Neuropsychiatric manifestations of COVID-19 can be clustered in three distinct symptom categories

Sci Rep. 2020 Dec 1;10(1):20957. doi: 10.1038/s41598-020-78050-6.

Abstract

Several studies have reported clinical manifestations of the new coronavirus disease. However, few studies have systematically evaluated the neuropsychiatric complications of COVID-19. We reviewed the medical records of 201 patients with confirmed COVID-19 (52 outpatients and 149 inpatients) that were treated in a large referral center in Tehran, Iran from March 2019 to May 2020. We used clustering approach to categorize clinical symptoms. One hundred and fifty-one patients showed at least one neuropsychiatric symptom. Limb force reductions, headache followed by anosmia, hypogeusia were among the most common neuropsychiatric symptoms in COVID-19 patients. Hierarchical clustering analysis showed that neuropsychiatric symptoms group together in three distinct groups: anosmia and hypogeusia; dizziness, headache, and limb force reduction; photophobia, mental state change, hallucination, vision and speech problem, seizure, stroke, and balance disturbance. Three non-neuropsychiatric cluster of symptoms included diarrhea and nausea; cough and dyspnea; and fever and weakness. Neuropsychiatric presentations are very prevalent and heterogeneous in patients with coronavirus 2 infection and these heterogeneous presentations may be originating from different underlying mechanisms. Anosmia and hypogeusia seem to be distinct from more general constitutional-like and more specific neuropsychiatric symptoms. Skeletal muscular manifestations might be a constitutional or a neuropsychiatric symptom.

MeSH terms

  • Ageusia / epidemiology
  • Anosmia / epidemiology
  • COVID-19 / pathology*
  • Comorbidity
  • Dyspnea / epidemiology
  • Female
  • Fever / epidemiology
  • Headache / epidemiology
  • Humans
  • Iran
  • Male
  • Middle Aged
  • Muscle Weakness / epidemiology
  • Nervous System Diseases / epidemiology*
  • SARS-CoV-2