Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19
Objective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-1...
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| Veröffentlicht in: | Internal Medicine 2021/11/15, Vol.60(22), pp.3559-3567 |
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| creator | Ishiyama, Hiroyuki Ishii, Junko Yoshimura, Hajime Tsunogae, Marie Fujiwara, Satoru Hiya, Satomi Inui, Ryoma Shiomi, Yuma Nakazawa, Shinsaku Kimura, Masamune Kuroda, Takehito Murakami, Yasutaka Maekawa, Kota Ohara, Nobuyuki Kohara, Nobuo Kawamoto, Michi |
| description | Objective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 ventilated patients (the most severe group), we evaluated neurological complications during admission, subacute neurological presentations, and neurological sequelae (51 and 137 days from the onset [median], respectively). Results Of the 95 patients (mean age 53 years old; 40% women), 63% had acute neurological presentations, with an increased prevalence in cases of severe infections (83% vs. 52%, p |
| doi_str_mv | 10.2169/internalmedicine.7802-21 |
| format | Article |
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We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 ventilated patients (the most severe group), we evaluated neurological complications during admission, subacute neurological presentations, and neurological sequelae (51 and 137 days from the onset [median], respectively). Results Of the 95 patients (mean age 53 years old; 40% women), 63% had acute neurological presentations, with an increased prevalence in cases of severe infections (83% vs. 52%, p<0.001). Impaired consciousness and limb weakness were more frequent in severe patients than in non-severe ones (0% vs. 49%; p<0.001, and 0% vs. 54%; p<0.001, respectively). In the most severe group (mean age 72 years old; 42% women), 83% of patients had neurological complications [cerebrovascular disease (17%), encephalopathy (82%), and neuropathy (55%)], and 92% had subacute neurological presentations [impaired consciousness (17%), higher brain dysfunction (82%), limb weakness (75%), and tremor (58%)]. Neurological sequelae were found in 83% of cases, including higher brain dysfunction (73%), limb weakness (50%), and tremor (58%). Conclusions Neurological manifestations are common in COVID-19, with the possibility of long-lasting sequelae.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.7802-21</identifier><identifier>PMID: 34511566</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Aged ; Cerebrovascular diseases ; Consciousness ; Coronaviruses ; COVID-19 ; Encephalopathy ; Female ; Hospitalization ; Humans ; infectious diseases ; intensive and critical care ; Internal medicine ; Male ; Middle Aged ; Nervous System Diseases - epidemiology ; Nervous System Diseases - etiology ; Neurological complications ; neurology ; Neuropathy ; Original ; Retrospective Studies ; SARS-CoV-2 ; Tremor</subject><ispartof>Internal Medicine, 2021/11/15, Vol.60(22), pp.3559-3567</ispartof><rights>2021 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2021</rights><rights>Copyright © 2021 by The Japanese Society of Internal Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c610t-26fd5c467a6fc2aa588fe422829186e30e5c73f116864e47ecdd8fa273079eec3</citedby><cites>FETCH-LOGICAL-c610t-26fd5c467a6fc2aa588fe422829186e30e5c73f116864e47ecdd8fa273079eec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666216/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8666216/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,1877,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34511566$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ishiyama, Hiroyuki</creatorcontrib><creatorcontrib>Ishii, Junko</creatorcontrib><creatorcontrib>Yoshimura, Hajime</creatorcontrib><creatorcontrib>Tsunogae, Marie</creatorcontrib><creatorcontrib>Fujiwara, Satoru</creatorcontrib><creatorcontrib>Hiya, Satomi</creatorcontrib><creatorcontrib>Inui, Ryoma</creatorcontrib><creatorcontrib>Shiomi, Yuma</creatorcontrib><creatorcontrib>Nakazawa, Shinsaku</creatorcontrib><creatorcontrib>Kimura, Masamune</creatorcontrib><creatorcontrib>Kuroda, Takehito</creatorcontrib><creatorcontrib>Murakami, Yasutaka</creatorcontrib><creatorcontrib>Maekawa, Kota</creatorcontrib><creatorcontrib>Ohara, Nobuyuki</creatorcontrib><creatorcontrib>Kohara, Nobuo</creatorcontrib><creatorcontrib>Kawamoto, Michi</creatorcontrib><title>Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Objective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 ventilated patients (the most severe group), we evaluated neurological complications during admission, subacute neurological presentations, and neurological sequelae (51 and 137 days from the onset [median], respectively). Results Of the 95 patients (mean age 53 years old; 40% women), 63% had acute neurological presentations, with an increased prevalence in cases of severe infections (83% vs. 52%, p<0.001). Impaired consciousness and limb weakness were more frequent in severe patients than in non-severe ones (0% vs. 49%; p<0.001, and 0% vs. 54%; p<0.001, respectively). In the most severe group (mean age 72 years old; 42% women), 83% of patients had neurological complications [cerebrovascular disease (17%), encephalopathy (82%), and neuropathy (55%)], and 92% had subacute neurological presentations [impaired consciousness (17%), higher brain dysfunction (82%), limb weakness (75%), and tremor (58%)]. Neurological sequelae were found in 83% of cases, including higher brain dysfunction (73%), limb weakness (50%), and tremor (58%). Conclusions Neurological manifestations are common in COVID-19, with the possibility of long-lasting sequelae.</description><subject>Aged</subject><subject>Cerebrovascular diseases</subject><subject>Consciousness</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Encephalopathy</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>infectious diseases</subject><subject>intensive and critical care</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nervous System Diseases - epidemiology</subject><subject>Nervous System Diseases - etiology</subject><subject>Neurological complications</subject><subject>neurology</subject><subject>Neuropathy</subject><subject>Original</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Tremor</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkcmOEzEQhi0EYsLAKyBLXLj04KXtdl-QUFhmpECQWCROlnFXJ44cO9huEDw9biVEMFyqDvXVX8uPEKbkilHZP3OhQArG72Fw1gW46hRhDaN30ILytm86xsVdtCA9VQ2r4QI9yHlHCFddz-6jC94KSoWUC_TlHUwp-rhx1nj81gQ3Qi6muBgyNmHAqxg2TZ22xx_g2wTeAHYBX8d8cMV49wsG_L7iEErGP1zZ4uX6883LhvYP0b3R-AyPTvkSfXr96uPyulmt39wsX6waKykpDZPjIGwrOyNHy4wRSo3QMqbmvSVwAsJ2fKRUKtlC24EdBjUa1nHS9QCWX6LnR93D9LX-w9ZNkvH6kNzepJ86Gqf_rQS31Zv4XSspZf1mFXh6EkixXpiL3rtswXsTIE5ZM9ExRtsaK_rkFrqL02xEpSQRnAqqSKXUkbIp5pxgPC9DiZ7907f907N_tVRbH_99zLnxj2EVWB-BXXVpA2fApOKsh_-VZR3J5ngacSbt1iQNgf8GqQG54A</recordid><startdate>20211115</startdate><enddate>20211115</enddate><creator>Ishiyama, Hiroyuki</creator><creator>Ishii, Junko</creator><creator>Yoshimura, Hajime</creator><creator>Tsunogae, Marie</creator><creator>Fujiwara, Satoru</creator><creator>Hiya, Satomi</creator><creator>Inui, Ryoma</creator><creator>Shiomi, Yuma</creator><creator>Nakazawa, Shinsaku</creator><creator>Kimura, Masamune</creator><creator>Kuroda, Takehito</creator><creator>Murakami, Yasutaka</creator><creator>Maekawa, Kota</creator><creator>Ohara, Nobuyuki</creator><creator>Kohara, Nobuo</creator><creator>Kawamoto, Michi</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20211115</creationdate><title>Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19</title><author>Ishiyama, Hiroyuki ; Ishii, Junko ; Yoshimura, Hajime ; Tsunogae, Marie ; Fujiwara, Satoru ; Hiya, Satomi ; Inui, Ryoma ; Shiomi, Yuma ; Nakazawa, Shinsaku ; Kimura, Masamune ; Kuroda, Takehito ; Murakami, Yasutaka ; Maekawa, Kota ; Ohara, Nobuyuki ; Kohara, Nobuo ; Kawamoto, Michi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c610t-26fd5c467a6fc2aa588fe422829186e30e5c73f116864e47ecdd8fa273079eec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Cerebrovascular diseases</topic><topic>Consciousness</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Encephalopathy</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>infectious diseases</topic><topic>intensive and critical care</topic><topic>Internal medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nervous System Diseases - epidemiology</topic><topic>Nervous System Diseases - etiology</topic><topic>Neurological complications</topic><topic>neurology</topic><topic>Neuropathy</topic><topic>Original</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Tremor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishiyama, Hiroyuki</creatorcontrib><creatorcontrib>Ishii, Junko</creatorcontrib><creatorcontrib>Yoshimura, Hajime</creatorcontrib><creatorcontrib>Tsunogae, Marie</creatorcontrib><creatorcontrib>Fujiwara, Satoru</creatorcontrib><creatorcontrib>Hiya, Satomi</creatorcontrib><creatorcontrib>Inui, Ryoma</creatorcontrib><creatorcontrib>Shiomi, Yuma</creatorcontrib><creatorcontrib>Nakazawa, Shinsaku</creatorcontrib><creatorcontrib>Kimura, Masamune</creatorcontrib><creatorcontrib>Kuroda, Takehito</creatorcontrib><creatorcontrib>Murakami, Yasutaka</creatorcontrib><creatorcontrib>Maekawa, Kota</creatorcontrib><creatorcontrib>Ohara, Nobuyuki</creatorcontrib><creatorcontrib>Kohara, Nobuo</creatorcontrib><creatorcontrib>Kawamoto, Michi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishiyama, Hiroyuki</au><au>Ishii, Junko</au><au>Yoshimura, Hajime</au><au>Tsunogae, Marie</au><au>Fujiwara, Satoru</au><au>Hiya, Satomi</au><au>Inui, Ryoma</au><au>Shiomi, Yuma</au><au>Nakazawa, Shinsaku</au><au>Kimura, Masamune</au><au>Kuroda, Takehito</au><au>Murakami, Yasutaka</au><au>Maekawa, Kota</au><au>Ohara, Nobuyuki</au><au>Kohara, Nobuo</au><au>Kawamoto, Michi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2021-11-15</date><risdate>2021</risdate><volume>60</volume><issue>22</issue><spage>3559</spage><epage>3567</epage><pages>3559-3567</pages><artnum>7802-21</artnum><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Objective Various neurological manifestations have been increasingly reported in coronavirus disease 2019 (COVID-19). We determined the neurological features and long-term sequelae in hospitalized COVID-19 patients. Methods We retrospectively studied 95 consecutive hospitalized patients with COVID-19 between March 1 and May 13, 2020. Acute neurological presentations (within two weeks of the symptom onset of COVID-19) were compared between 60 non-severe and 35 severely infected patients who required high-flow oxygen. In the 12 ventilated patients (the most severe group), we evaluated neurological complications during admission, subacute neurological presentations, and neurological sequelae (51 and 137 days from the onset [median], respectively). Results Of the 95 patients (mean age 53 years old; 40% women), 63% had acute neurological presentations, with an increased prevalence in cases of severe infections (83% vs. 52%, p<0.001). Impaired consciousness and limb weakness were more frequent in severe patients than in non-severe ones (0% vs. 49%; p<0.001, and 0% vs. 54%; p<0.001, respectively). In the most severe group (mean age 72 years old; 42% women), 83% of patients had neurological complications [cerebrovascular disease (17%), encephalopathy (82%), and neuropathy (55%)], and 92% had subacute neurological presentations [impaired consciousness (17%), higher brain dysfunction (82%), limb weakness (75%), and tremor (58%)]. Neurological sequelae were found in 83% of cases, including higher brain dysfunction (73%), limb weakness (50%), and tremor (58%). Conclusions Neurological manifestations are common in COVID-19, with the possibility of long-lasting sequelae.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>34511566</pmid><doi>10.2169/internalmedicine.7802-21</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cerebrovascular diseases Consciousness Coronaviruses COVID-19 Encephalopathy Female Hospitalization Humans infectious diseases intensive and critical care Internal medicine Male Middle Aged Nervous System Diseases - epidemiology Nervous System Diseases - etiology Neurological complications neurology Neuropathy Original Retrospective Studies SARS-CoV-2 Tremor |
| title | Neurological Manifestations and Long-term Sequelae in Hospitalized Patients with COVID-19 |
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