COVID-19 neurological manifestations - the experience of a tertiary hospital from Northeastern Romania

ROMANIA (Abstract): Well-known for its respiratory tropism, severe acute respiratory syndrome coronavirus 2 (SARS -CoV-2), can further affect both the central and peripheral nervous system causing a substantial source of morbidity and mortality.This study aimed to evaluate the neurological manifestations in SARS-CoV2-infected hospitalized patients and to evaluate the short-term outcomes based on clinical features, neurologic comorbidities, and laboratory.Materials and methods: We retrospectively analyzed medical records of patients with SARS-CoV-2 infection admitted to the "Sf.Parascheva" Clinical Hospital of Infectious Diseases Iasi between May 2020 and December 2022.Clinical features, frequency of neurological manifestations, and correlation with risk factors, pandemic waves, and the severity of the disease were evaluated.Results: We identified 160 patients hospitalized during the investigated period, the most frequent neurologic manifestations at the time of admission were fatigability (85% cases), headache (51.25% cases), myalgia (41.25% cases), vertigo (26.88% cases), confusion (21.25% cases) and less frequent anosmia (16.88% cases), ageusia (15% cases), paresthesia (3.13% cases).In all phases fatigability was predominant, being in over 80% of cases one of the symptoms at the moment of hospitalization, followed by cephalalgia and myalgia.Anosmia (25%) and ageusia (27%) were found most in phase two compared to all phases.In the second phase, the variant of concern was delta, causing more critical cases than all the other mentioned p eriods.Previous neurologic comorbidities such as dementia and stroke were correlated with a higher mortality risk.Conclusions: Neurological symptoms were a relatively frequent part of the clinical picture of SARS-CoV2 infection, and their incidence varied in different pandemic waves.Fatigability was the most constant finding.Previous neurologic comorbidities such as dementia and stroke were correlated with a higher mortality risk.