Neurological Manifestations in Critically Ill Patients With COVID-19: A Retrospective Study
Neurological Manifestations in Critically Ill Patients With COVID-19: A Retrospective Study
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DOI：
10.3389/fneur.2020.00806
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发表时间：
2020-07-10
影响因子：
3.4
通讯作者：
Guan, Hongzhi
中科院分区：
文献类型：
--
作者：
Fan, Siyuan;Xiao, Meng;Guan, Hongzhi
背景：2019冠状病毒病（COVID-19）的并发症涉及多个器官或系统，尤其是重症患者。我们的目标是调查COVID-19重症患者的神经系统并发症。方法：本回顾性单中心病例系列分析了2020年2月5日至4月2日在中国武汉同济医院重症监护室接受治疗的COVID-19重症患者。收集并分析人口统计学数据、临床和实验室检查结果、合并症和治疗。结果：在86例确诊的COVID-19患者中，54例（62.8%）为男性，平均（SD）年龄为66.6（11.1）岁。总体而言，65%的患者至少有一种神经系统症状。20例（23.3%）患者有中枢神经系统症状，包括谵妄、脑血管疾病和缺氧缺血性脑损伤，6例（7%）患者有神经肌肉受累。86例患者中有7例新发卒中，6例（7%）为缺血性卒中。缺血性脑卒中患者抗磷脂抗体阳性率明显高于非脑卒中患者（83.3%比26.9%，p < 0.05）。缺血性卒中患者更可能有较高的肌球蛋白水平和较低的血红蛋白水平。结论：COVID-19重症患者神经系统并发症的临床谱很广。中风、谵妄和神经肌肉疾病是COVID-19常见的神经系统并发症。医生应密切关注COVID-19重症患者的神经系统并发症。
Background:The complications of coronavirus disease 2019 (COVID-19) involved multiple organs or systems, especially in critically ill patients. We aim to investigate the neurological complications in critically ill patients with COVID-19. Methods:This retrospective single-center case series analyzed critically ill patients with COVID-19 at the intensive care unit of Tongji Hospital, Wuhan, China from February 5 to April 2, 2020. Demographic data, clinical and laboratory findings, comorbidities and treatments were collected and analyzed. Results:Among 86 patients with confirmed COVID-19, 54 patients (62.8%) were male, and the mean (SD) age was 66.6 (11.1) years. Overall, 65% patients presented with at least one neurological symptom. Twenty patients (23.3%) had symptoms involving the central nervous system, including delirium, cerebrovascular diseases and hypoxic-ischemic brain injury, while 6 patients (7%) had neuromuscular involvement. Seven of 86 patients exhibited new stroke and 6 (7%) cases were ischemic. A significantly higher prevalence of antiphospholipid antibodies was observed in patients with ischemic stroke than in those without stroke (83.3 vs. 26.9%,p< 0.05). Patients with ischemic stroke were more likely to have a higher myoglobulin level, and a lower hemoglobin level. Conclusions:The clinical spectrum of neurological complications in critically ill patients with COVID-19 was broad. Stroke, delirium and neuromuscular diseases are common neurological complications of COVID-19. Physicians should pay close attention to neurological complications in critically ill patients with COVID-19.