Keywords
SARS-CoV-2
Neurological changes
Central Nervous System
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Abstract
Objective: To analyze neurological and behavioral disorders of SARS-CoV-2 infection in Brazil. Methods: A retrospective observational study was conducted from the DATASUS database. Variables such as disturbances in consciousness/altered mental status, psychopathological manifestations, mortality rate and ICU admission rate evaluated by odds ratio (OR) and two-tailed test (p-value). Results: Neurological and behavioral disorders were reported in 564 (3.13%) patients, manifesting confusion (0.77%), lowered level of consciousness (LLC) (0.46%), drowsiness (0.37%), decreased general status (0.37%), and syncope (0.32%). LLC (OR: 3.04, p < 0.01), disorientation (OR: 2.62, p < 0.01), confusion (OR: 2.29, p < 0.01), decreased general status (OR: 2.09, p < 0.01) and sensory alteration (OR:1.91, p = 0.03) were significantly associated with mortality in hospitalized COVID-19 patients. Vertigo showed a negative association with disease mortality (OR: 0.26, p < 0.01) and agitation had the highest mortality observed (82%, p < 0.01). Conclusion: Vertigo was negatively associated with mortality, while RNC, disorientation, confusion, decreased general status and sensory changes was positive.
References
AGHAGOLI G, et. al. Neurological Involvement in COVID-19 and Potential Mechanisms: A Review. Neurocrit Care, 2021; 34(3): 1062-1071.
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.
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.
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.
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.
DRABIK L, et al. Neurological Prognostic Factors in Hospitalized Patients with COVID-19. Brain Sci., 2022; 12(2):193.
ESKANDAR EN, et al. Neurologic Syndromes Predict Higher In-Hospital Mortality in COVID-19. Neurology, 2021; 96(11): e1527-e1538.
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.
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.
GENEROSO JS, et al. Neurobiology of COVID-19: how can the virus affect the brain? Braz J Psychiatry, 2021; 43(6): 650–664.
HAKI C, et al. Neurological Symptoms and Diagnoses in Patients Hospitalized With COVID-19: Relationships With Mortality. Neurologist, 2021; 26(6): 237-243.
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.
HE Y, et al. What can the neurological manifestations of COVID-19 tell us: a meta-analysis. J Transl Med., 2021; 19(1): 363.
HELMS J, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med., 2020; 382(23): 2268-2270.
LEVEN Y e BÖSEL J. Neurological manifestations of COVID-19 - an approach to categories of pathology. Neurol Res Pract., 2021; 3(1): 39.
LIOTTA EM, et al. Frequent neurologic manifestations and encephalopathy-associated morbidity in COVID-19 patients. Ann Clin Transl Neurol., 2020; 7(11): 2221- 2230.
MAHALAKSHMI AM, et al. Does COVID-19 contribute to development of neurological disease? Immun Inflamm Dis., 2021; 9(1): 48–58.
MUELLER AL, et al. Why does COVID-19 disproportionately affect older people? Aging (Albany NY), 2020; 12(10): 9959-9981.
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.
PARK J, et al. Clinical Implications of Neurological Comorbidities and Complications in ICU Patients with COVID-19. J Clin Med., 2021; 10(11): 2281.
PEZZINI A e PADOVANI A. Lifting the mask on neurological manifestations of COVID-19. Nat Rev Neurol., 2020; 16(11): 636-644.
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.
ROMERO-SÁNCHEZ CM, et al. Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology, 2020; 95(8): e1060-e1070.
ROY D, et al. Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. Can J Neurol Sci., 2021; 48(1): 9-24.
SALAHUDDIN H, et al. Neurological Predictors of Clinical Outcomes in Hospitalized Patients With COVID-19. Front Neurol., 2020; 11: 585944.
SCHIRINZI T, et al. COVID-19: dealing with a potential risk factor for chronic neurological disorders. J Neurol., 2021; 268(4): 1171-1178.
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.
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.
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.
SOLOMON IH, et al. Neuropathological Features of Covid-19. N Engl J Med., 2020; 383(10): 989-992.
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.
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.
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.
TYSON B, et al. Altered mental status in 71 deaths due to COVID-19. Int J Neurosci., 2022; 132(6): 539-542.
WANG F, et al. Long-Term Respiratory and Neurological Sequelae of COVID-19. Med Sci Monit., 2020; 26: e928996.
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.
XIONG W, et al. Association of consciousness impairment and mortality in people with COVID‐19. Acta Neurol Scand., 2021; 144(3): 251–259.
XIONG W, et al. New onset neurologic events in people with COVID-19 in 3 regions in China. Neurology, 2020; 95(11): e1479-e1487.
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.
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.