Neurological complications in critical patients with COVID-19
| العنوان: | Neurological complications in critical patients with COVID-19 |
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| المؤلفون: | María José Abenza-Abildúa, R Alonso-Esteban, P Ruíz-Seco, J A Palacios-Castaño, G Gutierrez-Gutierrez, R Moreno-Zabaleta, P González-Ruano, M A Salvador-Maya, I Palmí-Cortés, M Mata-Álvarez de Santullano, M L Almarcha-Menargues, B Rojo Moreno-Arrones, N Gonzalo-García, F J Navacerrada-Barrero, J Fernández-Travieso, C. Pérez-López, C Algarra-Lucas, E Malmierca-Corral, M T Ramírez-Prieto, N Arenas-Valls, C Borrue-Fernández, B Sánchez-Cordón, C Jimeno-Montero, J Ojeda-Ruíz de Luna |
| المصدر: | Neurología (English Edition), Vol 35, Iss 9, Pp 621-627 (2020) Neurología (English Edition) |
| بيانات النشر: | Elsevier España, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, Pediatrics, Electroencephalography, Encephalopathy, Encefalopatías, Acute myopathy, lcsh:RC346-429, law.invention, 0302 clinical medicine, law, Materials Chemistry, Confusion, medicine.diagnostic_test, Age Factors, Middle Aged, Intensive care unit, Magnetic Resonance Imaging, Acute Disease, Female, Original Article, medicine.symptom, Coronavirus Infections, Encephalitis, Adult, medicine.medical_specialty, Neuromuscular disease, Coronavirus disease 2019 (COVID-19), Critical Care, Critical Illness, Pneumonia, Viral, Neuroimaging, 03 medical and health sciences, Betacoronavirus, Muscular Diseases, Paciente crítico, medicine, Humans, Myopathy, Pandemics, lcsh:Neurology. Diseases of the nervous system, Aged, Cerebral Hemorrhage, Retrospective Studies, Miopatía aguda, business.industry, Critical patient, SARS-CoV-2, Electromyoneurography, COVID-19, Length of Stay, medicine.disease, Spain, SARS-CoV2, Nervous System Diseases, business, 030217 neurology & neurosurgery |
| الوصف: | Introduction: We analysed the neurological complications of patients with severe SARS-CoV-2 infection who required intensive care unit (ICU) admission. Patients and methods: We conducted a retrospective, observational, descriptive study of consecutive patients admitted to the ICU due to severe respiratory symptoms secondary to SARS-CoV-2 infection between 1 April and 1 June 2020. Results: We included 30 patients with neurological symptoms; 21 were men (72.40%), and mean age (standard deviation [SD]) was 57.41 years (11.61). The mean duration of ICU stay was 18.83 days (14.33). The neurological conditions recorded were acute confusional syndrome in 28 patients (93.33%), neuromuscular disease in 15 (50%), headache in 5 (16.66%), cerebrovascular disease in 4 (13.33%), and encephalopathies/encephalitis in 4 (13.33%). CSF analysis results were normal in 6 patients (20%). Brain MRI or head CT showed alterations in 20 patients (66.6%). EEG was performed in all patients (100%), with 8 (26.66%) showing abnormal findings. In 5 of the 15 patients with clinical myopathy, diagnosis was confirmed with electroneuromyography. We found a correlation between older age and duration of ICU stay (P = 0.002; 95% CI, 4.032–6.022; OR). Conclusions: Severe COVID-19 mainly affects men, as observed in other series. Half of our patients presented acute myopathy, and almost all patients left the ICU with acute confusional syndrome, which fully resolved; no correlation was found with EEG or neuroimaging findings. Older age is associated with longer ICU stay. Resumen: Introducción: Nos proponemos analizar las complicaciones neurológicas de los pacientes con infección grave por SARS-CoV2, que han requerido ingreso en Unidad de Cuidados Intensivos (UCI). Pacientes y métodos: Estudio descriptivo retrospectivo, observacional, de pacientes consecutivos ingresado en UCI por infección respiratoria grave por SARS-CoV-2, desde el 1 de Abril hasta el 1 de Junio de 2020. Resultados: Registramos 30 pacientes con síntomas neurológicos, 21 hombres (72,40%), edad media: 57,41 años ± 11,61 desviación estándar (DE). Estancia media en UCI: 18,83 ± 14,33 DE. A nivel sindrómico: 28 pacientes (93,33%) con síndrome confusional agudo, 15 pacientes (50%) con patología neuromuscular, 5 (16,66%) cefalea, 4 (13,33%) con patología cerebrovascular, y 4 (13,33%) con encefalopatías/encefalitis. Punción lumbar normal en 6 pacientes (20%). La RMN craneal o TAC craneal mostró alteraciones en 20 casos (66,6%). Se realizó EEG en todos los pacientes (100%), alterado en 8 pacientes (26,66%). En 5 de los 15 pacientes con miopatía clínica se ha podido confirmar con ENMG. Hemos encontrado relación entre la mayor edad y los días de ingreso en UCI (P = 0,002, IC 95% 4,032-6,022; OR:). Conclusiones: La infección grave por COVID-19 afecta mayoritariamente a hombres, similar a lo descrito en otras series. La mitad de nuestros pacientes presentan una miopatía aguda, y casi la totalidad de los pacientes salen de la UCI con sindromes confusionales agudos, que evolucionan a la resolución completa, sin correlacionarse con los resultados del EEG o de pruebas de neuroimagen. La mayor edad sí se asocia con un mayor número de días de estancia en UCI. |
| اللغة: | English |
| تدمد: | 2173-5808 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::21b7397bb2ddd5a90a1914e2de256ff5Test http://www.sciencedirect.com/science/article/pii/S2173580820302212Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....21b7397bb2ddd5a90a1914e2de256ff5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21735808 |
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