Neurological Symptoms in Acute COVID-19 Infected Patients: A Survey Among Italian Physicians

Abstract

Background: COVID-19 is a pandemic disease and questions rise about the effect of coronavirus 2 (Sars-CoV-2) on nervous system. Its involvement could in part help explaining the pathogenesis of this condition and lead to novel therapeutic approaches. Methods: in order to quickly assess the involvement of the nervous system, an online survey to assess neurological symptoms in COVID-19 patients was developed and open to Italian clinicians involved in the diagnosis and management of patients. The survey was structured in three sections, with nine different items concerning the presence of different specific clinical abnormalities. Each item was graded from “absent” to “severe”. Findings: Seventy-two physicians with 9 different medical specialties, from 6 regions of Italy filled the online questionnaire. The survey shows that 82% of practitioners observed neurological symptoms. In most cases they are mild and non-specific, but in a minority of patients they can be severe. The most common symptoms observed are headache, myalgia, taste and smell abnormalities. Whilst there is no difference between neurologists and non-neurologists, experienced clinicians who evaluated more patients report more frequently neurological symptoms. Interpretation: In the Italian COVID-19 pandemia neurological symptoms occur frequently and they should be monitored in patients. Whilst some of the disturbances reported may be common to other infectious diseases and non-specific, smell and taste abnormalities shift the attention on the nervous system as entry door and damage location even for SARS-CoV-2 virus. This interpretation should prime research trials on early therapeutic approaches halting the infection in the nervous system. Funding Statement: University of Milan. Declaration of Interests: No competing interest. Ethics Approval Statement: The study was reviewed and approved by the borad of the italian society of neurology.