巴西巴伊亚州某参考医院急性SARS-CoV-2感染的神经学表现

IF 3 4区医学 Q2 INFECTIOUS DISEASES

Brazilian Journal of Infectious Diseases Pub Date : 2025-05-26 DOI:10.1016/j.bjid.2025.104542

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

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引用次数: 0

摘要

背景：新型冠状病毒病-19 （COVID-19）的神经系统表现与患者疾病严重程度和预后相关。本研究旨在描述一组COVID-19住院患者神经系统表现的频率和特征及其与患者预后的关系。方法回顾性观察研究纳入2020年4月至6月在当地医院住院的18岁及以上的RT-PCR检测到SARS-CoV-2的患者。使用结构化问卷从电子病历中收集参与者的特征。用泊松回归模型检验神经学表现对死亡率的影响。结果共纳入305例新冠肺炎患者，其中57.7%出现神经系统症状。急性脑病62例（20.3%），平均年龄65.5±15.9岁。在该组中，存在较高的合并症患病率（PR）（1.6）和严重疾病患病率（3.6），这是急性脑病的易感因素。他们也更有可能进入重症监护病房（3.1）和死亡（2.4）。中性粒细胞与淋巴细胞比值（NLR）中位数为7（四分位间距[IQR: 4-12]）。52名（17%）参与者出现化学感觉功能障碍，平均年龄53.3±14岁，共病的PR（0.8）低于无患者。重症PR略高（1.1），但ICU住院PR（0.7）和死亡PR（0.4）较低。LNR为3.8 （IQR: 2.2-7.8）。泊松回归分析显示，重症（PR = 3.13）、心脏病（PR = 1.65）、急性脑病（PR = 1.49）、糖尿病（PR = 1.46）和中性粒细胞淋巴细胞比（PR = 1.04）与死亡相关。相反，有化学感觉障碍（PR = 0.44）和长期住院（PR = 0.96）与生存率相关。结论急性脑病患者新型冠状病毒感染形式更严重，病死率更高。相比之下，化学感觉功能障碍与较轻的疾病表现和较好的预后有关。

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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 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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来源期刊

Brazilian Journal of Infectious Diseases 医学-传染病学

CiteScore

5.50

自引率

0.00%

发文量

925

审稿时长

41 days

期刊介绍： The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents. The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor, since its inception it has garnered a growing share of the publishing market.