Abstract
Amaç: Koronavirüs hastalığı 2019 (COVID-19), solunum ve gastrointestinal sistem bozukluklarına ek olarak nörolojik bozukluklara da neden olabilir. Bu çalışmada COVID-19 hastalarında nörolojik semptomların sıklığı ve klinik korelasyonlarının araştırılması amaçlandı.
Gereç ve Yöntem: Bu kesitsel çalışma, Türkiye'de COVID-19 hastalarını izlemek için Sağlık Bakanlığı tarafından yetkilendirilen iki pandemi hastanesinde COVID-19 teşhisi konulan 117 ardışık hasta ile gerçekleştirildi.
Bulgular: Hastaların ortalama yaşı 53.08 ± 15.63 yıldı (18-89 yaş aralığı). Çalışmaya altmış beş (%55,5) hafif (komplike olmayan), 32 (%27,4) orta (hafif pnömoni) ve 20 (%17,1) ağır (ağır pnömoni) hasta dahil edildi. Yetmiş dokuz hastanın (%67,5) nörolojik yakınmaları olduğu tespit edildi. En sık görülen semptom 36 (%30.7) hastada görülen tat bozukluğuydu. Diğer yaygın şikayetler koku alma bozukluğu (%25.6), baş ağrısı (%24.7) ve baş dönmesiydi (% 16.2). Nörolojik semptomları olan hastalar daha gençti ve eşlik eden komorbiditelere sahip olma olasılığı daha yüksekti. Şiddetli enfeksiyonu olan hastaların aynı zamanda eşlik eden komorbiditelere sahip olma olasılığı da daha yüksekti. Daha yüksek ferritin ve LDH seviyeleri ve daha düşük lenfosit sayıları, daha kötü hastalık seyri ile korele bulundu. Buna karşılık laboratuvar parametrelerinin sonuçları nörolojik semptomları olan ve olmayan hastalar arasında farklı değildi. Çalışma grubumuzda komorbidite sayısı ve sigara içme durumu, hastalık şiddeti ve nörolojik semptomların varlığı ile ilişkili değildi.
Sonuç: Sonuç olarak, bulgularımız kritik hastalığı olmayan COVID-19 olgularının yarısından fazlasının nörolojik şikayetler yaşadığını göstermiştir. Klinisyenler, koronovirüslerin nöroinvazif yayılmasından haberdar olmalı ve bu hastalarda, özellikle eşlik eden komorbiditeleri olan gençlerde nörolojik bozuklukları sorgulamalıdır. Hastaların ilk veya erken şikayetleri olabileceğinden, COVID-19'un nörolojik semptomlarını daha iyi tanımak, pandeminin kontrolü için özel bir öneme sahip olan erken tanı oranını artırmak için acil bir ihtiyaçtır.
Keywords
References
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- 23. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China JAMA 2020;323(11):1061-1069.
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Abstract
Objective: Coronavirus disease 2019 (COVID-19) may cause neurological impairments in addition to disorders of respiratory and gastrointestinal systems. We aimed to investigate the frequencies and clinical correlates of neurological symptoms in COVID-19.
Materials and Methods: This cross-sectional study was conducted with 117 consecutive patients diagnosed as having COVID-19 in two designated centers assigned by the government to follow up the COVID-19 patients in Turkey.
Results: The mean age was 53.08 ±15.63 years (range 18 to 89 years). Sixty-five (55.5%) mildly (non-complicated), 32 (27.4%) moderately (mild pneumonia), and 20 (17.1%) severely ill (severe pneumonia) patients are included. Seventy nine patients (67.5%) were detected to suffer from neurological complaints. The most common symptom was taste impairment seen in 36 (30.7%) patients. Other common complaints were smell impairment (25.6%), headache (24.7%), and dizziness (16.2%). Patients with neurological symptoms were younger, and more likely to have accompanying comorbidities. The patients with severe infection were also more likely to have coexisting comorbidities. Higher ferritin and LDH levels, and lower lymphocyte counts indicated the worse disease severity.
Conclusion: Our results demonstrated that more than half of the non-critically ill COVID-19 patients experiences neurological complaints. Clinicians should be aware of the neuroinvasive spread of the coronaviruses, and neurological symptoms should be questioned in particular the young patients with accompanying comorbidities.
Keywords
References
- 1. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382(18):1708-1720.
- 2. Johns Hopkins University & Medicine. COVID-19 map. Baltimore, MD: Johns Hopkins University; 2020. https://coronavirus.jhu.edu/map.html. Accessed 17 December 2020.
- 3. Jin Y, Yang H, Ji W, Wu W, Chen S, Zhang W, et al. Virology, Epidemiology, Pathogenesis, and Control of COVID-19. Viruses 2020;12(4):372.
- 4. Lovato A, de Filippis C, Marioni G. Upper airway symptoms in coronavirus disease 2019 (COVID-19). Am J Otolaryngol 2020;102474.
- 5. Esakandari H, Nabi-Afjadi M, Fakkari-Afjadi J, Farahmandian N, Miresmaeili SM, Bahreini E. A comprehensive review of COVID-19 characteristics. Biol Proced Online 2020;22:19.
- 6. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study. JAMA Neurol 2020;77(6):683-690.
- 7. Paterson RW, Brown RL, Benjamin L, Nortley R, Wiethoff S, Bharucha T, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain 2020;143(10):3104-3120.
- 8. Vacchiano V, Riguzzi P, Volpi L, Tappatà M, Avoni P, Rizzo G, et al. Early neurological manifestations of hospitalized COVID-19 patients. Neurol Sci 2020;41:2029–2031.
- 9. Membrilla JA, de Lorenzo Í, Sastre M, Díaz de Terán J. Headache as a Cardinal Symptom of Coronavirus Disease 2019: A Cross-Sectional Study. Headache Epub 2020 Sep 28.
- 10. Delorme C, Paccoud O, Kas A, Hesters A, Bombois S, Shambrook P, et al. Covid-19-related encephalopathy: a case series with brain FDG-PET/CT findings published online ahead of print, 2020 Aug 15. Eur J Neurol 10.1111/ene.14478.
- 11. Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, Kummerlen C, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med 2020;382(23):2268-2270.
- 12. Kandemirli SG, Dogan L, Sarikaya ZT, Kara S, Akinci C, Kaya D, et al. Brain MRI Findings in Patients in the Intensive Care Unit with COVID-19 Infection. Radiology 2020;297(1):E232-E235.
- 13. COVID-19 (SARS-CoV-2 Infection) Guide; Study of National Science Commission of Turkey. April 14, 2020. (COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi; Bilim Kurulu Çalışması) Turkish. Available at: https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf. Accessed May 14, 2020.
- 14. Lau K, Yu W, Chu C, Lau S, Sheng B, Yuen K. Possible central nervous system infection by SARS coronavirus. Emerg Infect Dis 2004;102:342-344.
- 15. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol 2020;277(8):2251-2261.
- 16. Beltrán-Corbellini Á, Chico-García JL, Martínez-Poles J, Rodríguez-Jorge F, Natera-Villalba E, Gómez-Corral J, et al. Acute-onset smell and taste disorders in the context of Covid-19: a pilot multicenter PCR-based case-control study. Eur J Neurol 2020;10.1111/ene.14273.
- 17. Li LQ, Huang T, Wang YQ, Wang ZP, Liang Y, Huang TB, et al. COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis J Med Virol 2020;92(6):577-583.
- 18. Lee Y, Min P, Lee S, Kim SW. Prevalence and Duration of Acute Loss of Smell or Taste in COVID-19 Patients. J Korean Med Sci 2020;3518:e174.
- 19. Moein ST, Hashemian SMR, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty RL. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol 2020;10.1002/alr.22587.
- 20. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus: a first step in understanding SARS pathogenesis. J Pathol 2004;2032:631-637.
- 21. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA Neurol 2020;77(8):1018-1027.
- 22. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet 2020;395:1033– 1034.
- 23. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China JAMA 2020;323(11):1061-1069.
- 24. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China published correction appears in Lancet. 2020 Jan 30. Lancet 2020;39510223:497‐506.
- 25. Allena M, Rossi P, Tassorelli C. Focus on therapy of the Chapter IV headaches provoked by exertional factors: primary cough headache, primary exertional headache and primary headache associated with sexual activity. J Headache Pain 2010;14:525–530.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | September 22, 2021 |
| Submission Date | January 18, 2021 |
| Published in Issue | Year 2021 Volume: 11 Issue: 3 |
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.