Neurological manifestations caused by COVID-19 in Alagoas, Brasil

Abstract

Introduction: COVID-19 affects several vital organs, including the brain, and can cause neurological manifestations. Objective: To characterize the neurological manifestations of hospitalized patients with laboratory confirmation of COVID-19, between May and August, 2020. Design and setting: Observational study at Veredas Hospital and University Hospital Professor Alberto Antunes in Alagoas, Brazil. Methods: Socio-demographic data, infectious and neurological symptoms, risk factors for neurological and infectious diseases, clinical history, treatment instituted and outcome of patients were collected. Results: We included 30 patients with a mean age of 61.05 ± 18.65 years, 70% were female. The average between the onset of COVID-19 symptoms and hospital admission was 10 ± 9.7 days. Systemic arterial hypertension (66.7%) and diabetes mellitus (63.3%) were the main comorbidities. Cough, fever (60%) and dyspnea (56.7%) stood out in general symptoms. The most frequent neurological symptoms were changes in the level of consciousness (56.7%), epileptic seizures (33.3%) and motor deficits (23.3%). Ischemic stroke (40%) was the main neurological diagnosis, followed by epileptic seizures (33.3%), delirium (13.3%), encephalitis (10%), SAH (6.6%), vasculitis (6, 6%), hemorrhagic stroke, TIA, cranial neuropathy, meningitis and peripheral neuropathy (3.3% each). Regarding treatment, 100% used antibiotic therapy, 96.7% prophylactic heparin, 50% mechanical ventilation, 46.7% antiparasitic, 20% vasoactive drugs and 6.7% hydroxychloroquine. The death rate was 40%. Conclusions: Neurological manifestations by patients with COVID-19 are not uncommon, presenting in different ways, and can be potentially fatal. The main neurological symptom was changes in the level of consciousness and diagnosis, ischemic stroke.