ABSTRACT
BACKGROUND: Concerns regarding potential neurologic complications of COVID-19 are being increasingly reported worldwide. Our objective was to investigate the neurologic complications of COVID-19 among a cohort of Lebanese patients with SARS-CoV-2 infection admitted to Rafik Hariri University Hospital (RHUH), the leading COVID-19 testing and treatment center in Lebanon. METHODS: This is a retrospective, single-center, observational study conducted from March to July 2020 at RHUH, Lebanon. RESULTS: Of 169 hospitalized patients with confirmed SARS-CoV-2 infection (mean {SD} age was 45.75 {19} years and 62.7% were men), 91 patients (53.8%) had severe infection and 78 patients (46.2%) had non-severe infection according to the American Thoracic Society guidelines for community-acquired pneumonia. Overall, 112 patients (66.3%) developed neurologic symptoms: CNS (46.1%), PNS (43.7%), and skeletal muscle injury (2.4%). Compared with patients with non-severe infection, patients with severe infection were significantly older, were male and more likely to have underlying disorders, especially diabetes and cardiac or cerebrovascular disease. Moreover, those patients experienced more typical COVID-19 symptoms at onset of illness such as fever, cough and fatigue. However, there was no significant difference in the frequency of all nervous system manifestations between the severe and the non-severe infection groups (57 {62.6%} vs 55 {70.5%}; p =0.316), except for impaired consciousness, where seven patients had impaired consciousness in the severe group compared to none in the non-severe group (p=0.012). CONCLUSION: A wide variety of neurologic symptoms were detected in our Lebanese cohort of hospitalized COVID-19 patients. A comprehensive knowledge of the neurologic manifestations will help healthcare providers to be more attentive to these complications.
ABSTRACT
INTRODUCTION: There is lack of universal agreement on the management of COVID-19. Intravenous high dose vitamin C (HDVC), remdesivir (RDV), and favipiravir (FPV) have been suggested as part of the treatment regimens and only RDV is approved by the Food and Drug Administration (FDA) so far. There is no study in Lebanon that addresses the descriptive cohort of HDVC and antiviral therapy amongst COVID-19 inpatients. Our goal was to highlight such a cohort. METHODOLOGY: A retrospective electronic chart review of COVID-19 inpatients was done over a period of 10 months (August 2020 to April 2021). Comparative data analysis was performed between HDVC and non-HDVC (NHDVC) groups, and RDV and FPV groups. RESULTS: Among HDVC patients, 70.1% (p = 0.035) and 67.2% (p = 0.008) had dyspnea and desaturation respectively. Patients on HDVC were less likely to remain in hospital for more than 20 days (p = 0.003). HDVC patients were more likely to be on oxygen therapy with 74.7% (p = 0.002). RDV patients were more likely to be on other COVID-19-related medications during hospitalization including the use of tofacitinib, baricitinib, tocilizumab, and anticoagulation as recommended in the guidelines. Statistical significance was noted for the status on discharge as 90.1% of the patients that received RDV were discharged after clinical improvement, compared to the 74.2% of the FPV patients. CONCLUSIONS: Further research is needed to establish local guidelines for the treatment of COVID-19. A significant role of HDVC and FPV might resurface if randomized control trials are conducted.