Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study

By L. Mao, Mengdie Wang, Shan-hui Chen, Quanwei He, Jiang Chang, Can‐dong Hong, Yi-fan Zhou, David Wang, Ya‐nan Li, Huijuan Jin and 1 more. medRxiv, 2020

983 citations recorded by the source corpus.

OBJECTIVE: To study the neurological manifestations of patients with coronavirus disease 2019 (COVID-19). DESIGN: Retrospective case series SETTING: Three designated COVID-19 care hospitals of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China. PARTICIPANTS: Two hundred fourteen hospitalized patients with laboratory confirmed diagnosis of severe acute respiratory syndrome from coronavirus 2 (SARS-CoV-2) infection. Data were collected from 16 January 2020 to 19 February 2020. MAIN OUTCOME MEASURES: Clinical data were extracted from electronic medical records and reviewed by a trained team of physicians. Neurological symptoms fall into three categories: central nervous system (CNS) symptoms or diseases (headache, dizziness, impaired consciousness, ataxia, acute cerebrovascular disease, and epilepsy), peripheral nervous system (PNS) symptoms (hypogeusia, hyposmia, hypopsia, and neuralgia), and skeletal muscular symptoms. Data of all neurological symptoms were checked by two trained neurologists. RESULTS: Of 214 patients studied, 88 (41.1%) were severe and 126 (58.9%) were non-severe patients. Compared with non-severe patients, severe patients were older (58.7 ± 15.0 years vs 48.9 ± 14.7 years), had more underlying disorders (42 [47.7%] vs 41 [32.5%]), especially hypertension (32 [36.4%] vs 19 [15.1%]), and showed less typical symptoms such as fever (40 [45.5%] vs 92 [73%]) and cough (30 [34.1%] vs 77 [61.1%]). Seventy-eight (36.4%) patients had neurologic manifestations. More severe patients were likely to have neurologic symptoms (40 [45.5%] vs 38 [30.2%]), such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]) and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]). CONCLUSION: Compared with non-severe patients with COVID-19, severe patients commonly had neurologic symptoms manifested as acute cerebrovascular diseases, consciousness impairment and skeletal muscle symptoms.

Subfields: Infectious Diseases, Neurology

View Paper: https://www.semanticscholar.org/paper/9e97913941d6df5b4e187cee5a1e284be39c354f

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In Infectious Diseases

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Citations in the corpus

• COVID-19, ACE2, and the cardiovascular consequences (2020, positive): “On the basis of studies on SARS-CoV and recent reports of the presence of viral load in the brain stem with SARS-CoV-2, a similar transfer of virus to the brain by ACE2 may occur via internalization and transport by various cranial nerves (32, 35).”
• Central nervous system manifestations of COVID-19: A systematic review (2020, background): “However, to ensure literature saturation, the authors scanned the reference lists of the included studies and could identify multiple references [9] [10] [11] [12] [13] [14] .”
• Nervous system involvement after infection with COVID-19 and other coronaviruses (2020, background): “Moreover, almost 40% of patients with COVID-19 develop headache, disturbed consciousness, and other brain dysfunction symptoms (Mao et al., 2020), and that an autopsy study reported that edema has been detected in brain tissue of COVID-19 patients (Xu et al., 2020).”
• Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence (2020, neutral): “In a study of 214 COVID-19 patients, 78 (36.4%) patients had neurological manifestations [32] .”
• A Review of SARS-CoV-2 and the Ongoing Clinical Trials (2020, background): “Aside from the gastrointestinal symptoms, a retrospective study of 214 patients in China reported that 5.6 % of patients experienced hypogeusia and 5.1 % experienced hyposmia [9] .”
• The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients (2020, background): “More recently, one study on 214 COVID‐19 patients by Mao et al.(43) further found that about 88% (78/88) among the severe patients displayed”
• Anosmia and Ageusia: Common Findings in COVID‐19 Patients (2020, background): “[1] analyzed the frequency of neurological manifestations in 214 patients with coronavirus disease (COVID-19) identifying anosmia in 11 (5.”
• COVID-19 Artificial Intelligence Diagnosis Using Only Cough Recordings (2020, background): “Studies [14] show a cognitive decline in COVID-19 patients and clinical evidence supports the importance of sentiments in the early-diagnosis of neurodegenerative decline [19, 30].”