Neurological consultations and diagnoses in a large, dedicated COVID-19 university hospital

• Autor(a) principal: Studart-Neto, Adalberto
• Data de Publicação: 2020
• Outros Autores: Guedes, Bruno Fukelmann, Tuma, Raphael De Luca E, Camelo Filho, Antonio Edvan, Kubota, Gabriel Taricani, Iepsen, Bruno Diógenes, Moreira, Gabriela Pantaleão, Rodrigues, Júlia Chartouni, Ferrari, Maíra Medeiros Honorato, Carra, Rafael Bernhard, Spera, Raphael Ribeiro, Oku, Mariana Hiromi Manoel, Terrim, Sara, Lopes, Cesar Castello Branco, Passos Neto, Carlos Eduardo Borges, Dalben, Matheus, De Souza, Julia Carvalhinho Carlos, Baima, José Pedro Soares, Da Silva, Tomás Fraga Ferreira, Moreno, Cristiane Araujo Martins, Silva, Andre Macedo Serafim, Heise, Carlos Otto, Mendonça, Rodrigo Holanda, Fortini, Ida, Smid, Jerusa, Adoni, Tarso, Gonçalves, Marcia Rubia Rodrigues, Pereira, Samira Luisa Apóstolos, Pinto, Lecio Figueira, Gomes, Helio Rodrigues, Zanotelli, Edmar, Brucki, Sonia Maria Dozzi, Conforto, Adriana Bastos, Castro, Luiz Henrique Martins, Nitrini, Ricardo
• Tipo de documento: preprint
• Idioma: eng
• Título da fonte: SciELO Preprints
• Texto Completo: https://preprints.scielo.org/index.php/scielo/preprint/view/971
• topic: Infecções por Coronavírus; COVID-19; Neurologia; Convulsões; Acidente Vascular Cerebral; Encefalopatias; Doenças Neuromusculares; Coronavirus Infections; COVID-19; Neurology; Seizures; Stroke; Metabolic Encephalopathy; Neuromuscular Diseases

Background: More than one-third of COVID-19 patients present neurological symptomsranging from anosmia to stroke and encephalopathy. Furthermore, pre-existingneurological conditions may require special treatment and may be associated with worseoutcomes. Notwithstanding, the role of neurologists in COVID-19 is probablyunderrecognized. Objective: The aim of this study was to report the reasons forrequesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital dasClínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bedCOVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosiswas confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurologyconsultations between March 23rd and May 23rd, 2020 were analyzed. Neurologistsperformed the neurological exam, assessed all available data to diagnose theneurological condition, and requested additional tests deemed necessary. Difficultdiagnoses were established in consensus meetings. After diagnosis, neurologists wereinvolved in the treatment. Results: Neurological consultations were requested for 89 outof 1,208 (7.4%) inpatient COVID admissions during that period. Main neurologicaldiagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurologicaldiseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brainlesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Mostneurological consultations in a COVID-19-dedicated hospital were requested for severeconditions that could have an impact on the outcome. First-line doctors should be able torecognize neurological symptoms; neurologists are important members of the medicalteam in COVID-19 hospital care.