Abstract
BackgroundClinical investigations have argued for long-term neurological manifestations in both hospitalised and non-hospitalised COVID-19 patients. It is unclear whether long-term neurological symptoms and features depend on COVID-19 severity.MethodsFrom a sample of 208 consecutive non-neurological patients hospitalised for COVID-19 disease, 165 survivors were re-assessed at 6 months according to a structured standardised clinical protocol. Prevalence and predictors of long-term neurological manifestations were evaluated using multivariate logistic regression analyses.ResultsAt 6-month follow-up after hospitalisation due to COVID-19 disease, patients displayed a wide array of symptoms; fatigue (34%), memory/attention (31%) and sleep disorders (30%) were the most frequent. At neurological examination, 40% of patients exhibited neurological abnormalities, such as hyposmia (18.0%), cognitive deficits (17.5%), postural tremor (13.8%) and subtle motor/sensory deficits (7.6%). Older age, premorbid comorbidities and severity of COVID-19 were independent predictors of neurological manifestations in logistic regression analyses.ConclusionsPremorbid vulnerability and severity of SARS-CoV-2 infection impact on prevalence and severity of long-term neurological manifestations.
Highlights
After the first cases of the novel coronavirus disease 2019 (COVID-19) were reported in Wuhan, China, in December 2019, the spread rapidly in Europe became a pandemic, involving millions of cases worldwide [1]
Hospitalisation data included the severity of COVID-19 disease, classified according to the Brescia-COVID Respiratory Severity Scale (BCRSS), stratifying patients into mild, moderate and severe [10] and the quick Sequential Organ Failure Assessment score [11]
Survivors were younger (p=0.001; 65.7±12.6 vs 78.6±8.6) and exhibited less comorbidities (p=0.004, mean Cumulative Illness Rating Scale [9] (CIRS) 1.36 ±0.51 vs 1.51±0.4) and lower COVID-19 severity (p=0.001, mean BCRSS 0.90±0.85 vs 2.89 ± 0.32) compared to deceased patients
Summary
After the first cases of the novel coronavirus disease 2019 (COVID-19) were reported in Wuhan, China, in December 2019, the spread rapidly in Europe became a pandemic, involving millions of cases worldwide [1]. With the increasing number of confirmed cases and the accumulating clinical data, it is now. Subjects previously hospitalised for COVID19 disease entered a longitudinal study in order to evaluate general and neurological manifestations after 6 months of follow-up and their potential relationship with premorbid conditions and severity of respiratory infection. Neurol Sci. Clinical investigations have argued for long-term neurological manifestations in both hospitalised and non-hospitalised COVID-19 patients. Clinical investigations have argued for long-term neurological manifestations in both hospitalised and non-hospitalised COVID-19 patients It is unclear whether long-term neurological symptoms and features depend on COVID-19 severity
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