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Article Type

Original Study

Abstract

Objective To study neurological and musculoskeletal (MSK) manifestations in coronavirus disease 2019 (COVID-19) patients with comorbidities compared with those without and study their association with COVID-19 disease severity. Materials and methods This is an observational, retrospective study. The data were collected from the first of January 2021 till the March 30, 2021, from electronic medical records in the ward and ICU of Mataria Teaching Hospital, and included 277 hospitalized COVID patients with examination and investigations confirming diagnosis of COVID-19 patients according to WHO interim guidance. The patients were presented with neurological and MSK manifestations. Neurological manifestations had presented in three sets: central nervous system manifestations (headache, dizziness, impaired consciousness, epilepsy, acute cerebrovascular disease, and seizure), peripheral nervous system manifestations (smell impairment, taste impairment, Guillain–Barre, and neuralgia), and MSK manifestations. We divided our patients into two groups, one with comorbidities and the other without, and compared both groups according to typical COVID-19 symptoms, neurological manifestations, laboratory findings, and severity of COVID-19 according to their respiratory status. Results We studied 277 patients whose mean (SD) age was 52.4 ± 14.5 years, 71 (53%) were females, and 63 (47%) were males with COVID-19 infection. Of all our patients, 134 (48.4%) had at least one of the underlying disorders. Those with high percentages were hypertension and diabetes. Of the patients, 122 (44%) had severe infection, and 155 (55.9%) patients had nonsevere infection according to their respiratory status. Of our patients 39.4% had nervous system manifestations. Comparing patients with nonsevere infection, patients with severe infection were older and had underlying diseases, especially hypertension and diabetes. They were manifested with fewer typical symptoms of COVID-19 and had more neurological manifestations, especially central nervous system manifestations in 39 (31.9%) patients versus 22 (14.2%), while peripheral nervous system manifestations were common in nonsevere patients. Thirty-four (21.9%) patients with nonsevere disease versus 14 (11.5%) patients with severe disease. Conclusion Neurological and MSK manifestations are commonly presented in patients with COVID-19 as an early manifestation and are not associated with the typical symptoms of COVID-19, and a few days later, the patients presented with severe respiratory manifestations associated with COVID infection, so clinicians should suspect this association to avoid the delayed diagnosis of the disease and for early isolation and effective treatment to decrease the incidence of case deterioration and decrease the mortality rate.

Keywords

Coronavirus disease 2019, neurological and musculoskeletal features, respiratory manifestations

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