Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India
Background: Though severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) virus primarily affects respiratory system, neurological involvement is well known. Aims: To describe the neurological manifestations of coronavirus disease 2019 (COVID-19) during three waves of the pandemic. Methodology...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=6;spage=1047;epage=1055;aulast=Kulkarni |
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| author | Rahul Kulkarni Dulari Gupta Shripad Pujari Vishal Deshpande Pravin Naphade Rushikesh Deshpande |
| author_facet | Rahul Kulkarni Dulari Gupta Shripad Pujari Vishal Deshpande Pravin Naphade Rushikesh Deshpande |
| author_sort | Rahul Kulkarni |
| collection | DOAJ |
| description | Background: Though severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) virus primarily affects respiratory system, neurological involvement is well known. Aims: To describe the neurological manifestations of coronavirus disease 2019 (COVID-19) during three waves of the pandemic. Methodology: This was an ambispective observational single-centre study to describe the neurological manifestations of COVID-19 infection among inpatients from a tertiary care referral centre in Western India from March 2020 to January 2022. Results: Out of 14,822 patients admitted with COVID-19, 307 (2.07%) had neurological manifestations. Neurological manifestations were seen in 1.87% in first wave (onset to 10 Feb 21); 2.37% in second wave (Feb 11, 2021 to Dec 31, 2021) and 6.26% in third wave (Jan 1, 2022 to Jan 31, 2022). The most common neurological manifestations were encephalopathy (34.5%), ischemic stroke (32.1%), and acute symptomatic seizures (8.8%). Encephalopathy (p = 0.028) was more common in first wave while seizures were more common in third wave (p = 0.001). In patients with encephalopathy, hypoxia (p = 0.0001), shock (p = 0.001), renal involvement (p = 0.002), and sepsis (p = 0.033) were associated with higher mortality; while those with no systemic involvement had better survival (p = 0.0001). Among patients with ischemic stroke, 32.1% did not have any traditional vascular risk factors. These patients were 9 years younger and required 6 days less hospitalization than patients of stroke with vascular risk factors. Conclusion: SARS-CoV-2 produces many central and peripheral nervous system manifestations. Encephalopathy was more common in first wave while acute symptomatic seizures were more common in third wave. Encephalopathy was most common neurological manifestation with progressively higher mortality with increased number of systemic comorbidities. Ischemic stroke was seen in patients who had vascular risk factors as well as in patients without them. |
| first_indexed | 2024-04-12T02:08:06Z |
| format | Article |
| id | doaj.art-9f15631b13e24161b52e90253d964fc9 |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-04-12T02:08:06Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-9f15631b13e24161b52e90253d964fc92022-12-22T03:52:29ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492022-01-012561047105510.4103/aian.aian_204_22Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from IndiaRahul KulkarniDulari GuptaShripad PujariVishal DeshpandePravin NaphadeRushikesh DeshpandeBackground: Though severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) virus primarily affects respiratory system, neurological involvement is well known. Aims: To describe the neurological manifestations of coronavirus disease 2019 (COVID-19) during three waves of the pandemic. Methodology: This was an ambispective observational single-centre study to describe the neurological manifestations of COVID-19 infection among inpatients from a tertiary care referral centre in Western India from March 2020 to January 2022. Results: Out of 14,822 patients admitted with COVID-19, 307 (2.07%) had neurological manifestations. Neurological manifestations were seen in 1.87% in first wave (onset to 10 Feb 21); 2.37% in second wave (Feb 11, 2021 to Dec 31, 2021) and 6.26% in third wave (Jan 1, 2022 to Jan 31, 2022). The most common neurological manifestations were encephalopathy (34.5%), ischemic stroke (32.1%), and acute symptomatic seizures (8.8%). Encephalopathy (p = 0.028) was more common in first wave while seizures were more common in third wave (p = 0.001). In patients with encephalopathy, hypoxia (p = 0.0001), shock (p = 0.001), renal involvement (p = 0.002), and sepsis (p = 0.033) were associated with higher mortality; while those with no systemic involvement had better survival (p = 0.0001). Among patients with ischemic stroke, 32.1% did not have any traditional vascular risk factors. These patients were 9 years younger and required 6 days less hospitalization than patients of stroke with vascular risk factors. Conclusion: SARS-CoV-2 produces many central and peripheral nervous system manifestations. Encephalopathy was more common in first wave while acute symptomatic seizures were more common in third wave. Encephalopathy was most common neurological manifestation with progressively higher mortality with increased number of systemic comorbidities. Ischemic stroke was seen in patients who had vascular risk factors as well as in patients without them.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=6;spage=1047;epage=1055;aulast=Kulkarniacute ischemic strokecovid-19encephalopathyneurological manifestations |
| spellingShingle | Rahul Kulkarni Dulari Gupta Shripad Pujari Vishal Deshpande Pravin Naphade Rushikesh Deshpande Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India Annals of Indian Academy of Neurology acute ischemic stroke covid-19 encephalopathy neurological manifestations |
| title | Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India |
| title_full | Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India |
| title_fullStr | Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India |
| title_full_unstemmed | Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India |
| title_short | Neurological manifestations in COVID-19 in three waves of the pandemic: An inpatient study from India |
| title_sort | neurological manifestations in covid 19 in three waves of the pandemic an inpatient study from india |
| topic | acute ischemic stroke covid-19 encephalopathy neurological manifestations |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=6;spage=1047;epage=1055;aulast=Kulkarni |
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