Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series

Neurological disorders associated with SARS-CoV-2 infection represent a clinical challenge because they encompass a broad neurological spectrum and may occur before the diagnosis of COVID-19. In this monocentric retrospective case series, medical records from patients with acute neurological disorde...

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Bibliographic Details
Published in:	Revue neurologique Vol. 177; no. 3; pp. 275 - 282
Main Authors:	Cleret de Langavant, L., Petit, A., Nguyen, Q.T.R., Gendre, T., Abdelhedi, J., Djellaoui, A., Seddik, L., Lim, L., Faugeras, F., Salhi, H., Wahab, A., Fechtenbaum, L., Dormeuil, A., Hosseini, H., Youssov, K., Fénelon, G., Bapst, B., Brugières, P., Tuilier, T., Kalsoum, E., Matignon, M.-B., Oniszczuk, J., Gallien, S., Vindrios, W., Melica, G., Scain, A.-L., Esser, R., Rostain, L., Guillaud, C., Dubos-Lascu, G., Saada, N., Guillet, H., Khellaf, M., Bardel, B., Ayache, S.S., Lefaucheur, J.-P., Pawlotsky, J.-M., Fourati, S., Bachoud-Lévi, A.-C.
Format:	Journal Article
Language:	English
Published:	France Elsevier Masson SAS 01-03-2021 Elsevier Masson
Subjects:	Adolescent Adult Aged Aged, 80 and over Amyotrophic Lateral Sclerosis COVID-19 - complications COVID-19 - epidemiology COVID-19 - psychology Diaphragmatic ultrasonography Female Humans Life Sciences Male Middle Aged Nervous System Diseases - epidemiology Nervous System Diseases - etiology Nervous System Diseases - virology Original Paris - epidemiology Phrenic nerve conduction Pulmonary function tests Retrospective Studies SARS-CoV-2 - physiology Young Adult Paris Pulmonary function tests Amyotrophic Lateral Sclerosis Diaphragmatic ultrasonography Phrenic nerve conduction
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Summary:	Neurological disorders associated with SARS-CoV-2 infection represent a clinical challenge because they encompass a broad neurological spectrum and may occur before the diagnosis of COVID-19. In this monocentric retrospective case series, medical records from patients with acute neurological disorders associated with SARS-CoV-2 infection from medicine departments of an academic center in Paris area were collected between March 15th and May 15th 2020. Diagnosis of SARS-CoV-2 was ascertained through specific RT-PCR in nasopharyngeal swabs or based on circulating serum IgG antibodies. Twenty-six patients diagnosed with SARS-CoV-2 infection presented with neurological disorders: encephalitis (N=8), encephalopathy (N=6), cerebrovascular events (ischemic strokes N=4 and vein thromboses N=2), other central nervous system (CNS) disorders (N=4), and Guillain-Barré syndrome (N=2). The diagnosis of SARS-CoV-2 was delayed on average 1.6 days after the onset of neurological disorder, especially in case of encephalitis 3.9 days, encephalopathy 1.0 day, and cerebrovascular event 2.7 days. Our study confirms that COVID-19 can yield a broad spectrum of neurological disorders. Because neurological presentations of COVID-19 often occur a few days before the diagnosis of SARS-COV-2 infection, clinicians should take preventive measures such as patient isolation and masks for any new admission to avoid nosocomial infections. Anti-SARS-CoV2 antibody detection in RT-PCR SARS CoV-2 negative suspected cases is useful to confirm a posteriori the diagnosis of atypical COVID-19 presentations.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0035-3787 0035-3787
DOI:	10.1016/j.neurol.2021.01.004