values, even higher than stroke patients. RT-PCR was performed in 8 CSF samples and was negative in all of them.

Conclusion

Neurological disturbances represent a significant and severe burden in COVID-19 patients, and they can be the presenting condition that leads to the diagnosis of the viral infection in a high percentage of patients. Evidence of direct viral mechanisms was scarce, but the pathogenesis of the diverse manifestations remains enigmatic.

中文翻译：

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COVID-19大流行期间进行咨询和住院的神经病学原因

背景

COVID-19疾病影响神经系统，并导致患者在入院时和大流行高峰期间住院期间的神经咨询增加。

方法

包括需要进行神经科咨询的临床和实验室诊断为COVID-19的患者，或在大流行高峰期2个月内入院时出现导致SARS-CoV-2感染的诊断的神经系统疾病的患者。在这个研究中。人口和临床变量进行了分析。

结果

包括三十五名患者。入院时出现的神经系统表现导致14例患者（40％）被诊断为COVID-19。住院期间会诊的最常见原因是中风（11），脑病（7），癫痫发作（6）和神经病（5），其次是晕厥（2），偏头痛（1），失眠（1） ，重症肌病（1）和残余构音障碍加剧（1）。除神经病外，最常见的神经系统疾病与严重疾病有关。脑病和癫痫发作的患者D-二聚体和铁蛋白值明显升高，甚至高于中风患者。RT-PCR在8个CSF样品中进行，所有样品均为阴性。

结论

神经系统疾病在COVID-19患者中代表着严重而又沉重的负担，它们可能是导致高比例患者诊断出病毒感染的主要症状。缺乏直接的病毒机制的证据，但各种表现形式的发病机理仍然是个谜。