• Rev Neurol France · Mar 2021

    Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series.

    • L Cleret de Langavant, A Petit, Q T R Nguyen, T Gendre, J Abdelhedi, A Djellaoui, L Seddik, L Lim, F Faugeras, H Salhi, A Wahab, L Fechtenbaum, A Dormeuil, H Hosseini, K Youssov, G Fénelon, B Bapst, P Brugières, T Tuilier, E Kalsoum, M-B Matignon, J Oniszczuk, S Gallien, W Vindrios, G Melica, A-L Scain, R Esser, L Rostain, C Guillaud, G Dubos-Lascu, N Saada, H Guillet, M Khellaf, B Bardel, S S Ayache, J-P Lefaucheur, J-M Pawlotsky, S Fourati, and A-C Bachoud-Lévi.
    • AP-HP, Centre de référence maladie de Huntington, service de neurologie, hôpital Henri-Mondor, Créteil, France; Université Paris-Est Créteil, faculté de médecine, Créteil, France; Département d'études cognitives, école normale supérieure, PSL University, Paris, France; Inserm U955, Institut Mondor de recherche biomédicale, équipe E01 NeuroPsychologie Interventionnelle, Créteil, France.
    • Rev Neurol France. 2021 Mar 1; 177 (3): 275-282.

    BackgroundNeurological disorders associated with SARS-CoV-2 infection represent a clinical challenge because they encompass a broad neurological spectrum and may occur before the diagnosis of COVID-19.MethodsIn this monocentric retrospective case series, medical records from patients with acute neurological disorders associated with SARS-CoV-2 infection from medicine departments of an academic center in Paris area were collected between March 15th and May 15th 2020. Diagnosis of SARS-CoV-2 was ascertained through specific RT-PCR in nasopharyngeal swabs or based on circulating serum IgG antibodies.ResultsTwenty-six patients diagnosed with SARS-CoV-2 infection presented with neurological disorders: encephalitis (N=8), encephalopathy (N=6), cerebrovascular events (ischemic strokes N=4 and vein thromboses N=2), other central nervous system (CNS) disorders (N=4), and Guillain-Barré syndrome (N=2). The diagnosis of SARS-CoV-2 was delayed on average 1.6 days after the onset of neurological disorder, especially in case of encephalitis 3.9 days, encephalopathy 1.0 day, and cerebrovascular event 2.7 days.ConclusionsOur study confirms that COVID-19 can yield a broad spectrum of neurological disorders. Because neurological presentations of COVID-19 often occur a few days before the diagnosis of SARS-COV-2 infection, clinicians should take preventive measures such as patient isolation and masks for any new admission to avoid nosocomial infections. Anti-SARS-CoV2 antibody detection in RT-PCR SARS CoV-2 negative suspected cases is useful to confirm a posteriori the diagnosis of atypical COVID-19 presentations.Copyright © 2021 Elsevier Masson SAS. All rights reserved.

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