Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality
Marcin Wnuk, Katarzyna Sawczyńska, Tomasz Kęsek, Paweł Wrona, Żaneta Chatys-Bogacka, Iwona Mazurkiewicz, Leszek Drabik, Jeremiasz Jagiełła, Joanna Szaleniec, Jacek Czepiel, Łukasz Pawliński, Artur Igor Bień, Michał Kania, Mateusz Fiema, Joanna Zięba-Parkitny, Agnes Hajek, Damian Ucieklak, Magdalena Wilk, Kamila Pośpiech, Patrycja Lechowicz, Karol Kasprzycki, Marianna Kopka, Jerzy Hohendorff, Barbara Katra, Małgorzata Kostrzycka, Michalina Adamczyk, Paulina Surowiec, Monika Rybicka, Jolanta Walczewska, Barbara Kamińska, Ewelina Piętak, Paweł Bryniarski, Monika Marona, Maciej Motyl, Alicja Kępińska-Wnuk, Małgorzata Włodarczyk, Klaudia Nowak, Elżbieta Gradek-Kwinta, Mateusz Czyżycki, Mateusz Dwojak, Agnieszka Rzemińska, Kamil Wężyk, Wojciech Koźmiński, Agnieszka Pułyk, Aleksander Garlicki, Tomasz Grodzicki, Maciej T. Małecki, Agnieszka Słowik
Abstract
OBJECTIVES: To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. MATERIAL AND METHODS: We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology. RESULTS: During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5-88.5] vs. 63.5 [51-77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). CONCLUSIONS: Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality.