Neurological manifestations of patients hospitalized with COVID-19 Diagnosis at OLSU-S

ABSTRACT

Objective: To determine the spectrum of neurological manifestations among COVID-19 patients admitted to Ochsner-Louisiana State University Health Sciences Center, Shreveport (OLSU-S) after SARS-CoV-2 positive results. Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is associated with increased incidence and prevalence of well-defined neurological manifestations. Based on clinical reports there is vast spectrum of neurological disorders associated with COVID-19 patients including metabolic encephalopathy, cerebrovascular disease, seizure disorder, and myelopathies. Design/Methods: We conducted a retrospective, observational study of hospitalized adult patients (age > 18 years) admitted to OLSU-S with laboratory confirmed SARS-COV-2. All clinical data was reviewed including epidemiology, clinical features, laboratory data, neuroradiological findings, hospital management and course from 150 patients hospitalized for COVID-19 management at OLSU-S. Results: We screened 150 patients admitted to OLSU-S with COVID-19 for the development of neurological diagnosis during their hospital course. 19 (12.66%) patients presented with new neurological signs and symptoms and were subsequently diagnosed with a neurological disorder With in the active COVID-19 infection period. The most common new neurological manifestation seen with COVID-19 was acute cerebrovascular accidents (CVA) (6%) followed by encephalopathy (4.66%), seizures (4%) and Guillain-Barre like syndrome (1.33%). The mean age of patients with neurological diagnosis was 60.74 ± 14.58 (standard deviation) (age range 25-76). The common neuroradiological diagnosis on COVID-19 patients with acute CVA includes middle cerebral artery infarction, venous infarction and hemorrhagic CVA. The most common EEG findings was diffuse background slowing consistent with moderate encephalopathy. 26% of the patients with new neurological diagnosis during acute COVID-19 had rapid clinical deterioration resulting in death. Conclusions: Our observations confirm the increased incidence of neurological manifestations seen in COVID-19 patients, with the elderly population being more susceptible. The subsequent development of a neurological disorder during COVID-19 was found to be associated with worse clinical outcomes and an overall poor prognosis.