Severe neurological manifestations of patients infected with the Sars-CoV-2: Registry in intensive care unit

ABSTRACT

Background and aims: Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with many neurological manifestations, mainly encephalitis, meningitis, acute cerebrovascular disease (ischemic and hemorrhagic), Guillain Barré syndrome (GBS) and seizures (1). Background In late December 2019 a novel coronavirus was identified in China causing severe respiratory disease. The virus causing the infection has been named - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms are mainly respiratory, around 40% may manifest with mild neurological symptoms. Methods: Methods: We included 35 patients with SARS-CoV-2 infection hospitalized in Intensive Care Unit, with presentation of severe neurological events. Results: Results: Our hospital (San José, Tecnológico de Monterrey) has treated 2,920 patients infected by COVID19 in 1 year, 351 patients have required intubation, 1.19% have severe neurological manifestations and the reported mortality is 11.4%. This cohort includes 82% males, median age 57.9 (±14.96 years), first day of consultation by the neurology service was 22.21 (±19.8 days), most frequent neurological presentation was encephalitis in 31.4%. The rest of neurological events were 5.7% myasthenic crisis, 2.9% microangiopathy, 5.7% Guillain Barre syndrome, 11.4 % status epilepticus, 22. 9% STROKE, and around 20% presented Posterior reversible encephalopathy syndrome (PRES) and Autonomic dysfunction in ‘long COVID’. Conclusions: Conclusion: Reports of severe neurological involvement in COVID-19 are increasing, which makes this problem particularly relevant to neurological critical care therapy. The nervous system can be directly or, more frequently, indirectly be involved. We anticipate that these neurological events will represent a large proportion of primary and secondary care consultations in coming months.