4. Observational study: prospective longitudinal cohort
In this paper recently published in Neurology, the authors aimed to determine whether neurological manifestations are common in hospitalised COVID-19 patients and to describe their main characteristics. They systematically reviewed all patients diagnosed with COVID-19 admitted to hospital in a Spanish population during March 2020. Of 841 patients hospitalised with COVID-19 (mean age 66 years, 56% men), 57% developed neurological symptoms. Non-specific symptoms such as myalgia (17%), headache (14%), and dizziness (6%) were present mostly in the early stages of infection. Anosmia (5%) and dysgeusia (6%) tended to occur early (60% as the first clinical manifestation) and were more frequent in milder cases. Disorders of consciousness occurred commonly (20%), mostly in older patients and in severe and advanced COVID-19. Myopathy (3%), dysautonomia (3%), cerebrovascular diseases (2%), seizures (1%), movement disorders (1%), encephalitis (n=1), Guillain-Barré syndrome (n=1), and optic neuritis (n=1) were also reported, but less frequently. Neurological complications were the main cause of death in 4% of all deceased study subjects. The authors concluded that neurological manifestations are common in hospitalised COVID-19 patients. In this series, more than half of patients presented with some form of neurological symptom.