Pereira Daniella Nunes, Bicalho Maria Aparecida Camargos, Jorge Alzira de Oliveira, Gomes Angélica Gomides Dos Reis, Schwarzbold Alexandre Vargas, Araújo Anna Luiza Homan, Cimini Christiane Corrêa Rodrigues, Ponce Daniela, Rios Danyelle Romana Alves, Grizende Genna Maira Santos, Manenti Euler Roberto Fernandes, Anschau Fernando, Aranha Fernando Graça, Bartolazzi Frederico, Batista Joanna d'Arc Lyra, Tupinambás Julia Teixeira, Ruschel Karen Brasil, Ferreira Maria Angélica Pires, Paraíso Pedro Gibson, Araújo Silvia Ferreira, Teixeira Antonio Lucio, Marcolino Milena Soriano
Faculdade de Medicina, Universidade Federal de Minas Gerais, Brazil.
Fundação Hospitalar do Estado de Minas Gerais (Fhemig), Germany.
eNeurologicalSci. 2022 Sep;28:100419. doi: 10.1016/j.ensci.2022.100419. Epub 2022 Jul 30.
Neurological manifestations have been associated with a poorer prognosis in COVID-19. However, data regarding their incidence according to sex and age groups is still lacking.
This retrospective multicentric cohort collected data from 39 Brazilian hospitals from 17 cities, from adult COVID-19 admitted from March 2020 to January 2022. Neurological manifestations presented at hospital admission were assessed according to incidence by sex and age group.
From 13,603 COVID-19 patients, median age was 60 years old and 53.0% were men. Women were more likely to present with headaches (22.4% vs. 17.7%, < 0.001; OR 1.36, 95% confidence interval [CI] 1.22-1.52) than men and also presented a lower risk of having seizures (OR 0.43, 95% CI 0.20-0.94). Although delirium was more frequent in women (6.6% vs. 5.7%, = 0.020), sex was not associated with delirium in the multivariable logistc regresssion analysis. Delirium, syncope and coma increased with age (1.5% [18-39 years] vs. 22.4% [80 years or over], p < 0.001, OR 1.07, 95% CI 1.06-1.07; 0.7% vs. 1.7%, = 0.002, OR 1.01, 95% CI 1.00-1.02; 0.2% vs. 1.3% p < 0.001, OR 1.04, 95% CI 1.02-1.06), while, headache (26.5% vs. 7.1%, OR 0.98, 95% CI 0.98-0.99), anosmia (11.4% vs. 3.3%, OR 0.99, 95% CI] 0.98-0.99 and ageusia (13.1% vs. 3.5%, OR 0.99, CI 0.98-0.99) decreased (p < 0.001 for all).
Older COVID-19 patients were more likely to present delirium, syncope and coma, while the incidence of anosmia, ageusia and headaches decreased with age. Women were more likely to present headache, and less likely to present seizures.
神经系统表现与新冠病毒病（COVID-19）预后较差相关。然而，关于其按性别和年龄组划分的发病率数据仍然缺乏。
这项回顾性多中心队列研究收集了来自巴西17个城市39家医院2020年3月至2022年1月收治的成年COVID-19患者的数据。根据性别和年龄组的发病率评估入院时出现的神经系统表现。
在13603例COVID-19患者中，中位年龄为60岁，男性占53.0%。女性比男性更易出现头痛（22.4%对17.7%，<0.001；比值比[OR]1.36，95%置信区间[CI]1.22 - 1.52），且癫痫发作风险较低（OR 0.43，95%CI 0.20 - 0.94）。虽然谵妄在女性中更常见（6.6%对5.7%，=0.020），但在多变量逻辑回归分析中，性别与谵妄无关。谵妄、晕厥和昏迷随年龄增加而增加（1.5%[18 - 39岁]对22.4%[80岁及以上]，p<0.001，OR 1.07，95%CI 1.06 - 1.07；0.7%对1.7%，=0.002，OR 1.01，95%CI 1.00 - 1.02；0.2%对1.3%，p<0.001，OR 1.04，95%CI 1.02 - 1.06），而头痛（26.5%对7.1%，OR 0.98，95%CI 0.98 - 0.99）、嗅觉丧失（11.4%对3.3%，OR 0.99，95%CI 0.98 - 0.99）和味觉丧失（13.1%对3.5%，OR 0.99，CI 0.98 - 0.99）则下降（均p<0.001）。
年龄较大的COVID-19患者更易出现谵妄、晕厥和昏迷，而嗅觉丧失、味觉丧失和头痛的发病率随年龄下降。女性更易出现头痛，且癫痫发作可能性较小。
