Neurological presentations of COVID-19: Findings from the Spanish Society of Neurology neuroCOVID-19 registry.
Neurological presentations of COVID-19: Findings from the Spanish Society of Neurology neuroCOVID-19 registry.
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COVID-19的神经学表现：来自西班牙神经病学学会神经COVID-19登记的结果。
DOI：
10.1016/j.jns.2020.117283
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发表时间：
2021-04-15
影响因子：
4.4
通讯作者：
Spanish neuroCOVID registry group
中科院分区：
文献类型：
--
作者：
García-Azorín D;Abildúa MJA;Aguirre MEE;Fernández SF;Moncó JCG;Guijarro-Castro C;Platas MG;Delgado FR;Andrés JML;Ezpeleta D;Spanish neuroCOVID registry group
我们报告了西班牙神经病学学会的NeuroCOVID-19注册表的研究结果。我们对有神经系统表现的新冠肺炎患者进行了一项多中心研究。参与研究的医生报告了人口统计学、临床和副临床数据，并判断新冠肺炎参与了导致神经症状的过程。总共提交了233个病例，包括74种不同的表现组合。最常见的报告是中风(27%)、神经肌肉症状(23.6%)、精神状态改变(23.6%)、嗅觉障碍(17.6%)、头痛(12.9%)和癫痫(11.6%)。患者的平均年龄为61.1岁，其中42.1%是女性；在精神状态改变、嗅觉障碍和头痛的患者中，女性比例较高。症状的出现因类别不同而有所不同。出现嗅觉障碍的平均(标准差)为2.9天(2.5天)，而神经肌肉症状出现时间为13.9天(10.1天)。33%的患者神经系统症状持续存在。97.7%的患者出现全身症状，99.4%的患者一般实验室检查结果异常。脑脊液分析异常率为62.7%(n=51)，但仅1例SARS-CoV-2阳性。新冠肺炎的神经系统表现多种多样。嗅觉障碍、肌痛和头痛出现在病程较早的阶段。精神状态改变、神经肌肉症状和中风与更严重的病情有关。新冠肺炎必须纳入大多数临床和放射学鉴别诊断。新冠肺炎可能会导致持续性和致残性的神经系统症状。
We report the findings from the Spanish Society of Neurology's NeuroCOVID-19 Registry. We performed a multicentre study of patients with neurological manifestations of COVID-19. Participating physicians reported demographic, clinical, and paraclinical data and judged the involvement of COVID-19 in causing neurological symptoms. A total of 233 cases were submitted, including 74 different combinations of manifestations. The most frequently reported were stroke (27%), neuromuscular symptoms (23.6%), altered mental status (23.6%), anosmia (17.6%), headache (12.9%), and seizures (11.6%). The mean age of patients was 61.1 years, with 42.1% being women; a higher proportion of women was recorded among patients with altered mental status, anosmia, and headache. The onset of symptoms differed within categories. Onset of anosmia occurred a mean (standard deviation) of 2.9 (2.5) days after the first general symptom, whereas neuromuscular symptoms appeared after 13.9 (10.1) days. Neurological symptoms were persistent in 33% of patients. General symptoms were present in 97.7% of patients, and results from general laboratory studies were abnormal in 99.4% of patients. Cerebrospinal fluid analysis findings were abnormal in 62.7% of the cases in which this test was performed (n = 51), but positive results for SARS-CoV-2 were only found in one case. The neurological manifestations of COVID-19 are diverse. Anosmia, myalgia, and headache occur earlier in the course of the disease. Altered mental status, neuromuscular symptoms, and stroke are associated with greater severity. COVID-19 must be incorporated into most clinical and radiological differential diagnoses. COVID-19 may cause persistent and disabling neurological symptoms.
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