The COVID-19 pandemic has infected more than 22 million people worldwide. Although much has been learned about COVID-19, we do not know much about its neurological features and their outcome. This observational study was conducted on the patients of Imam Hossein Hospital, and 361 adult patients (214 males) with confirmed diagnosis of COVID-19 from March 5, 2020 to April 3, 2020, were enrolled. Data was gathered on age, sex, comorbidities, initial symptoms, symptoms during the disease course, neurological symptoms, and outcome. The mean age of the patients was 61.90 ± 16.76 years. The most common initial symptoms were cough, fever, and dyspnea. In 21 patients (5.8%), the initial symptom was neurological. History of dementia was associated with severe COVID-19 disease (odds ratio = 1.28). During the course of the disease, 186 patients (51.52%) had at least one neurological symptom, the most common being headache (109 [30.2%]), followed by anosmia/ageusia (69, [19.1%]), and dizziness (54, [15%]). Also, 31 patients had neurological complications (8.58%). Anosmia, ageusia, dizziness, and headache were associated with favorable outcome (P < 0.001), while altered mental status and hemiparesis were associated with poor outcome. The mortality rate of patients who had neurological complications was more than twice than that of patients without neurological complication (P = 0.008). Almost half of the patients experienced at least one neurological symptom, which may be the initial presentation of COVID-19. Dementia appears to be associated with severe COVID-19. Mortality was higher in patients with neurological complications, and these patients needed more intensive care.

COVID-19 大流行已感染全球超过 2200 万人。尽管我们对 COVID-19 了解很多，但我们对其神经学特征及其结果知之甚少。这项观察性研究针对伊玛目侯赛因医院的患者进行，纳入了2020年3月5日至2020年4月3日期间确诊为COVID-19的361名成年患者（214名男性）。收集了有关年龄、性别、合并症、初始症状、病程期间的症状、神经系统症状和结果的数据。患者的平均年龄为 61.90 ± 16.76 岁。最常见的初始症状是咳嗽、发烧和呼吸困难。 21 名患者 (5.8%) 的首发症状是神经系统症状。痴呆病史与严重的 COVID-19 疾病相关（比值比 = 1.28）。在疾病过程中，186名患者（51.52%）出现至少一种神经系统症状，最常见的是头痛（109名[30.2%]），其次是嗅觉丧失/味觉缺失（69名[19.1%]）和头晕（ 54，[15%]）。此外，31 名患者出现神经系统并发症（8.58%）。嗅觉丧失、味觉缺失、头晕和头痛与良好的预后相关（ P < 0.001），而精神状态改变和偏瘫与不良的预后相关。有神经系统并发症患者的死亡率是无神经系统并发症患者的2倍以上（ P =0.008）。几乎一半的患者经历了至少一种神经系统症状，这可能是 COVID-19 的最初表现。痴呆症似乎与严重的 COVID-19 有关。患有神经系统并发症的患者死亡率较高，这些患者需要更多的重症监护。