Initial Neurological Symptoms Associated with COVID-19 during the First Outbreak in Bulgaria

During the first outbreak of COVID-19 in the spring of 2020 different symptoms of the disease were reported. Therefore, this study aimed to evaluate initial neurological symptoms of COVID-19 among hospitalized patients in that time period. In patients with confirmed COVID-19, initial symptoms, concomitant diseases, neurological signs, and neurological status were assessed. Sixty-six patients (mean age 63 years) were prospectively enrolled, 44 (66.7%) of them were males. Initial neurological symptoms were reported by 51 (77.3%), most commonly headache (14 [21.2%]), dizziness, and vertigo (14 [21.2%]). Dysgeusia was present in 13 (19.7%) and anosmia in 10 (15.2%) patients. Initial neurological symptoms were observed in 20 (76.9%) of ≤ 60 years patients, and 31 (77.5%) of > 60 years patients. Focal neurological deficit was found in 35 (53%) patients, 11 (42.3%) were ≤ 60 years. The presence of initial neurological symptoms in this study is higher than previously reported, without a difference in age groups, despite the higher somatic burden in the group of patients over 60 years of age.