Frequency and burden of neurological manifestations upon hospital presentation in COVID-19 patients: Findings from a large Brazilian cohort

Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection and outcomes in the Brazilian population. This study is part of the...

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Published in:Journal of the neurological sciences 2022-12, Vol.443, p.120485-120485, Article 120485
Main Authors: Marcolino, Milena Soriano, Anschau, Fernando, Kopittke, Luciane, Pires, Magda Carvalho, Barbosa, Izabela Guimarães, Pereira, Daniella Nunes, Ramos, Lucas Emanuel Ferreira, Assunção, Luís Fernando Israel, Costa, André Soares de Moura, Nogueira, Matheus Carvalho Alves, Duani, Helena, Martins, Karina Paula Medeiros Prado, Moreira, Leila Beltrami, Silva, Carla Thais Cândida Alves da, Oliveira, Neimy Ramos de, Ziegelmann, Patricia Klarmann, Guimarães-Júnior, Milton Henriques, Lima, Mauro Oscar Soares de Souza, Aguiar, Rubia Laura Oliveira, Menezes, Luanna Silva Monteiro, Oliveira, Talita Fischer, Souza, Maíra Dias, Farace, Bárbara Lopes, Cimini, Christiane Corrêa Rodrigues, Maurílio, Amanda de Oliveira, Guimarães, Silvana Mangeon Mereilles, Araújo, Silvia Ferreira, Nascimento, Guilherme Fagundes, Silveira, Daniel Vitório, Ruschel, Karen Brasil, Oliveira, Thainara Conceição de, Schwarzbold, Alexandre Vargas, Nasi, Luiz Antônio, Floriani, Maiara Anschau, Santos, Veridiana Baldon dos, Ramos, Carolina Marques, Alvarenga, Joice Coutinho de, Scotton, Ana Luiza Bahia Alves, Manenti, Euler Roberto Fernandes, Crestani, Gabriela Petry, Batista, Joanna d'Arc Lyra, Ponce, Daniela, Machado-Rugolo, Juliana, Bezerra, Adriana Falangola Benjamin, Martelli, Petrônio José de Lima, Vianna, Heloisa Reniers, Castro, Luís César de, Medeiros, Cássia Regina Gotler, Vietta, Giovanna Grunewald, Pereira, Elayne Crestani, Chatkin, José Miguel, Godoy, Mariana Frizzo de, Delfino-Pereira, Polianna, Teixeira, Antonio Lucio
Format: Article
Language:English
Subjects:
Ageusia - epidemiology
Ageusia - etiology
Anosmia
Brazil - epidemiology
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
Delirium
Headache - epidemiology
Headache - etiology
Hospitals
Humans
Neurologic manifestations
Prognosis
SARS-CoV-2
Shock, Septic - complications
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Summary:Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection and outcomes in the Brazilian population. This study is part of the Brazilian COVID-19 Registry, a multicentric cohort, including data from 37 hospitals. For the present analysis, patients were grouped according to the presence of reported symptoms (i.e., headache; anosmia and ageusia; syncope and dizziness) vs. clinically-diagnosed neurological manifestations (clinically-defined neurological syndrome: neurological signs or diagnoses captured by clinical evaluation) and matched with patients without neurological manifestations by age, sex, number of comorbidities, hospital of admission, and whether or not patients had underlying neurological disease. From 6,635 hospitalized patients with COVID-19, 30.8% presented reported neurological manifestations, 10.3% were diagnosed with a neurological syndrome and 60.1% did not show any neurological manifestations. In patients with reported symptoms, the most common ones were headache (20.7%), ageusia (11.1%) and anosmia (8.0%). In patients with neurological syndromes, acute encephalopathy was the most common diagnosis (9.7%). In the matched analysis, patients with neurological syndromes presented more cases of septic shock (17.0 vs. 13.0%, p = 0.045), intensive care unit admission (45.3 vs. 38.9%, p = 0.023), and mortality (38.7 vs. 32.6%, p = 0.026; and 39.2 vs. 30.3%, p 
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2022.120485