Neurological manifestations of SARS-CoV-2 infection among hospitalized patients

Ahmet Levent Aydin¹, Haci Ali Erdogan², Nomin Bold³, Habip Gedik³, Vildan Ayse Yayla², Ozlem Altuntas Aydin³, Kadriye Kart Yasar³

¹Koc University Hospital, Department of Neurosurgery, Istanbul, Turkey - ²University of Health Sciences, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Department of Neurology, Istanbul, Turkey - ³University of Health Sciences, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey

Introduction: Neurological symptoms in  SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infected patients and the course of COVID-19 in patients with neurological findings are determined.

Material and methods: Inpatient cases aged ≥18 years, followed-up in clinical services for COVID-19 diagnosis are studied. Patients were visited on 04.20.2020 and examined for central nervous system (CNS), peripheral nervous system (PNS) manifestations and muscular injury, from onset of symptoms to hospitalization. Risk factors associated with the severity of COVID-19 and the comparison of variables in terms of existence of neurological findings including CNS and PNS findings were performed. 

Results: Overall, 133 (54%) of the 242 patients of the study were male, mean age was 56.82±16.35 (18–91) years. Of these, 128 (52%) cases were defined as severe COVID-19. Outstanding symptoms at the onset were cough (62.8%), fever (46.7%), dyspnea (45.9%), and tiredness (31%). Further, 82 (33.9%) cases showed neurological findings at the first admission. Of those with neurological symptoms, 25.6% had CNS, 16.1% had PNS, 1.7% had muscular symptoms. In patients with CNS manifestations, the most common symptoms were headache (20.6%) and dizziness (7.4%). Impaired taste was the most common manifestation of PNS (11.2%). Neurological symptoms showed no significant difference between severe and non-severe COVID-19 groups except impaired taste (significantly higher in non-severe group). During follow-up, 17 (7%) patients needed intensive care unit. Nine (3.6%) patients died.

Conclusion: Frequency and variety of neurological findings in COVID-19 cases is too high to underestimate. Early diagnosis of these findings may prevent spread of COVID-19.