Neurologic manifestations in 1760 COVID-19 patients admitted to Papa Giovanni XXIII Hospital, Bergamo, Italy
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Neurologic manifestations in 1760 COVID‑19 patients admitted to Papa Giovanni XXIII Hospital, Bergamo, Italy Nicola Rifino1 · Bruno Censori2,4 · Emanuela Agazzi2 · Dario Alimonti1,2 · Virginio Bonito2 · Giorgia Camera2 · Marta Zaffira Conti2 · Camillo Foresti2 · Barbara Frigeni2 · Simonetta Gerevini3 · Maria Grimoldi2 · Sara La Gioia2 · Tania Partziguian2 · Stefano Quadri2 · Riccardo Riva2 · Maria Cristina Servalli2 · Manlio Sgarzi2 · Benedetta Storti1 · Marcella Vedovello2 · Elisabetta Venturelli2 · Martina Viganò1 · Annapaola Callegaro5 · Marco Arosio5 · Maria Sessa2 Received: 21 July 2020 / Revised: 22 September 2020 / Accepted: 29 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives Evidences from either small series or spontaneous reporting are accumulating that SARS-CoV-2 involves the Nervous Systems. The aim of this study is to provide an extensive overview on the major neurological complications in a large cohort of COVID-19 patients. Methods Retrospective, observational analysis on all COVID-19 patients admitted from February 23rd to April 30th, 2020 to ASST Papa Giovanni XXIII, Bergamo, Italy for whom a neurological consultation/neurophysiological assessment/neuroradiologic investigation was requested. Each identified neurologic complication was then classified into main neurologic categories. Results Of 1760 COVID-19 patients, 137 presented neurologic manifestations that manifested after COVID-19 symptoms in 98 pts and was the presenting symptom in 39. Neurological manifestations were classified as: (a) cerebrovascular disease [53 pts (38.7%)] including 37 ischemic and 11 haemorrhagic strokes, 4 transient ischemic attacks, 1 cerebral venous thrombosis; (b) peripheral nervous system diseases [31 (22.6%)] including 17 Guillain–Barrè syndromes; (c) altered mental status [49 (35.8%)] including one necrotizing encephalitis and 2 cases with RT-PCR detection of SARS-Cov-2 RNA in CSF; (d) miscellaneous disorders, among whom 2 patients with myelopathy associated with Ab anti-SARS-CoV-2 in CSF. Patients with peripheral nervous system involvement had more frequently severe ARDS compared to patients with cerebrovascular disease (87.1% vs 42%; difference = 45.1% 95% CI 42.0–48.2; χ2= 14.306; p
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