We report the findings from the Spanish Society of Neurology's NeuroCOVID-19 Registry.
We performed a multicentre study of patients with neurological manifestations of COVID-19. Participating ...physicians reported demographic, clinical, and paraclinical data and judged the involvement of COVID-19 in causing neurological symptoms.
A total of 233 cases were submitted, including 74 different combinations of manifestations. The most frequently reported were stroke (27%), neuromuscular symptoms (23.6%), altered mental status (23.6%), anosmia (17.6%), headache (12.9%), and seizures (11.6%). The mean age of patients was 61.1 years, with 42.1% being women; a higher proportion of women was recorded among patients with altered mental status, anosmia, and headache. The onset of symptoms differed within categories. Onset of anosmia occurred a mean (standard deviation) of 2.9 (2.5) days after the first general symptom, whereas neuromuscular symptoms appeared after 13.9 (10.1) days. Neurological symptoms were persistent in 33% of patients. General symptoms were present in 97.7% of patients, and results from general laboratory studies were abnormal in 99.4% of patients. Cerebrospinal fluid analysis findings were abnormal in 62.7% of the cases in which this test was performed (n = 51), but positive results for SARS-CoV-2 were only found in one case.
The neurological manifestations of COVID-19 are diverse. Anosmia, myalgia, and headache occur earlier in the course of the disease. Altered mental status, neuromuscular symptoms, and stroke are associated with greater severity. COVID-19 must be incorporated into most clinical and radiological differential diagnoses. COVID-19 may cause persistent and disabling neurological symptoms.
•NeuroCovid-19 is polymorph: Authors reported >70 different combinations of neurological syndromic presentations.•The symptom's timing varies from early (anosmia, headache, myalgia) to later stages (altered mental status, seizures, stroke, neuromuscular).•Some neurological symptoms might persist, as headache or anosmia; while other may cause persistent disability, as stroke or polyneuropathies.•Cerebrospinal fluid was frequently abnormal but direct isolation of SARS-CoV-2 occurred only in 1/233 cases.•Neurologists must be prepared to face the various neurological syndromes that may be associated with Covid-19 infection.
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