Neurological Manifestations and their Correlated Factorsin COVID-19 Patients; a Cross-Sectional Study

COVID-19 might present with other seemingly unrelated manifestations; for instance, neuro-logical symptoms. This study aimed to evaluate the neurologic manifestations and their correlated factors inCOVID-19 patients.

This retrospective observational study was conducted from March 17, 2020 toJune 20, 2020 in a tertiary hospital in Iran. The study population consisted of adult patients with a positive resultfor COVID-19 real-time reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal swabs.Both written and electronic data regarding baseline characteristic, laboratory findings, and neurological mani-festations were evaluated and reported.

727 COVID-19 patients with the mean age of 49.94 ± 17.49 yearswere studied (56.9% male). At least one neurological symptom was observed in 403 (55.4%) cases. Headache(29.0%), and smell (22.3%) and taste (22.0%) impairment were the most prevalent neurological symptoms, whileseizure (1.1%) and stroke (2.3%) were the least common ones. Patients with neurological manifestations weresignificantly older (p = 0.04), had greater body mass index (BMI) (p = 0.02), longer first symptom to admissionduration (p < 0.001) and were more frequently opium users (p = 0.03) compared to COVID-19 patients withoutneurological symptoms. O2 saturation was significantly lower in patients with neurological manifestations (p =0.04). In addition, medians of neutrophil count (p = 0.006), neutrophil-lymphocyte ratio (NLR) (p = 0.02) andc-reactive protein (CRP) (p = 0.001) were significantly higher and the median of lymphocyte count (p = 0.03) wassignificantly lower in patients with neurological manifestations.

The prevalence of neurologicalmanifestations in the studied cases was high (55.4%). This prevalence was significantly higher in older age,grated BMI, longer lasting disease, and opium usage.