Neurological syndromes associated with COVID-19: a multicenter study in Brazil
Abstract Background Neurological manifestations associated with COVID-19 remain partially described, mainly in low- and middle-income countries where diagnostic tools are limited. To address this, we assembled medical centers in Brazil with the goal of describing neurological syndromes associated wi...
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BMC
2025-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10504-6 |
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| author | Aline de Moura Brasil Matos Andre Borges Ferreira Gomes Fernanda Martins Maia Carvalho Francisco Tomaz Meneses de Oliveira Lohana Santana Almeida da Silva Flavia Esper Dahy Joao Victor Luisi de Moura Marcela Vieira Freire Jose Ernesto Vidal Rosa Maria Nascimento Marcusso Jerusa Smid Victor Rebelo Procaci Rodrigo Meireles Massaud Felipe Von Glehn Jorge Casseb Camila Malta Romano Augusto Cesar Penalva de Oliveira on behalf of NeurocovBR study group |
| author_facet | Aline de Moura Brasil Matos Andre Borges Ferreira Gomes Fernanda Martins Maia Carvalho Francisco Tomaz Meneses de Oliveira Lohana Santana Almeida da Silva Flavia Esper Dahy Joao Victor Luisi de Moura Marcela Vieira Freire Jose Ernesto Vidal Rosa Maria Nascimento Marcusso Jerusa Smid Victor Rebelo Procaci Rodrigo Meireles Massaud Felipe Von Glehn Jorge Casseb Camila Malta Romano Augusto Cesar Penalva de Oliveira on behalf of NeurocovBR study group |
| author_sort | Aline de Moura Brasil Matos |
| collection | DOAJ |
| description | Abstract Background Neurological manifestations associated with COVID-19 remain partially described, mainly in low- and middle-income countries where diagnostic tools are limited. To address this, we assembled medical centers in Brazil with the goal of describing neurological syndromes associated with COVID-19 during the first wave of the pandemic. Methods From June 1st, 2020 to June 1st, 2021, non-consecutive adult patients with new onset of six neurological syndromes up to 60 days after confirmed COVID-19 were included. Data were compiled from four tertiary centers and compared with general local COVID-19 data, as well as with a previous cohort focused on vascular syndrome. Results 197 patients were included, presenting with vascular syndromes (81), encephalopathy (68), encephalitis (19), Guillain-Barré syndrome (13), other neuropathies (12), and myelitis (4). The incidence curve of neurocovid mirrored that of COVID-19. Neurological syndromes were present regardless of COVID-19 severity. The median time from COVID-19 to onset of neurological symptoms was 14 days, suggesting a post-infectious immune-mediated mechanism. Patients were 10 times more likely to die (χ2 (1) = 356.55, p < 0.01, OR = 10.89) and 38 times more likely to be hospitalized than other COVID-19 patients (χ2 (1) = 1167.9, p < 0.01, OR = 38.22). Those developing vascular syndromes patients were 3 times more likely to require ICU (χ2 (1) = 37.12, p < 0.01, OR = 3.78) and 4 times more likely to die (χ2 (1) = 58.808, p < 0.01, OR = 4.73) than patients with vascular syndromes due to different etiologies. Conclusions Our study corroborates the association of neurological syndromes with COVID-19. The incidence correlated with local waves of COVID-19, and patients with neurocovid exhibited a higher susceptibility to adverse outcomes compared to other COVID-19 patients. Among all neurological syndromes, vascular syndromes were the most common, and their severity surpassed that of vascular syndromes not attributed to COVID-19. |
| format | Article |
| id | doaj-art-d2398c509d6d48b2abc09cf6cdc40fd5 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-d2398c509d6d48b2abc09cf6cdc40fd52025-02-02T12:10:48ZengBMCBMC Infectious Diseases1471-23342025-01-0125111210.1186/s12879-025-10504-6Neurological syndromes associated with COVID-19: a multicenter study in BrazilAline de Moura Brasil Matos0Andre Borges Ferreira Gomes1Fernanda Martins Maia Carvalho2Francisco Tomaz Meneses de Oliveira3Lohana Santana Almeida da Silva4Flavia Esper Dahy5Joao Victor Luisi de Moura6Marcela Vieira Freire7Jose Ernesto Vidal8Rosa Maria Nascimento Marcusso9Jerusa Smid10Victor Rebelo Procaci11Rodrigo Meireles Massaud12Felipe Von Glehn13Jorge Casseb14Camila Malta Romano15Augusto Cesar Penalva de Oliveira16on behalf of NeurocovBR study groupFaculdade de Medicina, Instituto de Medicina Tropical, Universidade de São PauloHospital Geral de FortalezaHospital Geral de FortalezaIrmandade Santa Casa de MisericórdiaIrmandade Santa Casa de MisericórdiaInstituto de Infectologia Emilio RibasInstituto de Infectologia Emilio RibasInstituto de Infectologia Emilio RibasInstituto de Infectologia Emilio RibasInstituto de Infectologia Emilio RibasInstituto de Infectologia Emilio RibasHospital Israelita Albert EinsteinHospital Israelita Albert EinsteinFaculdade de Medicina, Universidade de BrasíliaFaculdade de Medicina, Instituto de Medicina Tropical, Universidade de São PauloFaculdade de Medicina, Instituto de Medicina Tropical, Universidade de São PauloInstituto de Infectologia Emilio RibasAbstract Background Neurological manifestations associated with COVID-19 remain partially described, mainly in low- and middle-income countries where diagnostic tools are limited. To address this, we assembled medical centers in Brazil with the goal of describing neurological syndromes associated with COVID-19 during the first wave of the pandemic. Methods From June 1st, 2020 to June 1st, 2021, non-consecutive adult patients with new onset of six neurological syndromes up to 60 days after confirmed COVID-19 were included. Data were compiled from four tertiary centers and compared with general local COVID-19 data, as well as with a previous cohort focused on vascular syndrome. Results 197 patients were included, presenting with vascular syndromes (81), encephalopathy (68), encephalitis (19), Guillain-Barré syndrome (13), other neuropathies (12), and myelitis (4). The incidence curve of neurocovid mirrored that of COVID-19. Neurological syndromes were present regardless of COVID-19 severity. The median time from COVID-19 to onset of neurological symptoms was 14 days, suggesting a post-infectious immune-mediated mechanism. Patients were 10 times more likely to die (χ2 (1) = 356.55, p < 0.01, OR = 10.89) and 38 times more likely to be hospitalized than other COVID-19 patients (χ2 (1) = 1167.9, p < 0.01, OR = 38.22). Those developing vascular syndromes patients were 3 times more likely to require ICU (χ2 (1) = 37.12, p < 0.01, OR = 3.78) and 4 times more likely to die (χ2 (1) = 58.808, p < 0.01, OR = 4.73) than patients with vascular syndromes due to different etiologies. Conclusions Our study corroborates the association of neurological syndromes with COVID-19. The incidence correlated with local waves of COVID-19, and patients with neurocovid exhibited a higher susceptibility to adverse outcomes compared to other COVID-19 patients. Among all neurological syndromes, vascular syndromes were the most common, and their severity surpassed that of vascular syndromes not attributed to COVID-19.https://doi.org/10.1186/s12879-025-10504-6COVID-19Viral infectionsInfectionPost-Infectious Disorders |
| spellingShingle | Aline de Moura Brasil Matos Andre Borges Ferreira Gomes Fernanda Martins Maia Carvalho Francisco Tomaz Meneses de Oliveira Lohana Santana Almeida da Silva Flavia Esper Dahy Joao Victor Luisi de Moura Marcela Vieira Freire Jose Ernesto Vidal Rosa Maria Nascimento Marcusso Jerusa Smid Victor Rebelo Procaci Rodrigo Meireles Massaud Felipe Von Glehn Jorge Casseb Camila Malta Romano Augusto Cesar Penalva de Oliveira on behalf of NeurocovBR study group Neurological syndromes associated with COVID-19: a multicenter study in Brazil BMC Infectious Diseases COVID-19 Viral infections Infection Post-Infectious Disorders |
| title | Neurological syndromes associated with COVID-19: a multicenter study in Brazil |
| title_full | Neurological syndromes associated with COVID-19: a multicenter study in Brazil |
| title_fullStr | Neurological syndromes associated with COVID-19: a multicenter study in Brazil |
| title_full_unstemmed | Neurological syndromes associated with COVID-19: a multicenter study in Brazil |
| title_short | Neurological syndromes associated with COVID-19: a multicenter study in Brazil |
| title_sort | neurological syndromes associated with covid 19 a multicenter study in brazil |
| topic | COVID-19 Viral infections Infection Post-Infectious Disorders |
| url | https://doi.org/10.1186/s12879-025-10504-6 |
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