Neurologic manifestations associated with COVID-19: a multicentre registry.
COVID-19
Nervous system
Neurologic manifestations
Registry
SARS-CoV-2
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
09
09
2020
revised:
03
11
2020
accepted:
05
11
2020
pubmed:
16
11
2020
medline:
12
3
2021
entrez:
15
11
2020
Statut:
ppublish
Résumé
To provide an overview of the spectrum, characteristics and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted a single-centre retrospective study during the French coronavirus disease 2019 (COVID-19) epidemic in March-April 2020. All COVID-19 patients with de novo neurologic manifestations were eligible. We included 222 COVID-19 patients with neurologic manifestations from 46 centres in France. Median (interquartile range, IQR) age was 65 (53-72) years and 136 patients (61.3%) were male. COVID-19 was severe or critical in 102 patients (45.2%). The most common neurologic diseases were COVID-19-associated encephalopathy (67/222, 30.2%), acute ischaemic cerebrovascular syndrome (57/222, 25.7%), encephalitis (21/222, 9.5%) and Guillain-Barré syndrome (15/222, 6.8%). Neurologic manifestations appeared after the first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19-associated encephalopathy, 7 (5-10) days in encephalitis, 12 (7-18) days in acute ischaemic cerebrovascular syndrome and 18 (15-28) days in Guillain-Barré syndrome. Brain imaging was performed in 192 patients (86.5%), including 157 magnetic resonance imaging (70.7%). Among patients with acute ischaemic cerebrovascular syndrome, 13 (22.8%) of 57 had multiterritory ischaemic strokes, with large vessel thrombosis in 16 (28.1%) of 57. Brain magnetic resonance imaging of encephalitis patients showed heterogeneous acute nonvascular lesions in 14 (66.7%) of 21. Cerebrospinal fluid of 97 patients (43.7%) was analysed, with pleocytosis found in 18 patients (18.6%) and a positive SARS-CoV-2 PCR result in two patients with encephalitis. The median (IQR) follow-up was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). Clinical spectrum and outcomes of neurologic manifestations associated with SARS-CoV-2 infection were broad and heterogeneous, suggesting different underlying pathogenic processes.
Identifiants
pubmed: 33189873
pii: S1198-743X(20)30698-4
doi: 10.1016/j.cmi.2020.11.005
pmc: PMC7661948
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
458-466Investigateurs
Sophie Abgrall
(S)
Fanny Alby-Laurent
(F)
Thibault Allou
(T)
Joséphine Amevigbe
(J)
Hanifa Amarguellay
(H)
Nabil Alloussi
(N)
Guillaume Baille
(G)
Mathilde Barbaz
(M)
Imen Bekri
(I)
Lamia Bencherif
(L)
Samia Bensaadi
(S)
Guillaume Beraud
(G)
Alexandra Bizot
(A)
Laure Bottin
(L)
Fabrice Bruneel
(F)
Jean-Philippe Camdessanche
(JP)
Jeanne Chauffier
(J)
Jean-Philippe Csajaghy
(JP)
Chloé De Broucker
(C)
Thomas De Broucker
(T)
Luc Defebvre
(L)
Cécile Delorme
(C)
Elodie Dembloque
(E)
Nathalie Derache
(N)
Olivier Dereeper
(O)
Céline Derollez
(C)
Cécile Descotes-Genon
(C)
Virginie Desestret
(V)
Mathilde Devaux
(M)
Lydie Dubuc
(L)
Gilles Edan
(G)
Andréa Fickl
(A)
Thibault Fraisse
(T)
Michel Gugenheim
(M)
Karolina Hankiewicz
(K)
Yves Hansmann
(Y)
Geoffroy Hautecloque-Raysz
(G)
Carole Henry
(C)
Stéphanie Jobard
(S)
Fanny Jouan
(F)
Arnaud Kwiatkowski
(A)
Thibault Lalu
(T)
Sophie Landre
(S)
Annie Lannuzel
(A)
Johan Leguilloux
(J)
Camille Lejeune
(C)
Clémence Liegeois
(C)
Sophie Mahy
(S)
Jonathan Marey
(J)
Alexandra Maury
(A)
Elodie Meppiel
(E)
Laure Michel
(L)
Rita Mitri
(R)
Chloé Moulin
(C)
Solène Moulin
(S)
Nathan Peiffer-Smadja
(N)
Asma Omarjee
(A)
Canan Ozsancak
(C)
Peggy Perrin
(P)
Paul Petitgas
(P)
Fernando Pico
(F)
Marie Poupard
(M)
Valérie Rabier
(V)
Camille Rizzato
(C)
Caroline Roos
(C)
Julien Saison
(J)
Naomi Sayre
(N)
Nicolas Sedillot
(N)
François Sellal
(F)
Jérôme Servan
(J)
Caroline Storey
(C)
Laurent Suchet
(L)
Paul Tarteret
(P)
Pierre Tattevin
(P)
Mathilde Thiebaut
(M)
Claudia Vaduva
(C)
David Varlan
(D)
Adrien Wang
(A)
Virginie Zarrouk
(V)
Informations de copyright
Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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