Characteristics, onset, and evolution of neurological symptoms in patients with COVID-19
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COVID-19
Characteristics, onset, and evolution of neurological symptoms in patients with COVID-19 Imen Kacem 1,2 & Alya Gharbi 1,2 & Chahida Harizi 2,3 & Emira Souissi 1,2 & Mouna Safer 2,4 & Amina Nasri 1,2 & Hajer Letaief 2,4 & Manel Akkari 1,2 & Aicha Hechaichi 2,4 & Saloua Mrabet 1,2 & Sonia Dhaouadi 2,4 & Mouna Ben Djebara 1,2 & Sondes Derouiche 2,4 & Amina Gargouri 1,2 & Mohamed Chahed 2,5 & Nissaf Ben Alaya 2,4 & Riadh Gouider 1,2 Received: 27 August 2020 / Accepted: 27 October 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background A wide range of neurological manifestations has been described in COVID-19. Methods In this nationwide retrospective observational study, patients in Tunisia diagnosed with COVID-19 between the 2nd of March and the 16th of May 2020 were contacted by telephone. We collected demographic and clinical data and specified characteristics and evolution of main neurological symptoms. Results Of 1034 confirmed COVID-19 patients, 646 were included (mean age 42.17 years old) and 466 (72.1%) had neurological symptoms. Neurological symptoms were isolated 22.7% (n = 106). Headache was the most frequent neurological symptom (n = 279, 41.1%): mainly frontotemporal (n = 143, 51.1%) and mild or moderate (n = 165, 59.1%). When associated with fever (n = 143, 51.3%), headache was more likely to be severe and present at onset. Recovery was reported in 83.2%. Smell and taste impairment were found in 37.9% (n = 245) and 36.8% (n = 238) respectively. Among them, 65.3% (156/239) were anosmic and 63.2% (146/231) were ageusic. A complete improvement was found in 72.1% (174/240) of smell impairment and in 76.8% (179/ 233) of taste impairment. Myalgia (n = 241, 37.3%) and sleep disturbances (n = 241, 37.3%) were also frequent. Imported cases had more neurological symptoms (p = 0.001). In 14.5%, neurological symptoms preceded the respiratory signs (RS). RS were associated with more frequent (p = 0.006) and numerous (p < 0.001) neurological symptoms. Conclusions Neurological symptoms in COVID-19 are frequent, can be isolated and present at onset. A total recovery is the most recorded outcome. RS are predictive of neurological symptoms. Studies in to virus and host genetics should be considered to understand the different phenotypes. Keywords COVID-19 . SARS-CoV-2 . Neurological . Symptoms/manifestations . Tunisia
Introduction * Riadh Gouider [email protected] 1
Department of Neurology, LR18SP03, Clinical Investigation Center of Neurosciences and Mental Health, Universitary Hospital Razi-Mannouba, Tunis, Tunisia
2
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
3
Department of Epidemiology and Statistics, Abderrahman Mami Hospital, Ariana, Tunisia
4
National Observatory of New and Emerging Diseases of Tunisia, Tunis, Tunisia
5
Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
The coronavirus disease of 2019 (COVID-19), caused by the 2019 novel coronavirus SARS-CoV-2 [1], emerged i
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