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Neurologic Manifestations Seen in Most Hospitalized With COVID-19

Encephalopathy, seen in 31.8 percent of hospitalized patients, tied to worse functional outcome, mortality

WEDNESDAY, Oct. 7, 2020 (HealthDay News) — Neurologic manifestations are common in COVID-19, occurring in 82.3 percent of hospitalized patients, according to a study published online Oct. 5 in the Annals of Clinical and Translational Neurology.

Eric M. Liotta, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues characterized neurologic manifestations, their risk factors, and associated outcomes in 509 consecutive patients admitted with confirmed COVID-19 within a hospital network.

The researchers found that neurologic manifestations were present in 42.2, 62.7, and 82.3 percent of patients at COVID-19 onset, at hospitalization, and at any time during the disease course. Myalgias, headaches, encephalopathy, dizziness, dysgeusia, and anosmia were the most frequent neurologic manifestations (44.8, 37.7, 31.8, 29.7, 15.9, and 11.4 percent, respectively). Uncommon manifestations included strokes, movement disorders, motor and sensory deficits, ataxia, and seizures (ranging from 0.2 to 1.4 percent of patients each). Overall, 26.3 percent of patients had severe respiratory disease requiring mechanical ventilation. Severe COVID-19 and younger age were independent risk factors for developing any neurologic manifestation (odds ratios, 4.02 and 0.982, respectively). Overall, 71.1 percent of the patients had a favorable functional outcome at discharge. Encephalopathy was independently associated with worse functional outcome (odds ratio, 0.22) and with higher mortality within 30 days of hospitalization (21.7 versus 3.2 percent).

“Patients and clinicians need to be aware of the high frequency of neurologic manifestations of COVID-19 and the severity of altered mental function associated with this disease,” a coauthor said in a statement.

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