Journal Article

The spectrum of Neuro-COVID: A study of a comprehensively investigated large cohort from India

Vengalil, Seena, Chaudhuri, Jaydip, Ganaraja, V, Haripriya, K, Chakradhar, N, Cheerla, H, Alladi, Suvarna, Asranna, Ajay, Vaddepally, C, Mahale, Rohan, Vikram, Holla, Srijithesh, P, Netravathi, M, Seshagiri, Doniparthi, Maturu, V, Sagar Navanith, P, Kenchaiah, Raghavendra, Alluri, Swathi, Mailankody, Pooja

2022

Overview

Background: Though reports of neurological manifestations of COVID-19 have emerged from various parts of the world, the cohorts reported are from the West and mostly derived from electronic databases. Much remains unknown regarding neuro-COVID in developing countries. India is the second-worst affected country, and this study reports the neurological manifestations of COVID-19 in a comprehensively evaluated cohort. Objective: The aim of this study was to describe the range of neurological manifestations of COVID-19 in India with an emphasis on the risk factors, laboratory and imaging findings and short-term outcome. Methods: Retrospective review of hospital records of all confirmed COVID-19 patients with neurological manifestations, receiving inpatient care in two neurology referral hospitals were done. All demographic, clinical details, investigations, and treatment were analysed. Results: A total of 120 confirmed COVID-19 cases presenting with neurological symptoms were included. The mean age of illness and duration of illness was 48.03 ± 17.3 years and 10.9 ± 17.3 days respectively. New onset of neurological symptoms occurred in 100 cases while 20 patients had worsening of pre-existing neurological illness. Stroke was the commonest neurological disorder (43%), followed by encephalopathy (23%) and Guillain-Barre syndrome (10%). Other unusual neurological manifestations included new-onset headache (7%), seizures including denovo status epilepticus (5%) and meningo-encephalitis (5%). Nearly half of the patients had preceding COVID-19 symptoms. Poor outcome at discharge was seen in 40% and mortality occurred in 15%. Conclusion: Stroke and encephalopathy constitute the most common neurological manifestations. The absence of preceding COVID-19 symptoms in nearly half the cases is striking. Poor outcome was seen in nearly 50% despite early recognition and management.

• Publisher: Wolters Kluwer India Pvt. Ltd,Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,Wolters Kluwer - Medknow,Wolters Kluwer Medknow Publications
• Subject: Coronaviruses / COVID-19 / Developing countries / Encephalitis / Encephalopathy / Epilepsy / Guillain-Barre syndrome / LDCs / Nervous system diseases / Neurologic manifestations of general diseases / neurological manifestations / Original / Patients / Risk factors / Seizures / Statistics / Stroke