Vol 55, No 3 (2021)
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Published online: 2021-05-13

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Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality

Marcin Wnuk12, Katarzyna Sawczyńska2, Tomasz Kęsek3, Paweł Wrona3, Żaneta Chatys-Bogacka2, Iwona Mazurkiewicz3, Leszek Drabik45, Jeremiasz Jagiełła2, Joanna Szaleniec67, Jacek Czepiel89, Łukasz Pawliński310, Artur Igor Bień311, Michał Kania311, Mateusz Fiema311, Joanna Zięba-Parkitny311, Agnes Hajek311, Damian Ucieklak311, Magdalena Wilk311, Kamila Pośpiech311, Patrycja Lechowicz311, Karol Kasprzycki311, Marianna Kopka311, Jerzy Hohendorff311, Barbara Katra311, Małgorzata Kostrzycka311, Michalina Adamczyk311, Paulina Surowiec311, Monika Rybicka1213, Jolanta Walczewska1213, Barbara Kamińska1213, Ewelina Piętak1213, Paweł Bryniarski121314, Monika Marona21, Maciej Motyl1, Alicja Kępińska-Wnuk21, Małgorzata Włodarczyk1, Klaudia Nowak21, Elżbieta Gradek-Kwinta1, Mateusz Czyżycki1, Mateusz Dwojak1, Agnieszka Rzemińska1, Kamil Wężyk1, Wojciech Koźmiński1, Agnieszka Pułyk1, Aleksander Garlicki1516, Tomasz Grodzicki1718, Maciej Małecki1920, Agnieszka Słowik121
Pubmed: 34037979
Neurol Neurochir Pol 2021;55(3):314-321.

Abstract

Objectives. To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. Material and methods. We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology. Results. During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5–88.5] vs. 63.5 [51–77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003).

Conclusions. Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality.

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Neurologia i Neurochirurgia Polska