Background and objective: There is a need to improve the understanding of Covid-19 neurological complications in a temporal manner. The objective of our study was to find out temporal relationship of neurological manifestations and outcome in Covid-19 Patients.
Methods: This was a multi-center observational study from six centers in Pakistan. Data of covid patients with six months follow up was retrospectively collected from the hospital records. Time periods were divided into short-term (< 1 month), medium-term (2-3 months) and long-term (>4 months). SPSS version 26.0 (SPSS Inc., Chicago, IL, USA) was used to analyze the data.
Results: Neurological manifestations were reported in 208 out of 905 covid patients. One-hundred-twenty-five (60%) developed neurological manifestations within one month, 62 (30%) developed within 2-3 months and 21 (10%) developed between 4-6 months. Most common manifestations within one month included cerebrovascular disease (59%), neuromuscular disorders (14%) and neuropsychiatric disorders (10%). Common manifestations in 2-3 months group included neuromuscular manifestations (32%), neuropsychiatric manifestations (19%), cerebrovascular diseases (14 %), myalgia or musculoskeletal pain (14%), and vertigo, hearing problems or tinnitus (14%). Common manifestations in 4-6 months group included neuromuscular disorders (33%) cerebrovascular diseases (19%), fatigue / malaise (9%) anosmia/dysgeusia (9%) and Bell’s palsy (25%). The long-term patients differed from the short-term patients by a mean younger age on presentation (44.7 vs. 59 years), female predominance (52% vs. 28%), higher asymptomatic Covid infection (29% vs. 14%), better clinical outcomes (mean mRS of 1.6 vs. 3), and low mortality (0 vs 18%).
Conclusion: Neurological manifestations of covid infection may differ based on time duration since infection. Vascular complications are high in early period while neuromuscular manifestations are high in late period.
Hameed, Sajid; Soomro, Bashir; Iltaf, Samar; Malik, Abdul; Farooq, Anjum; Siddiqi, Alam Ibrahim; Awan, Safia; and Wasay, Mohammad
"Short, Medium and Long Term Neurological Manifestations and Outcome in Covid-19 Patients,"
Pakistan Journal of Neurological Sciences (PJNS): Vol. 17:
4, Article 7.
Available at: https://ecommons.aku.edu/pjns/vol17/iss4/7