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COVID-19 住院患者的神经系统症状和诊断:与死亡率的关系。

Neurological Symptoms and Diagnoses in Patients Hospitalized With COVID-19: Relationships With Mortality.

机构信息

Departments of Neurology.

the Department of Family Medicine, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.

出版信息

Neurologist. 2021 Nov 4;26(6):237-243. doi: 10.1097/NRL.0000000000000379.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a disease that affects many organs, especially the lung, and may lead to multiorgan failure. Studies describing neurological dysfunctions involving the central and peripheral nervous systems have emerged. In our study, we aimed to evaluate the neurological signs and symptoms in hospitalized patients with COVID-19.

METHODS

The data of 290 patients admitted to our center (ward and intensive care unit) who received a diagnosis of COVID-19 were analyzed retrospectively. Patients' demographic, clinical and laboratory data, and their neurological diseases, symptoms, and complications were compared.

RESULTS

Male sex, heart disease, chronic obstructive pulmonary disease and having a history of neurological disease were associated with increased mortality in patients with COVID-19. Seizures and altered consciousness were also found to be more common in patients who died. In addition, lower platelet counts (P=0.001), higher C-reactive protein levels (P<0.001) and higher D-dimer levels (P=0.003) were associated with increased risk of mortality.

CONCLUSIONS

We believe that close monitoring of any possible neurological manifestations is mandatory in hospitalized patients at the onset of COVID-19 and during disease progression. Clinical findings such as neurological symptoms and acute phase reactants are important in the follow-up and treatment of the disease.

摘要

背景

2019 年冠状病毒病(COVID-19)是一种影响多个器官的疾病,特别是肺部,并可能导致多器官衰竭。描述涉及中枢和周围神经系统的神经功能障碍的研究已经出现。在我们的研究中,我们旨在评估住院 COVID-19 患者的神经体征和症状。

方法

回顾性分析了 290 名在我们中心(病房和重症监护病房)接受 COVID-19 诊断的患者的数据。比较了患者的人口统计学、临床和实验室数据以及他们的神经疾病、症状和并发症。

结果

男性、心脏病、慢性阻塞性肺疾病和有神经病史与 COVID-19 患者的死亡率增加相关。在死亡患者中还发现癫痫发作和意识改变更为常见。此外,较低的血小板计数(P=0.001)、更高的 C 反应蛋白水平(P<0.001)和更高的 D-二聚体水平(P=0.003)与死亡率增加相关。

结论

我们认为,在 COVID-19 发病时和疾病进展期间,必须密切监测住院患者的任何可能的神经表现。神经症状和急性期反应物等临床发现对疾病的随访和治疗很重要。

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