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Neurologic manifestations associated with COVID-19: a multicentre registry

2020; Elsevier BV; Volume: 27; Issue: 3 Linguagem: Inglês

10.1016/j.cmi.2020.11.005

1469-0691

Elodie Meppiel, Nathan Peiffer‐Smadja, Alexandra Maury, Imen Bekri, Cécile Delorme, Virginie Desestret, Lucas Gorza, Geoffroy Hautecloque-Raysz, Sophie Landré, Annie Lannuzel, Solène Moulin, Peggy Perrin, Paul Petitgas, François SellaI, Adrien Wang, Pierre Tattevin, T. de Broucker, Sophie Abgrall, Fanny Alby‐Laurent, Thibault Allou, Joséphine Amevigbe, Hanifa Amarguellay, N. Alloussi, Guillaume Baille, Mathilde Barbaz, Imen Bekri, Lamia Bencherif, Samia Bensaadi, Guillaume Béraud, Alexandra Bizot, Laure Bottin, Fabrice Bruneel, Jean‐Philippe Camdessanché, J. Chauffier, Jean-Philippe Csajaghy, Chloé De Broucker, T. de Broucker, Luc Defebvre, Cécile Delorme, Elodie Dembloque, Nathalie Derache, Olivier Dereeper, Céline Derollez, Cécile Descotes-Genon, Virginie Desestret, Mathilde Devaux, Lydie Dubuc, Gilles Edan, Andréa Fickl, Thibault Fraisse, Michel Gugenheim, Karolina Hankiewicz, Yves Hansmann, Geoffroy Hautecloque-Raysz, Carole Henry, Stéphanie Jobard, F. Jouan, Arnaud Kwiatkowski, T. Lalu, Sophie Landré, Annie Lannuzel, Johan Leguilloux, C Lejeune, Clémence Liegeois, Sophie Mahy, Jonathan Marey, Alexandra Maury, Elodie Meppiel, Laure Michel, Rita De Mitri, Chloé Moulin, Solène Moulin, Nathan Peiffer‐Smadja, Asma Omarjee, Canan Özsancak, Peggy Perrin, Paul Petitgas, Fernando Pico, Marie Poupard, Valérie Rabier, Camille Rizzato, Caroline Roos, Julien Saison, N. Sayre, Nicolas Sedillot, François Sellal, Jérôme Servan, Caroline Storey, Laurent Suchet, Paul Tarteret, Pierre Tattevin, Mathilde Thiébaut, Claudia Vaduva, David Varlan, Adrien Wang, Virginie Zarrouk,

Peripheral Neuropathies and Disorders

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.