Annals of Indian Academy of Neurology (Jan 2022)

The spectrum of Neuro-COVID: A study of a comprehensively investigated large cohort from India

  • Seena Vengalil,
  • Rohan Mahale,
  • N Chakradhar,
  • Swathi Alluri,
  • P R Sagar Navanith,
  • V H Ganaraja,
  • K R Haripriya,
  • Holla Venkappayya Vikram,
  • Ajay Asranna,
  • Pooja Mailankody,
  • Doniparthi V Seshagiri,
  • H Manoj Cheerla,
  • V N Maturu,
  • C R Vaddepally,
  • Raghavendra Kenchaiah,
  • P R Srijithesh,
  • Jaydip Ray Chaudhuri,
  • M Netravathi,
  • Suvarna Alladi

DOI
https://doi.org/10.4103/aian.aian_310_21
Journal volume & issue
Vol. 25, no. 2
pp. 194 – 202

Abstract

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Background: Though reports of neurological manifestations of COVID-19 have emerged from various parts of the world, the cohorts reported are from the West and mostly derived from electronic databases. Much remains unknown regarding neuro-COVID in developing countries. India is the second-worst affected country, and this study reports the neurological manifestations of COVID-19 in a comprehensively evaluated cohort. Objective: The aim of this study was to describe the range of neurological manifestations of COVID-19 in India with an emphasis on the risk factors, laboratory and imaging findings and short-term outcome. Methods: Retrospective review of hospital records of all confirmed COVID-19 patients with neurological manifestations, receiving inpatient care in two neurology referral hospitals were done. All demographic, clinical details, investigations, and treatment were analysed. Results: A total of 120 confirmed COVID-19 cases presenting with neurological symptoms were included. The mean age of illness and duration of illness was 48.03 ± 17.3 years and 10.9 ± 17.3 days respectively. New onset of neurological symptoms occurred in 100 cases while 20 patients had worsening of pre-existing neurological illness. Stroke was the commonest neurological disorder (43%), followed by encephalopathy (23%) and Guillain-Barre syndrome (10%). Other unusual neurological manifestations included new-onset headache (7%), seizures including denovo status epilepticus (5%) and meningo-encephalitis (5%). Nearly half of the patients had preceding COVID-19 symptoms. Poor outcome at discharge was seen in 40% and mortality occurred in 15%. Conclusion: Stroke and encephalopathy constitute the most common neurological manifestations. The absence of preceding COVID-19 symptoms in nearly half the cases is striking. Poor outcome was seen in nearly 50% despite early recognition and management.

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