Manifestações neurológicas e comportamentais em pacientes com COVID-19
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Sep 30, 2023
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Resumo
Objetivo: Analisar distúrbios neurológicos e comportamentais da infecção pelo SARS-CoV-2 no Brasil. Métodos: Foi realizado um estudo observacional retrospectivo a partir da base de dados DATASUS. Variáveis como distúrbios na consciência/estado mental alterado, manifestações psicopatológicas, taxa de mortalidade e taxa de internação na UTI avaliadas por razão de chances (OR) e teste bicaudal (valor-p). Resultados: Distúrbios neurológicos e comportamentais foram reportados em 564 (3,13%) pacientes, manifestando confusão (0,77%), rebaixamento do nível da consciência (RNC) (0,46%), sonolência (0,37%) e queda do estado geral (0,37%). RNC (OR: 3.04, p < 0.01), desorientação (OR: 2.62, p < 0.01), confusão (OR: 2.29, p < 0.01), queda do estado geral (OR: 2.09, p < 0.01) e alteração sensorial (OR:1.91, p = 0.03) foram associados significativamente a mortalidade em pacientes com COVID-19 hospitalizados. Vertigem apresentou associação negativa com mortalidade da doença (OR: 0.26, p < 0.01) e agitação apresentou a maior mortalidade observada (82%, p < 0.01). Conclusão: Vertigem foi associada negativamente a mortalidade, enquanto RNC, desorientação, confusão, queda do estado geral e alterações sensoriais foi positivo.
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Como Citar
CunhaG. da, MedeirosP., CatalanD. T., & AnaniasF. (2023). Manifestações neurológicas e comportamentais em pacientes com COVID-19. Revista Eletrônica Acervo Saúde, 23(9), e13656. https://doi.org/10.25248/reas.e13656.2023
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Referências
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28. SHAO SC, et al. Prevalence, incidence and mortality of delirium in patients with COVID-19: a systematic review and meta-analysis. Age Ageing, 2021; 50(5): 1445-1453.
29. SINGAL CMS, et al. SARS-CoV-2, More than a Respiratory Virus: Its Potential Role in Neuropathogenesis. ACS Chem Neurosci., 2020; 11(13): 1887-1899.
30. SOLOMON IH, et al. Neuropathological Features of Covid-19. N Engl J Med., 2020; 383(10): 989-992.
31. STEFANO ML, et al. A Novel Vaccine Employing Non-Replicating Rabies Virus Expressing Chimeric SARS-CoV-2 Spike Protein Domains: Functional Inhibition of Viral/Nicotinic Acetylcholine Receptor Complexes. Med Sci Monit., 2020; 26: e926016.
32. TICINESI A, et al. Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital. Aging Clin Exp Res., 2020; 32(10): 2159-2166.
33. TRIGO J, et al. Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study. J Headache Pain, 2020; 21(1): 94.
34. TYSON B, et al. Altered mental status in 71 deaths due to COVID-19. Int J Neurosci., 2022; 132(6): 539-542.
35. WANG F, et al. Long-Term Respiratory and Neurological Sequelae of COVID-19. Med Sci Monit., 2020; 26: e928996.
36. WNUK M, et al. Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality. Neurol Neurochir Pol., 2021; 55(3): 314-321.
37. XIONG W, et al. Association of consciousness impairment and mortality in people with COVID‐19. Acta Neurol Scand., 2021; 144(3): 251–259.
38. XIONG W, et al. New onset neurologic events in people with COVID-19 in 3 regions in China. Neurology, 2020; 95(11): e1479-e1487.
39. YUKSEL H, et al. Neurological manifestations of COVID-19 in confirmed and probable cases: A descriptive study from a large tertiary care center. J Clin Neurosci., 2021; 86: 97-102.
40. ZIELIŃSKA-TUREK J, et al. Clinical features of neurological patients with coronavirus 2019: an observational study of one centre. Neurol Neurochir Pol., 2021; 55(2): 195-201.
2. BAIG AM, et al. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci., 2020; 11(7): 995-998.
3. CHOU SH, et al. Global Incidence of Neurological Manifestations Among Patients Hospitalized With COVID-19-A Report for the GCS-NeuroCOVID Consortium and the ENERGY Consortium. JAMA Netw Open, 2021; 4(5): 1-14.
4. COLLANTES MEV, et al. Neurological Manifestations in COVID-19 Infection: A Systematic Review and Meta-Analysis. Can J Neurol Sci., 2021; 48(1): 66-76.
5. DENG J, et al. The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis. Ann N Y Acad Sci., 2021; 1486(1): 90-111.
6. DRABIK L, et al. Neurological Prognostic Factors in Hospitalized Patients with COVID-19. Brain Sci., 2022; 12(2):193.
7. ESKANDAR EN, et al. Neurologic Syndromes Predict Higher In-Hospital Mortality in COVID-19. Neurology, 2021; 96(11): e1527-e1538.
8. FRONTERA JA, et al. A Prospective Study of Neurologic Disorders in Hospitalized Patients With COVID-19 in New York City. Neurology, 2021; 96(4): e575-e586.
9. GARCÍA-AZORÍN D, et al. Neurological Comorbidity Is a Predictor of Death in Covid-19 Disease: A Cohort Study on 576 Patients. Front Neurol., 2020; 11: 781.
10. GENEROSO JS, et al. Neurobiology of COVID-19: how can the virus affect the brain? Braz J Psychiatry, 2021; 43(6): 650–664.
11. HAKI C, et al. Neurological Symptoms and Diagnoses in Patients Hospitalized With COVID-19: Relationships With Mortality. Neurologist, 2021; 26(6): 237-243.
12. HARAPAN BN e YOO HJ. Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19). J Neurol., 2021; 268(9): 3059–3071.
13. HE Y, et al. What can the neurological manifestations of COVID-19 tell us: a meta-analysis. J Transl Med., 2021; 19(1): 363.
14. HELMS J, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med., 2020; 382(23): 2268-2270.
15. LEVEN Y e BÖSEL J. Neurological manifestations of COVID-19 - an approach to categories of pathology. Neurol Res Pract., 2021; 3(1): 39.
16. LIOTTA EM, et al. Frequent neurologic manifestations and encephalopathy-associated morbidity in COVID-19 patients. Ann Clin Transl Neurol., 2020; 7(11): 2221- 2230.
17. MAHALAKSHMI AM, et al. Does COVID-19 contribute to development of neurological disease? Immun Inflamm Dis., 2021; 9(1): 48–58.
18. MUELLER AL, et al. Why does COVID-19 disproportionately affect older people? Aging (Albany NY), 2020; 12(10): 9959-9981.
19. NETLAND J, et al. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol., 2008; 82(15): 7264-7275.
20. PARK J, et al. Clinical Implications of Neurological Comorbidities and Complications in ICU Patients with COVID-19. J Clin Med., 2021; 10(11): 2281.
21. PEZZINI A e PADOVANI A. Lifting the mask on neurological manifestations of COVID-19. Nat Rev Neurol., 2020; 16(11): 636-644.
22. ROGERS JP, et al. Neurology and neuropsychiatry of COVID-19: a systematic review and meta-analysis of the early literature reveals frequent CNS manifestations and key emerging narratives. J Neurol Neurosurg Psychiatry, 2021; 92(9): 932-941.
23. ROMERO-SÁNCHEZ CM, et al. Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology, 2020; 95(8): e1060-e1070.
24. ROY D, et al. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci., 2021; 48(1): 9-24.
25. SALAHUDDIN H, et al. Neurological Predictors of Clinical Outcomes in Hospitalized Patients With COVID-19. Front Neurol., 2020; 11: 585944.
26. SCHIRINZI T, et al. COVID-19: dealing with a potential risk factor for chronic neurological disorders. J Neurol., 2021; 268(4): 1171-1178.
27. SERRANO-CASTRO PJ, et al. Impact of SARS-CoV-2 infection on neurodegenerative and neuropsychiatric diseases: a delayed pandemic? Neurología (Engl Ed), 2020; 35(4): 245-251.
28. SHAO SC, et al. Prevalence, incidence and mortality of delirium in patients with COVID-19: a systematic review and meta-analysis. Age Ageing, 2021; 50(5): 1445-1453.
29. SINGAL CMS, et al. SARS-CoV-2, More than a Respiratory Virus: Its Potential Role in Neuropathogenesis. ACS Chem Neurosci., 2020; 11(13): 1887-1899.
30. SOLOMON IH, et al. Neuropathological Features of Covid-19. N Engl J Med., 2020; 383(10): 989-992.
31. STEFANO ML, et al. A Novel Vaccine Employing Non-Replicating Rabies Virus Expressing Chimeric SARS-CoV-2 Spike Protein Domains: Functional Inhibition of Viral/Nicotinic Acetylcholine Receptor Complexes. Med Sci Monit., 2020; 26: e926016.
32. TICINESI A, et al. Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital. Aging Clin Exp Res., 2020; 32(10): 2159-2166.
33. TRIGO J, et al. Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study. J Headache Pain, 2020; 21(1): 94.
34. TYSON B, et al. Altered mental status in 71 deaths due to COVID-19. Int J Neurosci., 2022; 132(6): 539-542.
35. WANG F, et al. Long-Term Respiratory and Neurological Sequelae of COVID-19. Med Sci Monit., 2020; 26: e928996.
36. WNUK M, et al. Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality. Neurol Neurochir Pol., 2021; 55(3): 314-321.
37. XIONG W, et al. Association of consciousness impairment and mortality in people with COVID‐19. Acta Neurol Scand., 2021; 144(3): 251–259.
38. XIONG W, et al. New onset neurologic events in people with COVID-19 in 3 regions in China. Neurology, 2020; 95(11): e1479-e1487.
39. YUKSEL H, et al. Neurological manifestations of COVID-19 in confirmed and probable cases: A descriptive study from a large tertiary care center. J Clin Neurosci., 2021; 86: 97-102.
40. ZIELIŃSKA-TUREK J, et al. Clinical features of neurological patients with coronavirus 2019: an observational study of one centre. Neurol Neurochir Pol., 2021; 55(2): 195-201.