Neurologic complications of COVID-19 - 20/05/20

Doi : 10.1016/j.ajem.2020.05.024

Rachel Bridwell, MD ^a, Brit Long, MD ^a,^{^⁎} , Michael Gottlieb, MD ^b
^a Department of Emergency Medicine, Brooke Army Medical Center, San Antonio, TX, United States of America
^b Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, United States of America

^⁎Corresponding author at: 3841 Roger Brooke Dr, Fort Sam, Houston, TX 78234, United States of America.3841 Roger Brooke DrFort SamHoustonTX78234United States of America

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Abstract

Background

Much of the focus regarding the global pandemic of coronavirus disease of 2019 (COVID-19) has been on the cardiovascular, pulmonary, and hematologic complications. However, neurologic complications have arisen as an increasingly recognized area of morbidity and mortality.

Objective

This brief report summarizes the neurologic complications associated with COVID-19 with an emphasis on the emergency medicine clinician.

Discussion

COVID-19 has infected over 3.5 million people and killed over 240,000 people worldwide. While pulmonary complications are profound, the neurologic system is also significantly impacted, with complications including acute cerebrovascular events, encephalitis, Guillain-Barré syndrome, acute necrotizing hemorrhagic encephalopathy, and hemophagocytic lymphohistiocytosis. Additionally, patients on immunosuppressive medications for pre-existing neurologic issues are at an increased risk for complications with COVID-19 infection, and many of the currently proposed COVID-19 therapies can interact with these medications.