ABSTRACT
Background: There are multisystemic consequences secondary to SARS- CoV-2 infection. Aim: To characterize neurological complications in patients admitted due to SARS-CoV-2 infection. Methods: Review of medical records of patients aged over 15 years with COVID-19 evaluated by the neurology team between April and August 2020 at a university hospital. Severity of the infection, referral reasons, neurological diagnoses and laboratory results were registered. The diagnoses were defined by consensus among the members of the hospital neurology group. Cerebrovascular and inflammatory diseases of the central and peripheral nervous system were defined as "probably associated" or "possibly associated" to COVID-19. Results: Ninety-six patients had at least 1 new neu- rological complication. 74% were admitted due to pneumonia and 20% due to a neurological disease. The most common reasons for neurological referral were impaired consciousness (39%), focal neurological deficit (24%), headache (9%) and seizures (5%). The most relevant neurological diagnoses were delirium in 48 patients, stroke in 24, critical illness polyneuropathy and myopathy in 17, seizures in 14, brachial plexopathy in 3, compressive neuropathies in 5, encephalitis in 1, possible vasculitis in 1 and Guillain-Barré syndrome in 1. Stroke and epilepsy were associated with increased length of hospital stay, but without differences in mortality. Conclusions: The spectrum of neurological complications of COVID-19 is wide. There are clinical entities typical of critically ill patients and also diseases associated directly and indirectly with the SARS-CoV2 infection.
Subject(s)
Humans , Aged , COVID-19/complications , Nervous System Diseases/epidemiology , Nervous System Diseases/virology , Neurology , Seizures/epidemiology , Seizures/virology , RNA, Viral , Hospitals, UniversityABSTRACT
Introducción: el año 2019 se conmemoraron los 500 años de la muerte de Leonardo da Vinci en el Chateux du Cloux, Francia. Según registros históricos, Leonardo vivió los últimos años de su vida con una parálisis en su mano derecha, atribuida a un probable accidente cerebrovascular (ACV), lo cual afectó a su capacidad para emprender nuevos proyectos pictóricos. Este trabajo describe como fueron los últimos años de vida de Leonardo, revisa los antecedentes sobre salud y su probable enfermedad neurológica, sus eventuales etio-logías y sus consecuencias. Desarrollo: Leonardo llegó a Francia en 1516 por invitación del rey Francisco I para llevar el Renacimiento y completar su formación personal. En 1517 es visitado por el cardenal Luis de Aragón, y su secretario registra en su diario que Leonardo se encuentra afectado de una parálisis de la mano derecha. Algunos autores sugieren un ACV como causa probable, sobretodo porque según el historiador Vasari, Leonardo vivió sus últimos años en condición de discapacidad. Se llega a plantear que su condición de vege-tariano habría podido influir como factor de riesgo de ACV. Sin embargo, un dibujo no fechado de Figino muestra a Leonardo con una parálisis de tipo periférica de la mano derecha, abriendo el diagnóstico diferencial. Conclusiones: no hay información suficiente para valorar el tipo y la causa de enfermedad neurológica de Leonardo da Vinci, no obstante, está influyó significativamente en su interacción con su discípulo Francisco Melzi y su mecenas Francisco I, hecho que contribuyó a que su legado perdure hasta hoy.
Introduction: the year2019 marked the 500th anniversary of the death of Leonardo da Vinci at the Chateau du Cloux, France. According to historical records, Leonardo lived the last years of his life with palsy on his right hand, attributed to a probable stroke, which affected his ability to undertake new pictorial projects. This study describes how were the last years of Leonardo's life, reviews his medical history and his probable neurological disease, with its possible etiologies and its consequences. Discussion: Leonardo arrived in France in 1516 invited by King Francis I to lead the Renaissance and complete his education. In 1517, cardinal Luis de Aragón visited Leonardo, and his secretary recorded in his diary that he was affected by a palsy on his right hand. Some authors suggest that stroke could have been a probable cause, especially because according to the historian Vasari, Leonardo lived his last years in a condition of disability. His vegetarian food habit could have been a risk factor for his suspected stroke. However, an undated drawing by Figino shows Leonardo with a peripheral nerve palsy on his right hand, opening up the differential diagnosis. Conclusions:there is not enough information to assess the type and cause of Leonardo da Vinci's neurological disease. However, this condition significantly affected his interaction with his discipleFrancisco Melzi and his patron Francisco I, a fact that contributed to his legacy enduring until today.