Manifestation of neurological symptoms in patients with severe Covid-19 in the intensive room: a retrospective, observational study

Abstract

Background: In addition to causing respiratory problems, patients with COVID-19 infection also present with neurological symptoms. We report neurological symptoms in a patient with severe COVID-19 infection admitted to the intensive care unit. Patients and Methods: We conducted a descriptive observational study from the patients treated in the intensive care unit (ICU) from October 2020 to September 2021 with neurological symptoms. Inclusion criteria for participants were patients who were confirmed positive for COVID-19 from the results of the nasopharyngeal polymerase chain reaction (PCR) swab, with neurological symptoms that appeared less ≤5 days before the results of the COVID-19 PCR swab were confirmed. Exclusion criteria were patients with negative PCR swab results, patients presenting with neurological symptoms >5 days before confirmed PCR, and patients with previously known neurological disorder. Results: A total of 160 COVID-19 patients were admitted to the ICU with neurological symptoms, consisting of 99 males (61.9%) and 61 females (38.1%). A total of 35 patients (21.9%) complained of headache, nine patients (5.6%) complained of vestibular disturbances, 23 patients (14.4%) with seizures, 88 patients (55%) with decreased consciousness (encephalopathy), nine patients with intracranial infection, 67 patients (41.9%) with stroke, and nine patients (5.6%) with movement disorders. Conclusion: The most common neurological symptom in severe COVID-19 patients treated in our ICU was decreased consciousness, followed by stroke and headache. Neurological symptoms found in patients with severe COVID-19 infection can be caused by direct viral infection or indirectly through the mechanism of severe hypoxia due to respiratory failure.