Cross-sectional case-control studies (Blue)
The main objective of this study was to analyse neurological symptoms during a COVID-19 infection and determine the pattern of symptoms by comparing outpatients with inpatients. A further goal was to identify possible predictors, such as pre-existing conditions and neurological symptoms. The authors recorded the clinical data of 40 inpatients and 42 outpatients in this retrospective, cross sectional study. Of them, 68 patients (83%), evenly distributed between the two groups, suffered from neurological symptoms. The onset of neurological symptoms and the related time ranges were identified in 41 patients (36 outpatients and 5 inpatients). Of these, 63.4% reported neurological symptoms on the first or second day of illness. 49 patients (72%) showed combinations of at least two to a maximum of seven different neurological symptoms. A more severe course of disease was correlated with age and male sex, but age was not identified as a predictor for the occurrence of neurological symptoms. Women suffered from central and neuromuscular symptoms more often than men (p = 0,004). The most common symptoms were fatigue (54%), headache (31%), loss of taste (31%), and loss of smell (27%). Pre-existing dementia was associated with increased lethality; similarly, pre-existing stroke was associated with a more severe course of COVID-19 infection. Hallucinations and confusion were related to an increased likelihood of death. The authors concluded that the present data demonstrate the importance of comprehensive neurological support of inpatients and outpatients affected by COVID-19.
Zifko U, Schmiedlechner T, Saelens J, Zifko K, Wagner M, Assadian O, Grisold W, Stingl H. COVID-19: Involvement of the nervous system. Identifying neurological predictors defining the course of the disease. J Neurol Sci. 2021 Apr 8;425:117438. doi: 10.1016/j.jns.2021.117438.