Neurological manifestations and COVID-19: Experiences from a tertiary care center at the Frontline
Open accessAbstract
Objective To report neurological manifestations seen in patients hospitalized with Coronavirus disease 2019 (COVID-19) from a large academic medical center in Chicago, Illinois. Methods We retrospectively reviewed data records of 50 patients with COVID-19 who were evaluated by the neurology services from March 1, 2020 - April 30, 2020. Patients were categorized into 2 groups based on timing of developing neurological manifestations: the "Neuro first" group had neurological manifestations upon initial assessment, and the "COVID first" group developed neurological symptoms greater than 24 h after hospitalization. The demographics, comorbidities, disease severity and neurological symptoms and diagnoses of both groups were analyzed. Statistical analysis was performed to compare the two groups. Results A total of 50 patients (48% African American and 24% Latino) were included in the analysis. Most common neurological manifestations observed were encephalopathy (n = 30), cerebrovascular disease (n = 20), cognitive impairment (n = 13), seizures (n = 13), hypoxic brain injury (n = 7), dysgeusia (n = 5), and extraocular movement abnormalities (n = 5). The "COVID-19 first" group had more evidence of physiologic disturbances on arrival with a more severe/critical disease course (83.3% vs 53.8%, p 0.025). Conclusion Neurologic manifestations of COVID-19 are highly variable and can occur prior to the diagnosis of or as a complication of the viral infection. Despite similar baseline comorbidities and demographics, the COVID-19 patients who developed neurologic symptoms later in hospitalization had more severe disease courses. Differently from previous studies, we noted a high percentage of African American and Latino individuals in both groups.
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A subset of COVID-19 patients report sustained mental problems.
“where a subset of patients report sustained mental problems (Heneka et al., 2020, Pinna et al., 2020)”
From Guanfacine’s mechanism of action in treating prefrontal cortical disorders: Successful translation across species (2020) · cites this paper as Pinna et al., 2020
The Results report cognitive abnormalities, particularly short-term memory impairment, in 12 of 50 COVID-19 patients. But the Limitations state that long-term follow-up data were unavailable, so the paper does not establish that these problems were sustained. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAnti-inflammatory effects of guanfacine may be useful for treating long-term neural consequences of COVID-19.
“The anti-inflammatory effects of guanfacine may also be useful for treating the long-term neural consequences of COVID-19”
From Guanfacine’s mechanism of action in treating prefrontal cortical disorders: Successful translation across species (2020) · cites this paper as Pinna et al., 2020
The Discussion (page unavailable) describes neurological manifestations of COVID-19, but does not discuss guanfacine or its anti-inflammatory effects. The Limitations (page unavailable) state that long-term follow-up data were unavailable. Searches for guanfacine and treatment of long-term neurological consequences found no supporting passage in our copy. (LLM, conf=0.75)
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Hypercoagulability of COVID-19 and Neurological Complications: A Review
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Neurological involvement in the respiratory manifestations of COVID-19 patients
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- Authors
- Pinna, P., Grewal, P., Hall, J. P., Tavarez, T., Dafer, R. M., Garg, R., Osteraas, N. D., Pellack, D. R., Asthana, A., Fegan, K., Patel, V., Conners, J. J., John, S., & Silva, I. D.
- Affiliations
- Rush University Medical Center (US)
- Corresponding author
- Pinna, Pranusha
- ORCID
- Venue
- Journal of the Neurological Sciences
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 415
- Pages
- 116969
- ISSN
- 0022-510X (ISSN-L)
- PMC
- PMC7832569
- OpenAlex
- W3033833391
- Cited by
- 169
- References
- 19
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 9 · 2023: 21 · 2022: 45 · 2021: 61 · 2020: 28
- FWCI
- 16.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the Neurological Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, neurological symptoms, encephalopathy, cerebrovascular disease, cognitive impairment, seizures, hypoxic brain injury, dysgeusia, disease severity, racial disparities, African American patients, Hispanic patients
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Chicago, Female, Humans, Male, Middle Aged, Nervous System Diseases, Pneumonia, Viral, Retrospective Studies, Time Factors, Comorbidity, Coronavirus Infections, Pandemics, Tertiary Care Centers
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