Abstract
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.
Keywords: Amyotrophic Lateral Sclerosis; Diaphragmatic ultrasonography; Phrenic nerve conduction; Pulmonary function tests.
【저자키워드】 Amyotrophic lateral sclerosis, Diaphragmatic ultrasonography, Phrenic nerve conduction, Pulmonary function tests, 【초록키워드】 COVID-19, SARS CoV-2, SARS-CoV-2, stroke, SARS-COV-2 infection, Infection, Diagnosis, Masks, RT-PCR, pulmonary, Encephalitis, Mask, Nasopharyngeal swab, Case series, Antibody detection, nasopharyngeal swabs, Nerve conduction, Patient, Isolation, Encephalopathy, Central nervous system, preventive measures, Neurological disorders, CNS, Admission, Guillain-barrè syndrome, broad spectrum, retrospective, Neurological disorder, Atypical, Amyotrophic lateral sclerosis, neurological, Nosocomial infections, preventive measure, medical records, medical record, Pulmonary function tests, clinician, SARS CoV, average, Paris, syndrome, serum IgG, circulating, disorder, Lateral Sclerosis, serum IgG antibodies, event, Phrenic nerve, collected, diagnosed, occur, diagnosis of COVID-19, diagnosis of SARS-CoV-2, Lateral, 【제목키워드】 clinical, retrospective, neurological, case sery,