Incidence of neurological manifestations and complications in patients with COVID-19 infection: a propensity score matching analysis

BackgroundThe novel coronavirus, SARS-CoV-2, can lead to potential neurological complications in COVID-19 patients. This study aims to assess the prevalence and associated risk factors of these complications among Thai individuals.MethodsWe conducted a retrospective study on hospitalized adults with COVID-19 at Thammasat University Hospital from April 2020 to September 2021, totaling 990 patients. We used propensity score matching and logistic regression to determine associated risk factors.ResultsOf the patients, 21.7% (215 individuals) manifested neurological complications, categorized as follows:Skeletal muscle injury: 16.3%Acute cerebrovascular disease: 0.8%Delirium: 2.4%Impaired consciousness: 2.6%Seizures: 0.5%Post-matching revealed risk factors significantly associated with neurological complications: overweight status, hypertension, diabetes mellitus, dyslipidemia, and severe infection. However, in a multivariable analysis, only severe infection remained significant (adjusted OR 3.71; p = 0.010). The presence of neurological complications was linked with an elevated mortality risk (OR 1.77, p = 0.005).ResultsOf the patients, 21.7% (215 individuals) manifested neurological complications, categorized as follows:Skeletal muscle injury: 16.3%Acute cerebrovascular disease: 0.8%Delirium: 2.4%Impaired consciousness: 2.6%Seizures: 0.5%Post-matching revealed risk factors significantly associated with neurological complications: overweight status, hypertension, diabetes mellitus, dyslipidemia, and severe infection. However, in a multivariable analysis, only severe infection remained significant (adjusted OR 3.71; p = 0.010). The presence of neurological complications was linked with an elevated mortality risk (OR 1.77, p = 0.005).ConclusionsIn the Thai COVID-19 patient cohort, roughly 22% experienced neurological complications, with severe infection standing out as a major risk factor. This underscores the importance of closely monitoring neurological symptoms in COVID-19 patients.