Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil

Background: Neurologic manifestations of Coronavirus Disease-19 (COVID-19) have been associated with patients’ disease severity and outcome. This study aimed to describe the frequency and characteristics of the neurological manifestations in a group of hospitalized individuals with COVID-19 and thei...

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Main Authors: Jesângeli de Sousa Dias, Maria Augusta Moreira Rebouças, Lilian Verena da Silva Carvalho, Thais Sampaio Silva, Jair Santana dos Santos, Astrid Xiomara Tatiana Otero Melendez, Carlos Brites
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Brazilian Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1413867025000431
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author Jesângeli de Sousa Dias
Maria Augusta Moreira Rebouças
Lilian Verena da Silva Carvalho
Thais Sampaio Silva
Jair Santana dos Santos
Astrid Xiomara Tatiana Otero Melendez
Carlos Brites
author_facet Jesângeli de Sousa Dias
Maria Augusta Moreira Rebouças
Lilian Verena da Silva Carvalho
Thais Sampaio Silva
Jair Santana dos Santos
Astrid Xiomara Tatiana Otero Melendez
Carlos Brites
author_sort Jesângeli de Sousa Dias
collection DOAJ
description Background: Neurologic manifestations of Coronavirus Disease-19 (COVID-19) have been associated with patients’ disease severity and outcome. This study aimed to describe the frequency and characteristics of the neurological manifestations in a group of hospitalized individuals with COVID-19 and their associations with patient outcomes. Methods: Patients aged 18 years or older admitted to a local hospital between April and June 2020 with SARS-CoV-2 detected by RT-PCR were included in this retrospective observational study. The characteristics of participants were collected from electronic medical records using a structured questionnaire. A Poisson regression model was used to examine the influence of neurological manifestations on mortality. Results: A total of 305 participants with COVID-19 were included, with 57.7 % of them presenting neurological symptoms. There were 62 (20.3 %) individuals with acute encephalopathy, with a mean age of 65.5 ± 15.9 years. In this group, higher Prevalence Ratios (PR) of comorbidities (1.6) and severe disease (3.6) were present, predisposing factors for acute encephalopathy. They were also more likely to be admitted to the intensive care unit (3.1) and to die (2.4). The median Neutrophil-Lymphocyte Ratio (NLR) was 7 (Interquartile Range [IQR: 4‒12]). Fifty-two (17 %) participants presented chemosensory dysfunction, with a mean age 53.3 ± 14 years and a lower PR of comorbidity (0.8) than those without. The severe diseases’ PR was slightly higher (1.1), but the PR of ICU admission (0.7), and deaths (0.4) was lower. The LNR was 3.8 (IQR: 2.2–7.8). Poisson regression analysis revealed that severe illness (PR = 3.13), cardiopathy (PR = 1.65), acute encephalopathy (PR = 1.49), diabetes (PR = 1.46), and neutrophil-lymphocyte ratio (PR = 1.04) were associated with death. Conversely, having chemosensory disorders (PR = 0.44) and a prolonged hospital stay (PR = 0.96) were associated with survival. Conclusion: Patients with acute encephalopathy had more severe forms of COVID-19 and higher mortality. In contrast, chemosensory dysfunction was associated with milder disease manifestations and a better prognosis.
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spelling doaj-art-3d4ed25ba0de461e9658c33b34eb34e02025-08-20T02:42:34ZengElsevierBrazilian Journal of Infectious Diseases1413-86702025-07-0129410454210.1016/j.bjid.2025.104542Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, BrazilJesângeli de Sousa Dias0Maria Augusta Moreira Rebouças1Lilian Verena da Silva Carvalho2Thais Sampaio Silva3Jair Santana dos Santos4Astrid Xiomara Tatiana Otero Melendez5Carlos Brites6Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Instituto Couto Maia, Salvador, Bahia, Brazil; Corresponding author.Instituto Couto Maia, Salvador, Bahia, BrazilInstituto Couto Maia, Salvador, Bahia, BrazilInstituto Couto Maia, Salvador, Bahia, BrazilInstituto Couto Maia, Salvador, Bahia, BrazilInstituto Couto Maia, Salvador, Bahia, BrazilPrograma de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, BrazilBackground: Neurologic manifestations of Coronavirus Disease-19 (COVID-19) have been associated with patients’ disease severity and outcome. This study aimed to describe the frequency and characteristics of the neurological manifestations in a group of hospitalized individuals with COVID-19 and their associations with patient outcomes. Methods: Patients aged 18 years or older admitted to a local hospital between April and June 2020 with SARS-CoV-2 detected by RT-PCR were included in this retrospective observational study. The characteristics of participants were collected from electronic medical records using a structured questionnaire. A Poisson regression model was used to examine the influence of neurological manifestations on mortality. Results: A total of 305 participants with COVID-19 were included, with 57.7 % of them presenting neurological symptoms. There were 62 (20.3 %) individuals with acute encephalopathy, with a mean age of 65.5 ± 15.9 years. In this group, higher Prevalence Ratios (PR) of comorbidities (1.6) and severe disease (3.6) were present, predisposing factors for acute encephalopathy. They were also more likely to be admitted to the intensive care unit (3.1) and to die (2.4). The median Neutrophil-Lymphocyte Ratio (NLR) was 7 (Interquartile Range [IQR: 4‒12]). Fifty-two (17 %) participants presented chemosensory dysfunction, with a mean age 53.3 ± 14 years and a lower PR of comorbidity (0.8) than those without. The severe diseases’ PR was slightly higher (1.1), but the PR of ICU admission (0.7), and deaths (0.4) was lower. The LNR was 3.8 (IQR: 2.2–7.8). Poisson regression analysis revealed that severe illness (PR = 3.13), cardiopathy (PR = 1.65), acute encephalopathy (PR = 1.49), diabetes (PR = 1.46), and neutrophil-lymphocyte ratio (PR = 1.04) were associated with death. Conversely, having chemosensory disorders (PR = 0.44) and a prolonged hospital stay (PR = 0.96) were associated with survival. Conclusion: Patients with acute encephalopathy had more severe forms of COVID-19 and higher mortality. In contrast, chemosensory dysfunction was associated with milder disease manifestations and a better prognosis.http://www.sciencedirect.com/science/article/pii/S1413867025000431COVID-19Acute encephalopathyChemosensory dysfunctionNeutrophil-lymphocyte-ratioEthnicityOutcome
spellingShingle Jesângeli de Sousa Dias
Maria Augusta Moreira Rebouças
Lilian Verena da Silva Carvalho
Thais Sampaio Silva
Jair Santana dos Santos
Astrid Xiomara Tatiana Otero Melendez
Carlos Brites
Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil
Brazilian Journal of Infectious Diseases
COVID-19
Acute encephalopathy
Chemosensory dysfunction
Neutrophil-lymphocyte-ratio
Ethnicity
Outcome
title Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil
title_full Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil
title_fullStr Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil
title_full_unstemmed Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil
title_short Neurological manifestations of acute SARS-CoV-2 infection in a reference hospital in Bahia, Brazil
title_sort neurological manifestations of acute sars cov 2 infection in a reference hospital in bahia brazil
topic COVID-19
Acute encephalopathy
Chemosensory dysfunction
Neutrophil-lymphocyte-ratio
Ethnicity
Outcome
url http://www.sciencedirect.com/science/article/pii/S1413867025000431
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