COVID-19'da Nörolojik Semptomların Sıklığı ve Klinik Korelasyonlarının Araştırılması

Abstract

Amaç: Koronavirüs hastalığı 2019 (COVID-19), solunum ve gastrointestinal sistem bozukluklarına ek olarak nörolojik bozukluklara da neden olabilir. Bu çalışmada COVID-19 hastalarında nörolojik semptomların sıklığı ve klinik korelasyonlarının araştırılması amaçlandı. Gereç ve Yöntem: Bu kesitsel çalışma, Türkiye'de COVID-19 hastalarını izlemek için Sağlık Bakanlığı tarafından yetkilendirilen iki pandemi hastanesinde COVID-19 teşhisi konulan 117 ardışık hasta ile gerçekleştirildi. Bulgular: Hastaların ortalama yaşı 53.08 ± 15.63 yıldı (18-89 yaş aralığı). Çalışmaya altmış beş (%55,5) hafif (komplike olmayan), 32 (%27,4) orta (hafif pnömoni) ve 20 (%17,1) ağır (ağır pnömoni) hasta dahil edildi. Yetmiş dokuz hastanın (%67,5) nörolojik yakınmaları olduğu tespit edildi. En sık görülen semptom 36 (%30.7) hastada görülen tat bozukluğuydu. Diğer yaygın şikayetler koku alma bozukluğu (%25.6), baş ağrısı (%24.7) ve baş dönmesiydi (% 16.2). Nörolojik semptomları olan hastalar daha gençti ve eşlik eden komorbiditelere sahip olma olasılığı daha yüksekti. Şiddetli enfeksiyonu olan hastaların aynı zamanda eşlik eden komorbiditelere sahip olma olasılığı da daha yüksekti. Daha yüksek ferritin ve LDH seviyeleri ve daha düşük lenfosit sayıları, daha kötü hastalık seyri ile korele bulundu. Buna karşılık laboratuvar parametrelerinin sonuçları nörolojik semptomları olan ve olmayan hastalar arasında farklı değildi. Çalışma grubumuzda komorbidite sayısı ve sigara içme durumu, hastalık şiddeti ve nörolojik semptomların varlığı ile ilişkili değildi. Sonuç: Sonuç olarak, bulgularımız kritik hastalığı olmayan COVID-19 olgularının yarısından fazlasının nörolojik şikayetler yaşadığını göstermiştir. Klinisyenler, koronovirüslerin nöroinvazif yayılmasından haberdar olmalı ve bu hastalarda, özellikle eşlik eden komorbiditeleri olan gençlerde nörolojik bozuklukları sorgulamalıdır. Hastaların ilk veya erken şikayetleri olabileceğinden, COVID-19'un nörolojik semptomlarını daha iyi tanımak, pandeminin kontrolü için özel bir öneme sahip olan erken tanı oranını artırmak için acil bir ihtiyaçtır.

Keywords

• SARS-CoV
• COVID-19
• Pandemi
• Nörolojik semptomlar

The Frequencies and Clinical Correlates of Neurological Symptoms in COVID-19

Abstract

Objective: Coronavirus disease 2019 (COVID-19) may cause neurological impairments in addition to disorders of respiratory and gastrointestinal systems. We aimed to investigate the frequencies and clinical correlates of neurological symptoms in COVID-19. Materials and Methods: This cross-sectional study was conducted with 117 consecutive patients diagnosed as having COVID-19 in two designated centers assigned by the government to follow up the COVID-19 patients in Turkey. Results: The mean age was 53.08 ±15.63 years (range 18 to 89 years). Sixty-five (55.5%) mildly (non-complicated), 32 (27.4%) moderately (mild pneumonia), and 20 (17.1%) severely ill (severe pneumonia) patients are included. Seventy nine patients (67.5%) were detected to suffer from neurological complaints. The most common symptom was taste impairment seen in 36 (30.7%) patients. Other common complaints were smell impairment (25.6%), headache (24.7%), and dizziness (16.2%). Patients with neurological symptoms were younger, and more likely to have accompanying comorbidities. The patients with severe infection were also more likely to have coexisting comorbidities. Higher ferritin and LDH levels, and lower lymphocyte counts indicated the worse disease severity. Conclusion: Our results demonstrated that more than half of the non-critically ill COVID-19 patients experiences neurological complaints. Clinicians should be aware of the neuroinvasive spread of the coronaviruses, and neurological symptoms should be questioned in particular the young patients with accompanying comorbidities.

Keywords

• SARS-CoV
• COVID-19
• Pandemics
• Neurological symptoms

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