{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:12:59Z","timestamp":1782990779346,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T00:00:00Z","timestamp":1613952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coronavirus disease 2019 (Covid\u201019) might present neurological symptoms. We aimed to evaluate the frequency of them at the moment of emergency department (ED) visit and their impact in the prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study including all consecutive hospitalized cases between March 8th and April 11th, 2020. Covid\u201019 diagnosis was confirmed by polymerase chain reaction test and\/or serology. We compared, in patients with and without neurological symptoms on admission, demographic, clinical presentation, and frequency and type of abnormal laboratory values. We analyzed the variables that were associated with in\u2010hospital all\u2010cause mortality by Cox\u2010regression log\u2010rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 576 hospitalized patients, 250 (43.3%) female, aged 67.2\u00a0years. At the moment of ED visit, 320 (55.6%) described neurological symptoms, including anosmia (146, 25.3%), myalgia (139, 24.1%), headache (137, 23.8%), and altered mental status (98, 17.0%). Neurological symptoms started the first symptomatic day in 198 (54.2%) cases. Patients with neurological symptoms presented later to the ED (7.9 versus. 6.6\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.019). Only four (0.6%) cases had no typical Covid\u201019 general symptoms, and only six (1.9%) had a normal laboratory results, for a sensitivity of 98.7% (95% confidence interval (CI): 96.6%\u201399.6%) and 98.1% (95% CI: 95.7%\u201399.2%), respectively. In the multivariate Cox\u2010regression of mortality predictors, anosmia (HR: 0.358, 95%CI: 0.140\u20130.916) and altered mental status (HR: 1.867, 95%CI: 1.162\u20133.001) were significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neurological symptoms were the most frequent extrapulmonary symptoms. They were present in half of the Covid\u201019 patients at the time of the ED visit. Anosmia on admission was an independent predictor of lower in\u2010hospital mortality and altered mental status on admission predicted in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.2058","type":"journal-article","created":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T09:29:55Z","timestamp":1613986195000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Neurological symptoms in Covid\u201019 patients in the emergency department"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3132-1064","authenticated-orcid":false,"given":"David","family":"Garc\u00eda\u2010Azor\u00edn","sequence":"first","affiliation":[{"name":"Department of Neurology. 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