Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 110, Belo Horizonte, Brazil; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 190, sala 246, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS/ CNPq). R. Ramiro Barcelos, 2359, Prédio 21, Sala 507, Porto Alegre, Brazil.
Grupo Hospitalar Conceição. Brazilian National Health System, Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor. Av. Francisco Trein, 326, Porto Alegre, Brazil.
J Neurol Sci. 2022 Dec 15;443:120485. doi: 10.1016/j.jns.2022.120485. Epub 2022 Nov 9.
Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection and outcomes in the Brazilian population.
This study is part of the Brazilian COVID-19 Registry, a multicentric cohort, including data from 37 hospitals. For the present analysis, patients were grouped according to the presence of reported symptoms (i.e., headache; anosmia and ageusia; syncope and dizziness) vs. clinically-diagnosed neurological manifestations (clinically-defined neurological syndrome: neurological signs or diagnoses captured by clinical evaluation) and matched with patients without neurological manifestations by age, sex, number of comorbidities, hospital of admission, and whether or not patients had underlying neurological disease.
From 6,635 hospitalized patients with COVID-19, 30.8% presented reported neurological manifestations, 10.3% were diagnosed with a neurological syndrome and 60.1% did not show any neurological manifestations. In patients with reported symptoms, the most common ones were headache (20.7%), ageusia (11.1%) and anosmia (8.0%). In patients with neurological syndromes, acute encephalopathy was the most common diagnosis (9.7%). In the matched analysis, patients with neurological syndromes presented more cases of septic shock (17.0 vs. 13.0%, p = 0.045), intensive care unit admission (45.3 vs. 38.9%, p = 0.023), and mortality (38.7 vs. 32.6%, p = 0.026; and 39.2 vs. 30.3%, p < 0.001) when compared to controls.
COVID-19 in-hospital patients with clinically defined neurological syndromes presented a higher incidence of septic shock, ICU admission and death when compared to controls.
关于拉丁美洲国家 COVID-19 神经系统表现和预后的科学数据仍然缺乏。因此，本研究旨在了解 SARS-CoV-2 感染在巴西人群中的神经系统表现和结局。
本研究是巴西 COVID-19 登记处的一部分，这是一个多中心队列，包括来自 37 家医院的数据。在本分析中，根据是否报告有症状（即头痛、嗅觉和味觉丧失、晕厥和头晕）和是否有临床诊断的神经系统表现（临床定义的神经系统综合征：通过临床评估捕获的神经系统体征或诊断）将患者分组，并根据年龄、性别、合并症数量、入院医院以及患者是否有基础神经系统疾病与无神经系统表现的患者进行匹配。
在 6635 例住院 COVID-19 患者中，30.8%有报告的神经系统表现，10.3%被诊断为神经系统综合征，60.1%没有任何神经系统表现。在有报告症状的患者中，最常见的症状是头痛（20.7%）、味觉丧失（11.1%）和嗅觉丧失（8.0%）。在有神经系统综合征的患者中，急性脑病是最常见的诊断（9.7%）。在匹配分析中，有神经系统综合征的患者发生感染性休克的病例更多（17.0%比 13.0%，p=0.045），入住重症监护病房的比例更高（45.3%比 38.9%，p=0.023），死亡率也更高（38.7%比 32.6%，p=0.026；39.2%比 30.3%，p<0.001）。
与对照组相比，临床诊断为神经系统综合征的 COVID-19 住院患者发生感染性休克、入住重症监护病房和死亡的发生率更高。
