BEYOND RESPIRATORY DAMAGE – NEUROLOGICAL INVOLVEMENT IN SARS-CoV-2 INFECTION

Abstract

Although the respiratory damage associated with SARS-CoV-2 infection is well known, clinical and experimental studies have shown that the Coronaviridae family has a certain tropism for both the central and peripheral nervous system. Most patients with this pathology also associate neurological manifestations, often of a central type, with varying degrees of difficulty. The aim of this study was to evaluate the newly developed neurological manifestations in SARS-CoV-2 infected hospitalized patients. Material and method: We retrospectively analyzed medical records of patients with SARS-CoV-2 infection admitted in the Clinical Hospital of Infectious Diseases “Sf. Parascheva” Iasi between May 2020 – May 2022. Clinical features, frequency and correlation with risk factors (for example age, gender, comorbidities) and also severity of infection were evaluated. Results: We have identified 133 patients hospitalized during analyzed period and the majority presented significant comorbidities (94.84% cases). Fatigability (51.88% cases), myalgia (32.33% cases), impaired consciousness (decreased consciousness or confusion to encephalopathy) (27.88% cases), headache (28.57% cases) were the most frequent neurological features identified. A changing pattern in neurological manifestations was found during the pandemics’ waves, with an increase of incidence of fatigability and myalgia during the fifth wave of pandemic. Conclusions: Neurological symptoms were a relatively constant part of the clinical picture of SARS-CoV-2 infection. They had polymorphic and various features during the pandemic waves. The incidence of headache, myalgia and fatigability was highly increased during the last wave of pandemics. Impairment of consciousness was significantly correlated with age, neurological and cardiovascular comorbidities.