Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series

Neurological disorders associated with SARS-CoV-2 infection represent a clinical challenge because they encompass a broad neurological spectrum and may occur before the diagnosis of COVID-19. In this monocentric retrospective case series, medical records from patients with acute neurological disorde...

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Bibliographic Details
Published in:Revue neurologique 2021-03, Vol.177 (3), p.275-282
Main Authors: Cleret de Langavant, L., Petit, A., Nguyen, Q.T.R., Gendre, T., Abdelhedi, J., Djellaoui, A., Seddik, L., Lim, L., Faugeras, F., Salhi, H., Wahab, A., Fechtenbaum, L., Dormeuil, A., Hosseini, H., Youssov, K., Fénelon, G., Bapst, B., Brugières, P., Tuilier, T., Kalsoum, E., Matignon, M.-B., Oniszczuk, J., Gallien, S., Vindrios, W., Melica, G., Scain, A.-L., Esser, R., Rostain, L., Guillaud, C., Dubos-Lascu, G., Saada, N., Guillet, H., Khellaf, M., Bardel, B., Ayache, S.S., Lefaucheur, J.-P., Pawlotsky, J.-M., Fourati, S., Bachoud-Lévi, A.-C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Amyotrophic Lateral Sclerosis
COVID-19 - complications
COVID-19 - epidemiology
COVID-19 - psychology
Diaphragmatic ultrasonography
Female
Humans
Life Sciences
Male
Middle Aged
Nervous System Diseases - epidemiology
Nervous System Diseases - etiology
Nervous System Diseases - virology
Original
Paris - epidemiology
Phrenic nerve conduction
Pulmonary function tests
Retrospective Studies
SARS-CoV-2 - physiology
Young Adult
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Summary:Neurological disorders associated with SARS-CoV-2 infection represent a clinical challenge because they encompass a broad neurological spectrum and may occur before the diagnosis of COVID-19. In this monocentric retrospective case series, medical records from patients with acute neurological disorders associated with SARS-CoV-2 infection from medicine departments of an academic center in Paris area were collected between March 15th and May 15th 2020. Diagnosis of SARS-CoV-2 was ascertained through specific RT-PCR in nasopharyngeal swabs or based on circulating serum IgG antibodies. Twenty-six patients diagnosed with SARS-CoV-2 infection presented with neurological disorders: encephalitis (N=8), encephalopathy (N=6), cerebrovascular events (ischemic strokes N=4 and vein thromboses N=2), other central nervous system (CNS) disorders (N=4), and Guillain-Barré syndrome (N=2). The diagnosis of SARS-CoV-2 was delayed on average 1.6 days after the onset of neurological disorder, especially in case of encephalitis 3.9 days, encephalopathy 1.0 day, and cerebrovascular event 2.7 days. Our study confirms that COVID-19 can yield a broad spectrum of neurological disorders. Because neurological presentations of COVID-19 often occur a few days before the diagnosis of SARS-COV-2 infection, clinicians should take preventive measures such as patient isolation and masks for any new admission to avoid nosocomial infections. Anti-SARS-CoV2 antibody detection in RT-PCR SARS CoV-2 negative suspected cases is useful to confirm a posteriori the diagnosis of atypical COVID-19 presentations.
ISSN:0035-3787
0035-3787
DOI:10.1016/j.neurol.2021.01.004