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Background <p>Neurological manifestations associated with COVID-19 remain partially described, mainly in low- and middle-income countries where diagnostic tools are limited. To address this, we assembled medical centers in Brazil with the goal of describing neurological syndromes associated with COVID-19 during the first wave of the pandemic.</p> Methods <p>From June 1st, 2020 to June 1st, 2021, non-consecutive adult patients with new onset of six neurological syndromes up to 60 days after confirmed COVID-19 were included. Data were compiled from four tertiary centers and compared with general local COVID-19 data, as well as with a previous cohort focused on vascular syndrome.</p> Results <p>197 patients were included, presenting with vascular syndromes (81), encephalopathy (68), encephalitis (19), Guillain-Barré syndrome (13), other neuropathies (12), and myelitis (4). The incidence curve of neurocovid mirrored that of COVID-19. Neurological syndromes were present regardless of COVID-19 severity. The median time from COVID-19 to onset of neurological symptoms was 14 days, suggesting a post-infectious immune-mediated mechanism. Patients were 10 times more likely to die (χ<sup>2</sup> (1) = 356.55, p &lt; 0.01, OR = 10.89) and 38 times more likely to be hospitalized than other COVID-19 patients (χ<sup>2</sup> (1) = 1167.9, p &lt; 0.01, OR = 38.22). Those developing vascular syndromes patients were 3 times more likely to require ICU (χ<sup>2</sup> (1) = 37.12, p &lt; 0.01, OR = 3.78) and 4 times more likely to die (χ<sup>2</sup> (1) = 58.808, p &lt; 0.01, OR = 4.73) than patients with vascular syndromes due to different etiologies.</p> Conclusions <p>Our study corroborates the association of neurological syndromes with COVID-19. The incidence correlated with local waves of COVID-19, and patients with neurocovid exhibited a higher susceptibility to adverse outcomes compared to other COVID-19 patients. Among all neurological syndromes, vascular syndromes were the most common, and their severity surpassed that of vascular syndromes not attributed to COVID-19.</p>

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Neurological syndromes associated with COVID-19: a multicenter study in Brazil

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  • 发表日期：

    2025年1月27日

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  • Aline de Moura Brasil Matos,
  • Andre Borges Ferreira Gomes,
  • Fernanda Martins Maia Carvalho,
  • Francisco Tomaz Meneses de Oliveira,
  • Lohana Santana Almeida da Silva,
  • Flavia Esper Dahy,
  • Joao Victor Luisi de Moura,
  • Marcela Vieira Freire,
  • Jose Ernesto Vidal,
  • Rosa Maria Nascimento Marcusso,
  • Jerusa Smid,
  • Victor Rebelo Procaci,
  • Rodrigo Meireles Massaud,
  • Felipe Von Glehn,
  • Jorge Casseb,
  • Camila Malta Romano,
  • Augusto Cesar Penalva de Oliveira,
  • Mariana Saconato,
  • Jose Angelo L. Lindoso,
  • Rosa PSF Ferrarese,
  • Graziela UL Domingues,
  • Jaques Sztanjbok,
  • Michel EJ Haziot,
  • Rene LM Rivero,
  • Lucio NA Batista,
  • Cleonisio L. Rodrigues,
  • Isaac HM Maia,
  • Norberto AF Frota,
  • Daniele M. Lima,
  • Fabricio O. Lima,
  • Felipe A. Rocha,
  • Tiago P. Feijo,
  • Daniel GF Tavora,
  • Karoline F. Mororo,
  • Francisco Silvanei S. Gonçalves,
  • Anderson V. Paula,
  • Alvina Clara Félix,
  • Caio S. Souza,
  • Thais M. Romano,
  • Lorena S. Viana,
  • Gustavo Bruniera,
  • Marcel K. Uehara,
  • Marcos VT. Fujino,
  • Thiago D. Correa,
  • Alcino A. Barbosa,
  • Fabiana Hirata,
  • Iron Dangoni,
  • Natalia M. Athayde

摘要

Background

Neurological manifestations associated with COVID-19 remain partially described, mainly in low- and middle-income countries where diagnostic tools are limited. To address this, we assembled medical centers in Brazil with the goal of describing neurological syndromes associated with COVID-19 during the first wave of the pandemic.

Methods

From June 1st, 2020 to June 1st, 2021, non-consecutive adult patients with new onset of six neurological syndromes up to 60 days after confirmed COVID-19 were included. Data were compiled from four tertiary centers and compared with general local COVID-19 data, as well as with a previous cohort focused on vascular syndrome.

Results

197 patients were included, presenting with vascular syndromes (81), encephalopathy (68), encephalitis (19), Guillain-Barré syndrome (13), other neuropathies (12), and myelitis (4). The incidence curve of neurocovid mirrored that of COVID-19. Neurological syndromes were present regardless of COVID-19 severity. The median time from COVID-19 to onset of neurological symptoms was 14 days, suggesting a post-infectious immune-mediated mechanism. Patients were 10 times more likely to die (χ2 (1) = 356.55, p < 0.01, OR = 10.89) and 38 times more likely to be hospitalized than other COVID-19 patients (χ2 (1) = 1167.9, p < 0.01, OR = 38.22). Those developing vascular syndromes patients were 3 times more likely to require ICU (χ2 (1) = 37.12, p < 0.01, OR = 3.78) and 4 times more likely to die (χ2 (1) = 58.808, p < 0.01, OR = 4.73) than patients with vascular syndromes due to different etiologies.

Conclusions

Our study corroborates the association of neurological syndromes with COVID-19. The incidence correlated with local waves of COVID-19, and patients with neurocovid exhibited a higher susceptibility to adverse outcomes compared to other COVID-19 patients. Among all neurological syndromes, vascular syndromes were the most common, and their severity surpassed that of vascular syndromes not attributed to COVID-19.