A Survey on Respiratory and Neurological Symptoms in Alzheimer’s, Schizophrenia, Bipolar, and Migraine Patients Following COVID-19 Infection
Authors: Aboofazeli Amir , Sarrafzadeh Sheida , Qaraee Najafabadi Ali , Hammami Behnaz , Soheili Roben , Sadeghi Ahmadreza , Letafati Arash 
Published: February 2024

Background: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 led to the global coronavirus disease 2019 (COVID-19) pandemic with a wide range of clinical symptoms. Neurological complications have been a significant concern, with diverse symptoms and potential neuroinvasive mechanisms. The pandemic has also impacted individuals with mental health conditions, such as migraines, bipolar disorder (BD), and schizophrenia, highlighting the complex interconnections between physical and mental health during these challenging times. Objectives: This retrospective report from the Iranian Network for Research in Viral Diseases (INRVD) study aimed to investigate the multifaceted interactions between COVID-19, neurological complications, and mental health disorders (e.g., migraines, BD, and schizophrenia) to better understand their collective impact on individuals’ health and well-being. Methods: This study involved 63 individuals who tested positive for COVID-19, including 32 females (50.8%) and 31 males (49.2%). The participants were categorized into different groups based on their underlying conditions: 7 individuals with schizophrenia, 8 with BD, 6 with migraines, 12 with Alzheimer's disease, and 30 with COVID-19 without any underlying neurologic disorder. This investigation was carried out in 12 hospitals supervised by the INRVD between March 2020 and May 2021. The study used frequencies and percentages to describe the data and employed chi-square tests, including the contingency coefficient, to explore associations between COVID-19 symptoms and disease groups. Results: The analysis of clinical manifestations revealed distinctive patterns. Cough was the most prevalent symptom across the entire sample, affecting over 79% of participants. Fever followed as the second most common symptom, with approximately 62% of individuals reporting it. Fatigue ranked third, impacting 57% of the subjects. In contrast, vomiting was the least frequently reported symptom, with an incidence of only 14.3%. In terms of specific conditions, a notable discrepancy was observed in the prevalence of headaches. Although present in 71.4% of individuals with schizophrenia, this symptom was reported by only 50% of those with BD, followed by 66.7% with migraines and 83.3% with Alzheimer’s. The patients without neurologic disorders exhibited a lower incidence of neurological manifestations, with only 23.3% reporting headaches. Conclusions: This study provides insights into the clinical manifestations of COVID-19 in individuals with distinct underlying conditions. The prevalence and presentation of symptoms varied significantly across the different groups, and neurological symptoms exhibited a higher prevalence in this patient group than those without any underlying neurologic disorders. This study aimed for a more comprehensive understanding of the probable intricate interplay between COVID-19, underlying health conditions, and clinical manifestations. Understanding these differences is crucial for tailoring effective clinical interventions.