Key study findings and message • Acute CVA (5.7%), impaired consciousness (14.8%), skeletal muscle injury (19.3%) more likely in severe disease (P < 0.05, P < 0.001)
• Patients with CNS symptoms more likely to have lower `lymphocyte and platelet counts and higher BUN (P < 0.05, P < 0.01, P < 0.05)
• Patients with muscle injury more likely to have higher neutrophils, CRP, D-dimer and lower lymphocyte count (P < 0.05, P < 0.001, P < 0.05, P < 0.01)
• Neurologic symptoms may be due to direct viral pathogenicity via hematogenous or retrograde neuronal spread, immunosuppression, or coagulation disorders Can present with encephalopathy acutely or during hospitalization • High correlation between reported olfactory symptoms and regional reporting of COVID-19
• Olfactory symptoms may be due to neuroepithelia injury and damage to olfactory roots. Cytokine storm (known in influenza, other viral infections, more common in pediatrics) Mechanism unknown, may be due to critical illness–related encephalopathy, cytokines, medication-induced or direct viral pathogenicity.