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BMC Infect Dis . Neurological syndromes associated with COVID-19: a multicenter study in Brazil

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2025 Jan 27;25(1):123.
doi: 10.1186/s12879-025-10504-6. Neurological syndromes associated with COVID-19: a multicenter study in Brazil

Aline de Moura Brasil Matos[SUP] 1 [/SUP], Andre Borges Ferreira Gomes[SUP] 2 3 [/SUP], Fernanda Martins Maia Carvalho[SUP] 2 3 [/SUP], Francisco Tomaz Meneses de Oliveira[SUP] 4 [/SUP], Lohana Santana Almeida da Silva[SUP] 4 [/SUP], Flavia Esper Dahy[SUP] 5 [/SUP], Joao Victor Luisi de Moura[SUP] 5 [/SUP], Marcela Vieira Freire[SUP] 5 [/SUP], Jose Ernesto Vidal[SUP] 5 [/SUP], Rosa Maria Nascimento Marcusso[SUP] 5 [/SUP], Jerusa Smid[SUP] 5 [/SUP], Victor Rebelo Procaci[SUP] 6 [/SUP], Rodrigo Meireles Massaud[SUP] 6 [/SUP], Felipe Von Glehn[SUP] 7 [/SUP], Jorge Casseb[SUP] 1 [/SUP], Camila Malta Romano[SUP] #[/SUP][SUP] 8 9 [/SUP], Augusto Cesar Penalva de Oliveira[SUP] #[/SUP][SUP] 5 [/SUP]; NeurocovBR study group



Collaborators, Affiliations
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 (χ[SUP]2[/SUP] (1) = 356.55, p < 0.01, OR = 10.89) and 38 times more likely to be hospitalized than other COVID-19 patients (χ[SUP]2[/SUP] (1) = 1167.9, p < 0.01, OR = 38.22). Those developing vascular syndromes patients were 3 times more likely to require ICU (χ[SUP]2[/SUP] (1) = 37.12, p < 0.01, OR = 3.78) and 4 times more likely to die (χ[SUP]2[/SUP] (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.

Keywords: COVID-19; Infection; Post-Infectious Disorders; Viral infections.

 
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