Neuropsychiatric Manifestations in COVID - 19 (1282)

Objective: Coronavirus infections are known to have neuro invasive potential with consequent neuropsychiatric manifestations. Since early recognition and prompt management of neuropsychiatric manifestations in these patients have a potential to decrease overall morbidity and mortality. We analyzed COVID-19 adult patients from January 20, 2020 to June 10th, 2020. 40,469 patients were diagnosed with COVID-19 among whom 9086 patients had neuropsychiatric manifestations. Background: Corona Virus 2 is a highly pathogenic coronavirus identified as causing mild to severe symptoms involving Respiratory, GI, Cardiac and tend to have neuroinvasive potential. In the largest study thus far, Mao et al reported a case series of 214 patients, where approximately one-third of these patients had neurological symptoms including stroke, encephalopathy and myopathy. We studied, 40,469 COVID-19 patients, our aim is to describe the demographics, neurological manifestations, and complications of COVID-19. Design/Methods: De-identified COVID-19 patient data was extracted using TriNetX from Jan 20, 2020 to June 10 2020. Study population included patients with age 18 years or older with a positive diagnosis of COVID-19 Results: Of the total 40,469 COVID-19 patients, (22.5%) patients had neuropsychiatric manifestations. The most common neurologic manifestations included headaches (3.7%) and sleep disorders (3.4%). Other manifestations were encephalopathy (2.3%), myalgia (2.0%), pain (1.8%), loss of taste and smell (1.2%), stroke and transient ischemic attack (TIA) (1.0%), dizziness (0.9%), extrapyramidal and movement disorders (0.7%), seizures (0.6%), polyneuropathy (0.6%), and nerve root and plexus disorders (0.4%). Common psychiatric manifestations included anxiety and other related disorders (4.6%), mood disorders (3.8%). Less than 1% of all psychiatric manifestations included emotional state symptoms and signs (0.8%), suicidal ideation (0.2%). Conclusions: Potential mechanisms of neuropsychiatric manifestation include direct CNS infiltration, cytokine network dysregulation, peripheral immune cell transmigration, and post-infectious autoimmune response. Clinicians need to be aware of these manifestations in COVID-19 patients, given the morbidity and mortality of neuropsychiatric involvement. Disclosure: Dr. Veerapaneni has nothing to disclose. Dr. Battini has nothing to disclose. Dr. Sharma has nothing to disclose. Dr. Dandu has nothing to disclose. Dr. Yadala has nothing to disclose. Dr. Veerapaneni has nothing to disclose. Suman Siddamreddy has nothing to disclose. Dr. Brown has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NuvOx Pharma. Dr. Kapoor has nothing to disclose. Dr. Kovvuru has nothing to disclose. Dr. Onteddu has nothing to disclose. Dr. Nalleballe has nothing to disclose.