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Published in: Neurological Sciences 8/2020

01-08-2020 | Joint Pain | COVID-19

Early neurological manifestations of hospitalized COVID-19 patients

Authors: Veria Vacchiano, P. Riguzzi, L. Volpi, M. Tappatà, P. Avoni, G. Rizzo, L. Guerra, S. Zaccaroni, P. Cortelli, R. Michelucci, R. Liguori

Published in: Neurological Sciences | Issue 8/2020

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Abstract

Introduction

Neurological manifestations can occur during coronavirus disease 19 (COVID-19). Several pathogenic mechanisms have been hypothesized, without conclusive results. In this study, we evaluated the most frequent neurological symptoms in a cohort of hospitalized COVID-19 patients, and also investigated the possible relationship between plasmatic inflammatory indices and olfactory disorders (ODs) and between muscle pain and creatine kinase (CK).

Methods

We consecutively enrolled hospitalized COVID-19 patients. A structured questionnaire concerning typical and neurological symptoms, focusing on headache, dizziness, ODs, taste disorders (TDs), and muscle pain, was administrated by telephone interviews.

Results

Common neurological symptoms were reported in the early phase of the disease, with a median onset ranging from 1 to 3 days. Headache showed tension-type features and was more frequently associated with a history of headache. Patients with ODs less frequently needed oxygen therapy. Inflammatory indices did not significantly differ between patients with and without ODs. Muscle pain did not show any association with CK level but was more frequently associated with arthralgia and headache.

Conclusion

In our cohort, ODs were an early symptom of COVID-19, more frequently reported by patients with milder forms of disease. Headache in association with arthralgia and muscle pain seems to reflect the common symptoms of the flu-like syndrome, and not COVID-19 infection-specific.
Literature
1.
go back to reference Mao L, Jin H, Wang M et al (2020) Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 10:e201127 Mao L, Jin H, Wang M et al (2020) Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 10:e201127
2.
go back to reference Lai C-C, Ko W-C, Lee P-I, Jean S-S, Hsueh P-R (2020) Extra-respiratory manifestations of COVID-19. Int J Antimicrob Agents 22 Lai C-C, Ko W-C, Lee P-I, Jean S-S, Hsueh P-R (2020) Extra-respiratory manifestations of COVID-19. Int J Antimicrob Agents 22
3.
go back to reference Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S (2020) 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 6 Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S (2020) 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 6
4.
go back to reference Henkin RI, Schmidt L, Velicu I (2013) Interleukin 6 in hyposmia. JAMA Otolaryngol Head Neck Surg 139(7):728–734CrossRef Henkin RI, Schmidt L, Velicu I (2013) Interleukin 6 in hyposmia. JAMA Otolaryngol Head Neck Surg 139(7):728–734CrossRef
5.
go back to reference Marlowe NI (1992) Pain sensitivity and headache: an examination of the central theory. J Psychosom Res 36(1):17–24CrossRef Marlowe NI (1992) Pain sensitivity and headache: an examination of the central theory. J Psychosom Res 36(1):17–24CrossRef
6.
go back to reference Brann DH, Tsukahara T, Weinreb C, Logan DW, Datta SR Non-neural expression of SARS-CoV-2 entry genes in the olfactory epithelium suggests mechanisms underlying anosmia in COVID-19 patients. bioRxiv 2020.03.25.009084 Brann DH, Tsukahara T, Weinreb C, Logan DW, Datta SR Non-neural expression of SARS-CoV-2 entry genes in the olfactory epithelium suggests mechanisms underlying anosmia in COVID-19 patients. bioRxiv 2020.03.25.009084
7.
go back to reference Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS (2020) Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol 12 Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS (2020) Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol 12
8.
go back to reference Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS (2020) Self-reported olfactory loss associates with outpatient clinical course in Covid-19. Int Forum Allergy Rhinol. 24 Yan CH, Faraji F, Prajapati DP, Ostrander BT, DeConde AS (2020) Self-reported olfactory loss associates with outpatient clinical course in Covid-19. Int Forum Allergy Rhinol. 24
9.
go back to reference Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J (2004) Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol 203(2):622–630CrossRef Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J (2004) Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol 203(2):622–630CrossRef
Metadata
Title
Early neurological manifestations of hospitalized COVID-19 patients
Authors
Veria Vacchiano
P. Riguzzi
L. Volpi
M. Tappatà
P. Avoni
G. Rizzo
L. Guerra
S. Zaccaroni
P. Cortelli
R. Michelucci
R. Liguori
Publication date
01-08-2020
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 8/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04525-z

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