Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
Universidade Federal de São Paulo, Departamento de Medicina, São Paulo SP, Brazil.
Arq Neuropsiquiatr. 2023 Feb;81(2):146-154. doi: 10.1055/s-0043-1761433. Epub 2023 Mar 22.
The neurological manifestations in COVID-19 adversely impact acute illness and post-disease quality of life. Limited data exist regarding the association of neurological symptoms and comorbid individuals.
To assess neurological symptoms in hospitalized patients with acute COVID-19 and multicomorbidities.
Between June 2020 and July 2020, inpatients aged 18 or older, with laboratory-confirmed COVID-19, admitted to the Hospital São Paulo (Federal University of São Paulo), a tertiary referral center for high complexity cases, were questioned about neurological symptoms. The Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire was used. The data were analyzed as a whole and whether subjective olfactory dysfunction was present or not.
The mean age of the sample was 55 ± 15.12 years, and 58 patients were male. The neurological symptoms were mostly xerostomia (71%), ageusia/hypogeusia (50%), orthostatic intolerance (49%), anosmia/hyposmia (44%), myalgia (31%), dizziness (24%), xerophthalmia (20%), impaired consciousness (18%), and headache (16%). Furthermore, 91% of the patients had a premorbidity. The 44 patients with subjective olfactory dysfunction were more likely to have hypertension, diabetes, weakness, shortness of breath, ageusia/hypogeusia, dizziness, orthostatic intolerance, and xerophthalmia. The COMPASS-31 score was higher than that of previously published controls (14.85 ± 12.06 vs. 8.9 ± 8.7). The frequency of orthostatic intolerance was 49% in sample and 63.6% in those with subjective olfactory dysfunction (2.9-fold higher risk compared to those without).
A total of 80% of inpatients with multimorbidity and acute COVID-19 had neurological symptoms. Chemical sense and autonomic symptoms stood out. Orthostatic intolerance occurred in around two-thirds of the patients with anosmia/hyposmia. Hypertension and diabetes were common, mainly in those with anosmia/hyposmia.
COVID-19 的神经系统表现会对急性疾病和疾病后生活质量产生不利影响。关于神经系统症状与合并症个体之间的关联，目前仅有有限的数据。
评估住院的急性 COVID-19 合并多种合并症患者的神经系统症状。
2020 年 6 月至 2020 年 7 月，对入住圣保罗医院（圣保罗联邦大学的三级转诊中心）的年龄在 18 岁及以上、实验室确诊 COVID-19 的住院患者进行了神经系统症状询问。采用综合自主症状评分 31 问卷（COMPASS-31）进行调查。分析了整体数据以及是否存在主观嗅觉功能障碍。
样本的平均年龄为 55±15.12 岁，58 名男性患者。神经系统症状主要为口干（71%）、味觉丧失/减退（50%）、体位性不耐受（49%）、嗅觉丧失/减退（44%）、肌痛（31%）、头晕（24%）、眼干（20%）、意识障碍（18%）和头痛（16%）。此外，91%的患者有合并症。44 例有主观嗅觉功能障碍的患者更可能患有高血压、糖尿病、乏力、呼吸急促、味觉丧失/减退、头晕、体位性不耐受和眼干。COMPASS-31 评分高于之前发表的对照组（14.85±12.06 与 8.9±8.7）。样本中体位性不耐受的发生率为 49%，而主观嗅觉功能障碍者为 63.6%（与无嗅觉功能障碍者相比，风险高 2.9 倍）。
80%的合并多种疾病和急性 COVID-19 的住院患者有神经系统症状。化学感觉和自主症状突出。约三分之二的嗅觉丧失/减退患者出现体位性不耐受。高血压和糖尿病很常见，主要发生在嗅觉丧失/减退的患者中。
