Clinical characteristics of 365 hospitalized COVID-19 patients with neurological symptoms: an observational study

• Published in: Acta neurologica Belgica 2023-10, Vol.123 (5), p.1805-1811
• Main Authors: Vahabizad, Fahimeh, Togha, Mansoureh, Ariyanfar, Shadi, Fattahi, Mohammad-Reza, Haghighi, Samaneh, Ebadi, Zahra, Ahmadi Karvigh, Sanaz, Heidari, Sara, Shafaei, Maryam, Ashraf, Hale, Haddadi, Azar, Talebpour, Mohammad, Safaei, Arash, Asefi, Hoda
• Format: Article
• Language: English
• Subjects: Biomedical and Life Sciences; Biomedicine; Medicine/Public Health; Neurology; Neuroradiology; Neurosciences; Original; Original Article
• ISSN: 0300-9009; 2240-2993
• DOI: 10.1007/s13760-022-02027-7

Objective Since the beginning of the COVID-19 pandemic, a number of COVID-related neurological manifestations have been reported. We aimed to categorize the features of hospitalized COVID-19 patients who experienced neurological symptoms. Methods In this descriptive, cross-sectional study, we enrolled all patients hospitalized with COVID-19 who experienced neurological symptoms in two hospitals in Tehran. Diagnosis of COVID-19 was established by PCR tests or computed tomography of the chest combined with COVID-19 clinical findings. The clinical characteristics, laboratory data, and imaging findings from 365 patients were analyzed. Results The average patient age was 59.2 ± 16.7 years and included 213 males and 152 females. The most prevalent neurological symptoms were headache (56.2%), impaired consciousness (55%), and dizziness (20.5%). During hospitalization, most of the patients did not require mechanical ventilation (81.9%). The percentage of patients with end-organ damage was 9% and mortality was 15%. Regression analysis on the neurological symptoms indicated that the mortality rate of patients with headaches was 84% lower than for the other neurological symptoms. Hyperglycemia was significantly related with end-organ damage and mortality ( p  = 0.029, p  = 0.08, respectively). New vascular lesions were evident on brain MRIs of 9 patients and brain CTs of 16 patients. Conclusion Among the neurological symptoms of patients with COVID-19, headache appeared to indicate a protective factor against development of end-organ damage as well as mortality.