Case series/case reports (Indigo)
The objective of this study was to characterise the breadth of neurological findings associated with SARS-CoV-2 infection in a diverse group of inpatients at an urban, US medical center. Patients were identified through an electronic medical record review from April 15, 2020, until July 1, 2020, at a large safety-net hospital in Boston, MA, caring primarily for underserved, low-income, and elderly patients. All hospitalised adult patients with positive nasopharyngeal swab or respiratory PCR testing for SARS-CoV-2 during their hospitalisation, or in the 30 days prior to admission, who received an inpatient neurological or neurocritical care consultation or admission during the study period were enrolled. Seventy-four patients were identified (42/57% male, median age 64 years). The majority of patients self-identified as Black or African-American (38, 51%). The most common neurological symptoms at presentation to hospital included altered mental status (39, 53%), fatigue (18, 24%), and headache (18, 18%). Fifteen patients had ischaemic strokes (20%). There were 10 in-hospital mortalities, with moderately severe disability among survivors at discharge (14%, median modified Rankin Scale score of 4). The authors concluded that neurological findings spanned inflammatory and vascular pathologies, sequelae of critical illness and metabolic derangements, possible direct involvement of the nervous system by SARS-CoV-2, and exacerbation of underlying neurological conditions, highlighting a broad range of possible aetiologies of neurological complications in patients with COVID-19. Further studies are needed to characterise the infectious and post-infectious neurological complications of COVID-19 in diverse patient populations.
DOI: https://doi.org/10.1212/CPJ.0000000000001031
