The experience of diagnosis and treatment of neurological diseases combined with coronavirus disease 2019: analysis of five cases

Objective To investigate the clinical characteristics, diagnosis and treatment of neurological diseases combined with coronavirus disease 2019(COVID-19). Methods The data of five patients of neurological diseases combined with COVID-19 (including two suspected cases) in the Department of Neurology, Renmin Hospital of Wuhan University from January 1, 2020 to February 24, 2020 were retrospectively collected. The epidemiology, clinical manifestations, laboratory and radiologic characteristics, diagnosis, treatment and outcomes of these cases were described and analyzed. Results Among the five patients, three were confirmed cases and two were suspected cases with a history of indirect contact with confirmed cases of COVID-19. The age of these patients was (76.4 ± 9.3) years. Neurological diseases included cerebral infarction in two cases, cerebral hemorrhage, Guillain-Barre syndrome and Alzheimer's disease each in one case. There was one acute case and one chronic case, and three patients were in the sequelae stage of acute diseases. One patient had an open airway as a result of Guillain-Barre syndrome. There were four cases of limb paralysis, half of whom were hemiplegic and quadriplegic respectively. The initial symptom was fever in all cases, and they showed a decrease in lymphocyte count. Four patients with chest computed tomographic scans showed bilateral lung lesions, of whom two cases showed multiple lung patches and ground glass shadows. Tests for 2019 novel coronavirus nucleic acid were positive in three patients and negative in two. The time from onset of COVID-19 to diagnosis was (6.6 ± 5.6) d. As of February 24, two patients died and the remaining were still hospitalized. Conclusions Neurological diseases, especially in elderly patients with limb paralysis, open airways and stroke, can be complicated by COVID-19, of which the prognosis is poor. Neurologists need to identify this situation early and pay attention to strengthening protection. Key words: Coronavirus disease 2019; Neurological diseases; Clinical characteristics