Clinical features of patients diagnosed with COVİD-19 who apply to the emergency department with neurological symptoms

Detailing the neurological effects and symptoms of the outbreak caused by COVID-19 may enable faster measures to be taken in similar outbreaks in the coming years. In this study, we aimed to elucidate the neurological symptoms caused by COVID-19 and the clinical characteristics of patients. In this descriptive retrospective study, patients diagnosed with COVID-19 among patients admitted to Pamukkale University Hospital Emergency Department between March 2020 and March 2023 were included. Brain CT and Brain MR images, laboratory and radiological tests of patients with neurological symptoms were analyzed and their post-emergency department status was recorded. A total of 231 patients were included in the study. The mean age of the patients between 18-96 years was 71.31 years. Of the patients included in the study, 179 (77.5%) were 65 years and older. Of the patients, 138 (59.7%) were female and 93 (40.3%) were male. Cerebrovascular accident (CVA) was the most common diagnosis in 35 (15.2%) patients, followed by acute renal failure in 8 (3.4%) patients and transient ischemic attack (TIA) in 5 (2.1%) patients. 117 patients (50.6%) had confusion, 67 (29%) had weakness and 59 (25.5%) had dyspnea. Among 222 patients who underwent brain CT, 148 (66.7%) had no pathologic findings on brain CT. Of the 74 (33.3%) patients with pathologic findings, the most common finding was infarction in 49 (21.2%) patients. There was no statistically significant difference in the presence of pathology in brain CT according to age and gender variables (p>0.05). 95 (41%) patients underwent brain MRI. The presence of findings on MRI was not statistically significant according to age and gender variables (p>0.05). The most common pathologic finding among patients who underwent brain MRI was infarction in 45 (19.4%) patients. The elevated WBC values of patients with pathologic findings on brain MRI were statistically significant (p=0.025). D-Dimer values were found to be statistically significant according to the presence of pathologic findings on brain MRI (p=0.034). D-Dimer values were higher in patients with pathologic findings on brain MRI. In addition, in our study, ferritin values of patients with typical COVID-19 involvement on thoracic CT scans were statistically significantly higher (p=0.017). In conclusion, we think that the neurological symptoms accompanying COVID-19 are supported by CT and MR imaging, and CRP, D-Dimer, PLT and WBC have a significant relationship with imaging. We think that rapid intervention to these symptoms in the treatment phase of patients with neurologic symptoms may accelerate the patient's recovery.