Neurological manifestations in patients with COVID-19: A Tunisian study

ABSTRACT

Background and aims: Various neurological manifestations have been reported in association with the coronavirus disease of 2019 (COVID-19) and may be the initial or only presentations of the disease. Even, the virus increased risk of exacerbations of chronic neurological disorders. Methods: We conducted a prospective study in the department of neurology of the Military Hospital of Tunis from September 2020 to December 2020 including patients hospitalized for COVID-19 with neurological manifestations. The diagnosis was made by real-time reverse-transcription polymerase chain reaction (RT-PCR) analysis of nasal swab specimens. Results: 14 patients were included. Cerebrovascular complications of COVID-19 were acute ischemic stroke (n=5), cerebral hemorrhage (n=1) and cerebral venous thrombosis of the sigmoid sinus (n=1). Two patients with previously stable myasthenia gravis had myasthenic exacerbation and one of them required intubation for hypoxemic respiratory failure. Decompensation of chronic neuroinflammatory disorders was observed in two cases relapse of multiple sclerosis (n=1) and Neuro-Behçet's disease (n=1). One patient followed for epilepsy was hospitalized for uncontrolled seizure following infection with COVID-19, and two patients had clinical findings of encephalitis including confusion, headache and fever. The outcome was favorable for 12 patients who received symptomatic treatment of COVID-19 along with treatment for their disease. Two patients with ischemic stroke were died. Conclusion: In the current pandemic context, physicians should be aware of the broad spectrum of neurological signs of COVID-19 for early diagnosis and management of patients.