DOI of the published preprint https://doi.org/10.1590/0004-282X20200089
Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital
DOI:
https://doi.org/10.1590/0004-282X20200089Keywords:
Coronavirus Infections, COVID-19, Neurology, Seizures, Stroke, Metabolic Encephalopathy, Neuromuscular DiseasesAbstract
Background: More than one-third of COVID-19 patients present neurological symptoms
ranging from anosmia to stroke and encephalopathy. Furthermore, pre-existing
neurological conditions may require special treatment and may be associated with worse
outcomes. Notwithstanding, the role of neurologists in COVID-19 is probably
underrecognized. Objective: The aim of this study was to report the reasons for
requesting neurological consultations by internists and intensivists in a COVID-19-
dedicated hospital. Methods: This retrospective study was carried out at Hospital das
Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bed
COVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosis
was confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurology
consultations between March 23rd and May 23rd, 2020 were analyzed. Neurologists
performed the neurological exam, assessed all available data to diagnose the
neurological condition, and requested additional tests deemed necessary. Difficult
diagnoses were established in consensus meetings. After diagnosis, neurologists were
involved in the treatment. Results: Neurological consultations were requested for 89 out
of 1,208 (7.4%) inpatient COVID admissions during that period. Main neurological
diagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurological
diseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brain
lesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Most
neurological consultations in a COVID-19-dedicated hospital were requested for severe
conditions that could have an impact on the outcome. First-line doctors should be able to
recognize neurological symptoms; neurologists are important members of the medical
team in COVID-19 hospital care.
Downloads
Submitted
Posted
How to Cite
Section
Copyright (c) 2020 Adalberto Studart-Neto, Bruno Fukelmann Guedes, Raphael De Luca E Tuma, Antonio Edvan Camelo Filho, Gabriel Taricani Kubota, Bruno Diógenes Iepsen, Gabriela Pantaleão Moreira, Júlia Chartouni Rodrigues, Maíra Medeiros Honorato Ferrari, Rafael Bernhard Carra, Raphael Ribeiro Spera, Mariana Hiromi Manoel Oku, Sara Terrim, Cesar Castello Branco Lopes, Carlos Eduardo Borges Passos Neto, Matheus Dalben, Julia Carvalhinho Carlos De Souza, José Pedro Soares Baima, Tomás Fraga Ferreira Da Silva, Cristiane Araujo Martins Moreno, Andre Macedo Serafim Silva, Carlos Otto Heise, Rodrigo Holanda Mendonça, Ida Fortini, Jerusa Smid, Tarso Adoni, Marcia Rubia Rodrigues Gonçalves, Samira Luisa Apóstolos Pereira, Lecio Figueira Pinto, Helio Rodrigues Gomes, Edmar Zanotelli, Sonia Maria Dozzi Brucki, Adriana Bastos Conforto, Luiz Henrique Martins Castro, Ricardo Nitrini
This work is licensed under a Creative Commons Attribution 4.0 International License.
