Kulkarni Rahul, Gupta Dulari, Pujari Shripad, Deshpande Vishal, Naphade Pravin, Deshpande Rushikesh
Department of Neurology, Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India.
Ann Indian Acad Neurol. 2022 Nov-Dec;25(6):1047-1055. doi: 10.4103/aian.aian_204_22. Epub 2022 May 3.
Though severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) virus primarily affects respiratory system, neurological involvement is well known.
To describe the neurological manifestations of coronavirus disease 2019 (COVID-19) during three waves of the pandemic.
This was an ambispective observational single-centre study to describe the neurological manifestations of COVID-19 infection among inpatients from a tertiary care referral centre in Western India from March 2020 to January 2022.
Out of 14,822 patients admitted with COVID-19, 307 (2.07%) had neurological manifestations. Neurological manifestations were seen in 1.87% in first wave (onset to 10 Feb 21); 2.37% in second wave (Feb 11, 2021 to Dec 31, 2021) and 6.26% in third wave (Jan 1, 2022 to Jan 31, 2022). The most common neurological manifestations were encephalopathy (34.5%), ischemic stroke (32.1%), and acute symptomatic seizures (8.8%). Encephalopathy (p = 0.028) was more common in first wave while seizures were more common in third wave (p = 0.001). In patients with encephalopathy, hypoxia (p = 0.0001), shock (p = 0.001), renal involvement (p = 0.002), and sepsis (p = 0.033) were associated with higher mortality; while those with no systemic involvement had better survival (p = 0.0001). Among patients with ischemic stroke, 32.1% did not have any traditional vascular risk factors. These patients were 9 years younger and required 6 days less hospitalization than patients of stroke with vascular risk factors.
SARS-CoV-2 produces many central and peripheral nervous system manifestations. Encephalopathy was more common in first wave while acute symptomatic seizures were more common in third wave. Encephalopathy was most common neurological manifestation with progressively higher mortality with increased number of systemic comorbidities. Ischemic stroke was seen in patients who had vascular risk factors as well as in patients without them.
尽管严重急性呼吸综合征冠状病毒2（SARS-CoV-2）主要影响呼吸系统，但神经系统受累也广为人知。
描述2019冠状病毒病（COVID-19）在疫情三波期间的神经系统表现。
这是一项前瞻性和回顾性相结合的单中心观察性研究，旨在描述2020年3月至2022年1月期间印度西部一家三级医疗转诊中心住院患者中COVID-19感染的神经系统表现。
在14822例COVID-19住院患者中，307例（2.07%）有神经系统表现。第一波（发病至2021年2月10日）有神经系统表现的占1.87%；第二波（2021年2月11日至2021年12月31日）占2.37%；第三波（2022年1月1日至2022年1月31日）占6.26%。最常见的神经系统表现为脑病（34.5%）、缺血性中风（32.1%）和急性症状性癫痫发作（8.8%）。脑病在第一波中更常见（p = 0.028），而癫痫发作在第三波中更常见（p = 0.001）。在患有脑病的患者中，缺氧（p = 0.0001）、休克（p = 0.001）、肾脏受累（p = 0.002）和脓毒症（p = 0.033）与较高的死亡率相关；而没有全身受累的患者生存率更高（p = 0.0001）。在缺血性中风患者中，32.1%没有任何传统血管危险因素。这些患者比有血管危险因素的中风患者年轻9岁，住院时间少6天。
SARS-CoV-2可产生多种中枢和周围神经系统表现。脑病在第一波中更常见，而急性症状性癫痫发作在第三波中更常见。脑病是最常见的神经系统表现，随着全身合并症数量的增加，死亡率逐渐升高。缺血性中风在有血管危险因素的患者以及没有血管危险因素的患者中均有出现。
