Manifestaciones neurológicas y desenlaces clínicos en pacientes hospitalizados con COVID-19: Cohorte retrospectiva en un hospital Peruano
DOI:
https://doi.org/10.35434/rcmhnaaa.2023.164.1979Palabras clave:
COVID-19, Sistema Nervioso, Mortalidad, Polineuropatías, Ventilación mecánicaResumen
Introducción: La mayoría de los pacientes hospitalizados por COVID-19 presentan una manifestación neurológica, pero los marcadores para manifestaciones neurológicas específicas y cómo estas afectan los resultados clínicos aún no están claros. Objetivo: Describir la frecuencia de manifestaciones neurológicas en pacientes hospitalizados con COVID-19 y analizar su relación con marcadores y desenlaces clínicos relevantes. Métodos: Estudio retrospectivo incluyendo adultos hospitalizados por COVID-19 con al menos una manifestación neurológica. Cefalea, anosmia, ageusia, y polineuromiopatia se clasificaron como manifestaciones neurológicas inespecíficas, mientras que crisis epilepticas, disminución del nivel de conciencia, delirio, ataxia, movimientos anormales, y eventos cerebrovasculares como específicas. Asociaciones evaluadas: a) covariables clínicas y de laboratorio con presentación de manifestación neurológica específica; b) manifestación neurológica específica con gravedad de COVID-19, ventilación mecánica y mortalidad; y c) duración de la ventilación mecánica y polineuromiopatia. Resultados: De 338 pacientes incluidos, 61,2% tenía COVID-19 grave, 25,2% estaba en ventilación mecánica y 23,7% murió. Las manifestaciones neurológicas más frecuentes fueron cefalea (68,3%), delirio (41,9%), disminución del nivel de conciencia (40,8%) y polineuromiopatia (21,8%). El dímero-D alto y la linfopenia se asociaron con manifestación neurológica específica. Se encontró al menos una manifestación neurológica específica en 39,9% de pacientes, y este grupo se asociación con COVID-19 grave, ventilación mecánica y mortalidad. Finalmente, una mayor duración en ventilación mecánica se asoció con mayor frecuencia de polineuromiopatia. Conclusión: Las manifestaciones neurológicas específicas fueron frecuentes en pacientes hospitalizados con COVID-19 y se asocian con mayor gravedad clínica y laboratorial.
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Derechos de autor 2024 Luis Quispe-Moore, Miguel A. Vences, Victor Saquisela-Alburqueque, Elder Quispe-Huamani, Luis Cortez-Salazar, Wendy Seminario G., Mercedes Suarez-Loro, Enrique Portocarrero-Nieto, Carlos Alva-Diaz, Christoper A. Alarcon-Ruiz
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
