Department of Neurology, LR18SP03, Clinical Investigation Center of Neurosciences and Mental Health, Universitary Hospital Razi-Mannouba, Tunis, Tunisia.
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Neurol Sci. 2021 Jan;42(1):39-46. doi: 10.1007/s10072-020-04866-9. Epub 2020 Nov 17.
A wide range of neurological manifestations has been described in COVID-19.
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.
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.
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.
在 COVID-19 中已描述了广泛的神经表现。
在这项全国性回顾性观察研究中，通过电话联系了 2020 年 3 月 2 日至 5 月 16 日期间在突尼斯被诊断为 COVID-19 的患者。我们收集了人口统计学和临床数据，并指明了主要神经系统症状的特征和演变。
在 1034 例确诊的 COVID-19 患者中，有 646 例（平均年龄为 42.17 岁）患有神经系统症状，其中 466 例（72.1％）神经系统症状为孤立性的。神经系统症状孤立出现的占 22.7％（n = 106）。头痛是最常见的神经系统症状（n = 279，41.1％）：主要是额颞部（n = 143，51.1％）和轻度或中度（n = 165，59.1％）。当与发热（n = 143，51.3％）相关时，头痛更可能是严重的并且是首发症状。83.2％的患者报告了康复。嗅觉和味觉障碍分别发现于 37.9％（n = 245）和 36.8％（n = 238）的患者中。其中，65.3％（156/239）的患者无嗅觉，63.2％（146/231）的患者味觉缺失。嗅觉障碍的完全改善率为 72.1％（174/240），味觉障碍的完全改善率为 76.8％（179/233）。肌痛（n = 241，37.3％）和睡眠障碍（n = 241，37.3％）也很常见。输入病例的神经系统症状更多（p = 0.001）。在 14.5％的情况下，神经系统症状先于呼吸系统症状（RS）出现。RS 与更频繁（p = 0.006）和更多（p <0.001）的神经系统症状相关。
COVID-19 中的神经系统症状很常见，可以孤立出现并且是首发症状。完全康复是最常见的结局。RS 可预测神经系统症状。应考虑对病毒和宿主遗传学的研究，以了解不同的表型。
