Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series
BACKGROUND: 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. METHODS: In this monocentric retrospective case series, medical records from patients with acute...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Masson SAS.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877203/ https://www.ncbi.nlm.nih.gov/pubmed/33610347 http://dx.doi.org/10.1016/j.neurol.2021.01.004 |
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author | 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. |
author_facet | 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. |
author_sort | Cleret de Langavant, L. |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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 15(th) and May 15(th) 2020. Diagnosis of SARS-CoV-2 was ascertained through specific RT-PCR in nasopharyngeal swabs or based on circulating serum IgG antibodies. RESULTS: 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. CONCLUSIONS: 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. |
format | Online Article Text |
id | pubmed-7877203 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Masson SAS. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78772032021-02-11 Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series 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. Rev Neurol (Paris) Original Article BACKGROUND: 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. METHODS: 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 15(th) and May 15(th) 2020. Diagnosis of SARS-CoV-2 was ascertained through specific RT-PCR in nasopharyngeal swabs or based on circulating serum IgG antibodies. RESULTS: 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. CONCLUSIONS: 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. Elsevier Masson SAS. 2021-03 2021-02-11 /pmc/articles/PMC7877203/ /pubmed/33610347 http://dx.doi.org/10.1016/j.neurol.2021.01.004 Text en © 2021 Elsevier Masson SAS. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article 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. Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series |
title | Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series |
title_full | Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series |
title_fullStr | Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series |
title_full_unstemmed | Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series |
title_short | Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series |
title_sort | clinical description of the broad range of neurological presentations of covid-19: a retrospective case series |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877203/ https://www.ncbi.nlm.nih.gov/pubmed/33610347 http://dx.doi.org/10.1016/j.neurol.2021.01.004 |
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