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Neurological syndromes associated with COVID-19: a multicenter study in Brazil

2025; BioMed Central; Volume: 25; Issue: 1 Linguagem: Inglês

10.1186/s12879-025-10504-6

1471-2334

Aline de Moura Brasil Matos, Andre Borges Ferreira Gomes, Fernanda Carvalho, Francisco Tomaz Meneses de Oliveira, Lohana Santana Almeida da Silva, Flávia Esper Dahy, João Moura, Marcela Vieira Freire, José E. Vidal, Rosa Maria Nascimento Marcusso, Jerusa Smid, Victor Rebelo Procaci, Rodrigo Meireles Massaud, Felipe von Glehn, Jorge Casseb, Camila Malta Romano, Augusto César Penalva de Oliveira, Mariana Saconato, José Ângelo Lauletta Lindoso, Roberto Ferrarese, Graziela U. de Lima Domingues, Jaques Sztanjbok, Michel E. Haziot, Rene Leandro Magalhães Rivero, Luiza Ivete Vieira Batista, Cleonísio Leite Rodrigues, Isabel Maia, Norberto Anízio Ferreira Frota, Daniele M. Lima, Fabrício Oliveira Lima, Felipe Almeida Rocha, Tiago P. Feijo, Daniel Gurgel Fernandes Távora, Karoline F. Mororo, Francisco Rocha Gonçalves, Anderson Vicente De Paula, Alvina Clara Félix, Caio S. Souza, Thaís Malta Romano, Lorena Souza Viana, Gustavo Bruniera, M. Uehara, Masako Fujino, Thiago Domingos Corrêa, Alcino A Barbosa, Fabiana Hirata, Iron Dangoni, Natália Merten Athayde,

COVID-19 Clinical Research Studies

Neurological manifestations associated with COVID-19 remain partially described, mainly in low- and middle-income countries where diagnostic tools are limited. To address this, we assembled medical centers in Brazil with the goal of describing neurological syndromes associated with COVID-19 during the first wave of the pandemic. From June 1st, 2020 to June 1st, 2021, non-consecutive adult patients with new onset of six neurological syndromes up to 60 days after confirmed COVID-19 were included. Data were compiled from four tertiary centers and compared with general local COVID-19 data, as well as with a previous cohort focused on vascular syndrome. 197 patients were included, presenting with vascular syndromes (81), encephalopathy (68), encephalitis (19), Guillain-Barré syndrome (13), other neuropathies (12), and myelitis (4). The incidence curve of neurocovid mirrored that of COVID-19. Neurological syndromes were present regardless of COVID-19 severity. The median time from COVID-19 to onset of neurological symptoms was 14 days, suggesting a post-infectious immune-mediated mechanism. Patients were 10 times more likely to die (χ2 (1) = 356.55, p < 0.01, OR = 10.89) and 38 times more likely to be hospitalized than other COVID-19 patients (χ2 (1) = 1167.9, p < 0.01, OR = 38.22). Those developing vascular syndromes patients were 3 times more likely to require ICU (χ2 (1) = 37.12, p < 0.01, OR = 3.78) and 4 times more likely to die (χ2 (1) = 58.808, p < 0.01, OR = 4.73) than patients with vascular syndromes due to different etiologies. Our study corroborates the association of neurological syndromes with COVID-19. The incidence correlated with local waves of COVID-19, and patients with neurocovid exhibited a higher susceptibility to adverse outcomes compared to other COVID-19 patients. Among all neurological syndromes, vascular syndromes were the most common, and their severity surpassed that of vascular syndromes not attributed to COVID-19.