Mexican registry of neurologic manifestations in patients with confirmed COVID-19: Preliminary results

Objective: To describe the neurologic manifestations and complications of Mexican patients with confirmed coronavirus disease 2019 (COVID-19). Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed to have reached Mexico in February 2020. At present, Mexico is one of the most affected countries by the pandemic of COVID-19 worldwide. In the first months of the pandemic, only a few Mexican studies on COVID-19 had been reported. Scarce national data limited our understanding of the unique nuances that may occur in our setting and hindered the interpretation of evidence from other countries in the local context. Design/Methods: In March 2020, the Mexican Academy of Neurology (MAN) launched a national registry to have a clearer picture of the full spectrum of neurologic manifestations and complications of COVID-19 in Mexican patients. This online registry was available to all MAN members. Only patients with SARS-CoV-2 detected by real-time RT-PCR were included in this analysis. Results: At the end of August 2020, 89 patients (31 women, 34.8%) have been included. Their mean age was 50.5±18.8 years. Most cases were reported in central and southern regions (96%). Most patients showed respiratory symptoms (87%) and were admitted to hospital (88%). Among severe neurologic manifestations, vascular etiologies were the most commonly reported: ischemic stroke (n=17), intraparenchymal hemorrhage (n=6), and subarachnoid hemorrhage (n=4). Olfactory and gustatory dysfunctions were reported in 34 and 26 patients. Headache and delirium were reported in 54 and 18 patients. 7 patients had seizures. Meningitis and encephalitis were reported in 2 and 5 patients. 5 cases of Guillain-Barre syndrome were reported;three of them were classified as axonal variants. Neurologic sequelae were reported in 30 patients (33%). 19 (21%) patients died. Conclusions: In this nationwide registry, one in five patients with COVID-19 and neurologic manifestations died. Cerebrovascular insults were the most common severe neurologic manifestations.