Abstract: Background: Coronavirus disease 2019 (COVID-19) infection causes a wide variety of neurological disorders by affecting both central and peripheral nervous systems. The cytokine storm (CS) has been blamed for the development of severe neurological disorders in COVID-19. However, the relationship between COVID-19 CS and neurological manifestations has not been adequately studied. Thus, we aimed to investigate the neurological presentations in patients with COVID-19 CS. Methods: The study population consisted of hospitalized moderate-to-severe COVID-19 patients. It was divided into two groups CS (36 patients, 29.3%) and non-CS (87 patients, 70.7%) based on significant clinical symptoms, elevated inflammatory marker levels, radiological findings, and interleukin-6 levels (IL-6). Results: The three most common neurological symptoms in the CS group were altered level of consciousness, headache, and unsteadiness. Altered level of consciousness was higher in the CS group (69.4%) than the non-CS group (25.3%) ( p :0.001). The frequency of headache was comparable in both groups ( p :0.186). The number of patients requiring intensive care unit and intubation was higher in the CS group ( p :0.005 and p :0.001). The mortality rate in the CS group (38.9%) was higher than the non-CS group (8.0%) ( p :0.001). IL-6, CRP, ferritin, neutrophil-lymphocyte ratio, procalcitonin, and D-dimer levels were higher in the CS group (for all p :0.001) while lymphocyte count was lower ( p :0.003). Conclusion: The most common neurological presentation in patients with CS was altered level of consciousness. The presence of CS was an independent risk factor for high mortality.
【저자키워드】 COVID-19, Cytokine storm, interleukin-6, Neurological disorders, Altered level of consciousness, 【초록키워드】 Coronavirus disease 2019, Hospitalized, intensive care, Clinical symptoms, IL-6, Infection, intubation, CRP, ferritin, procalcitonin, headache, Lymphocyte count, Patient, mortality rate, patients, marker, D-dimer level, Frequency, Neurological disorder, Inflammatory, neurological, study population, high mortality, independent risk factor, moderate-to-severe COVID-19 patients, neurological manifestation, radiological, Neurological symptom, elevated, variety, comparable, cause, two group, affecting, Altered, in both group, patients with COVID-19, 【제목키워드】 storm, presentation, with COVID-19,