AUTHOR=Fan Siyuan , Xiao Meng , Han Fei , Xia Peng , Bai Xiaoyin , Chen Huan , Zhang Hongmin , Ding Xin , Zhao Hua , Zhao Jing , Sun Xuefeng , Jiang Wei , Wang Chunyao , Cao Wei , Guo Fan , Tian Ran , Gao Peng , Wu Wei , Ma Jie , Wu Dong , Liu Zhengyin , Zhou Xiang , Wang Jinglan , Guan Tianjia , Qin Yan , Li Taisheng , Xu Yingchun , Zhang Dong , Chen Yu , Xie Jing , Li Yongzhe , Yan Xiaowei , Zhu Yicheng , Peng Bin , Cui Liying , Zhang Shuyang , Guan Hongzhi 

TITLE=Neurological Manifestations in Critically Ill Patients With COVID-19: A Retrospective Study

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00806

DOI=10.3389/fneur.2020.00806

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> The complications of coronavirus disease 2019 (COVID-19) involved multiple organs or systems, especially in critically ill patients. We aim to investigate the neurological complications in critically ill patients with COVID-19.</p><p><bold>Methods:</bold> This retrospective single-center case series analyzed critically ill patients with COVID-19 at the intensive care unit of Tongji Hospital, Wuhan, China from February 5 to April 2, 2020. Demographic data, clinical and laboratory findings, comorbidities and treatments were collected and analyzed.</p><p><bold>Results:</bold> Among 86 patients with confirmed COVID-19, 54 patients (62.8%) were male, and the mean (SD) age was 66.6 (11.1) years. Overall, 65% patients presented with at least one neurological symptom. Twenty patients (23.3%) had symptoms involving the central nervous system, including delirium, cerebrovascular diseases and hypoxic-ischemic brain injury, while 6 patients (7%) had neuromuscular involvement. Seven of 86 patients exhibited new stroke and 6 (7%) cases were ischemic. A significantly higher prevalence of antiphospholipid antibodies was observed in patients with ischemic stroke than in those without stroke (83.3 vs. 26.9%, <italic>p</italic> &lt; 0.05). Patients with ischemic stroke were more likely to have a higher myoglobulin level, and a lower hemoglobin level.</p><p><bold>Conclusions:</bold> The clinical spectrum of neurological complications in critically ill patients with COVID-19 was broad. Stroke, delirium and neuromuscular diseases are common neurological complications of COVID-19. Physicians should pay close attention to neurological complications in critically ill patients with COVID-19.</p>