Archives of Academic Emergency Medicine (Apr 2021)

Neurological Manifestations and their Correlated Factors in COVID-19 Patients; a Cross-Sectional Study

  • Farzad Ashrafi,
  • Davood Ommi,
  • Alireza Zali,
  • Sina Khani,
  • Amirali Soheili,
  • Mehran Arab-Ahmadi,
  • Behdad Behnam,
  • Shabnam Nohesara,
  • Farbod Semnani,
  • Alireza Fatemi,
  • Mehri Salari,
  • Reza Jalili khoshnood,
  • Mohammad Vahidi,
  • Niloofar Ayoobi-Yazdi,
  • Saeed Hosseini Toudeshki,
  • Elham Sobhrakhshankhah

DOI
https://doi.org/10.22037/aaem.v9i1.1210
Journal volume & issue
Vol. 9, no. 1

Abstract

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Introduction: COVID-19 might present with other seemingly unrelated manifestations; for instance, neurological symptoms. This study aimed to evaluate the neurologic manifestations and their correlated factors in COVID-19 patients. Methods: This retrospective observational study was conducted from March 17, 2020 to June 20, 2020 in a tertiary hospital in Iran. The study population consisted of adult patients with a positive result for COVID-19 real-time reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal swabs. Both written and electronic data regarding baseline characteristic, laboratory findings, and neurological manifestations were evaluated and reported. Results: 727 COVID-19 patients with the mean age of 49.94 ± 17.49 years were studied (56.9% male). At least one neurological symptom was observed in 403 (55.4%) cases. Headache (29.0%), and smell (22.3%) and taste (22.0%) impairment were the most prevalent neurological symptoms, while seizure (1.1%) and stroke (2.3%) were the least common ones. Patients with neurological manifestations were significantly older (p = 0.04), had greater body mass index (BMI) (p = 0.02), longer first symptom to admission duration (p < 0.001) and were more frequently opium users (p = 0.03) compared to COVID-19 patients without neurological symptoms. O2 saturation was significantly lower in patients with neurological manifestations (p = 0.04). In addition, medians of neutrophil count (p = 0.006), neutrophil-lymphocyte ratio (NLR) (p = 0.02) and c-reactive protein (CRP) (p = 0.001) were significantly higher and the median of lymphocyte count (p = 0.03) was significantly lower in patients with neurological manifestations. Conclusion: The prevalence of neurological manifestations in the studied cases was high (55.4%). This prevalence was significantly higher in older age, grated BMI, longer lasting disease, and opium usage.

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