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Neurological presentations of COVID-19: Findings from the Spanish society of neurology neuroCOVID-19 registry
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2020-12-01 , DOI: 10.1016/j.jns.2020.117283
David García-Azorín 1 , María José Abenza Abildúa 2 , María Elena Erro Aguirre 3 , Santiago Fernández Fernández 4 , Juan Carlos García Moncó 5 , Cristina Guijarro-Castro 6 , Montserrat González Platas 7 , Fernando Romero Delgado 8 , José Miguel Láinez Andrés 9 , David Ezpeleta 10 ,
Affiliation  

Objective We report the findings from the Spanish Society of Neurology's NeuroCOVID-19 Registry. Methods We performed a multicentre study of patients with neurological manifestations of COVID-19. Participating physicians reported demographic, clinical, and paraclinical data and judged the involvement of COVID-19 in causing neurological symptoms. Results A total of 233 cases were submitted, including 74 different combinations of manifestations. The most frequently reported were stroke (27%), neuromuscular symptoms (23.6%), altered mental status (23.6%), anosmia (17.6%), headache (12.9%), and seizures (11.6%). The mean age of patients was 61.1 years, with 42.1% being women; a higher proportion of women was recorded among patients with altered mental status, anosmia, and headache. The onset of symptoms differed within categories. Onset of anosmia occurred a mean (standard deviation) of 2.9 (2.5) days after the first general symptom, whereas neuromuscular symptoms appeared after 13.9 (10.1) days. Neurological symptoms were persistent in 33% of patients. General symptoms were present in 97.7% of patients, and results from general laboratory studies were abnormal in 99.4% of patients. Cerebrospinal fluid analysis findings were abnormal in 62.7% of the cases in which this test was performed (n = 51), but positive results for SARS-CoV-2 were only found in one case. Conclusions The neurological manifestations of COVID-19 are diverse. Anosmia, myalgia, and headache occur earlier in the course of the disease. Altered mental status, neuromuscular symptoms, and stroke are associated with greater severity. COVID-19 must be incorporated into most clinical and radiological differential diagnoses. COVID-19 may cause persistent and disabling neurological symptoms.

中文翻译:

COVID-19 的神经学表现:来自西班牙神经病学学会 neuroCOVID-19 登记处的调查结果

目的 我们报告了西班牙神经病学学会 NeuroCOVID-19 登记处的发现。方法 我们对具有 COVID-19 神经系统表现的患者进行了一项多中心研究。参与的医生报告了人口统计学、临床和临床外数据,并判断了 COVID-19 在引起神经系统症状中的作用。结果共提交病例233例,包括74种不同的表现组合。最常报告的是中风 (27%)、神经肌肉症状 (23.6%)、精神状态改变 (23.6%)、嗅觉丧失 (17.6%)、头痛 (12.9%) 和癫痫发作 (11.6%)。患者的平均年龄为 61.1 岁,其中 42.1% 为女性;在精神状态改变、嗅觉丧失和头痛的患者中,女性比例较高。症状的发作因类别而异。嗅觉缺失的平均(标准偏差)发生在第一个全身症状出现后 2.9 (2.5) 天,而神经肌肉症状出现在 13.9 (10.1) 天后。33% 的患者神经系统症状持续存在。97.7% 的患者存在一般症状,99.4% 的患者一般实验室检查结果异常。在进行该测试的病例中,有 62.7%(n = 51)的脑脊液分析结果异常,但仅在 1 例病例中发现了 SARS-CoV-2 阳性结果。结论 COVID-19 的神经系统表现多种多样。嗅觉丧失、肌痛和头痛发生在病程的早期。精神状态改变、神经肌肉症状和中风与更严重的疾病有关。必须将 COVID-19 纳入大多数临床和放射学鉴别诊断。COVID-19 可能会导致持续和致残的神经系统症状。
更新日期:2020-12-01
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