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Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management
  1. Yifan Zhou1,
  2. Wei Li2,
  3. David Wang3,
  4. Ling Mao1,
  5. Huijuan Jin1,
  6. Yanan Li1,
  7. Candong Hong1,
  8. Shengcai Chen1,
  9. Jiang Chang4,
  10. Quanwei He1,
  11. Mengdie Wang1,
  12. Bo Hu1
  1. 1 Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  2. 2 Department of Neurology, Army Medical Center of PLA, Chongqing 400042, China
  3. 3 Neurovascular Division, Barrow Neurological Institute, Saint Joseph Hospital Medical Center, Phoenix, Arizona 85013, USA
  4. 4 Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan 430030, China
  1. Correspondence to Professor Bo Hu; hubo{at}


Coronavirus disease-2019 (COVID‐19) has become a global pandemic. COVID-19 runs its course in two phases, the initial incubation phase and later clinical symptomatic phase. Patients in the initial incubation phase often have insidious clinical symptoms, but they are still highly contagious. At the later clinical symptomatic phase, the immune system is fully activated and the disease may enter the severe infection stage in this phase. Although many patients are known for their respiratory symptoms, they had neurological symptoms in their first 1–2 days of clinical symptomatic phase, and ischaemic stroke occurred 2 weeks after the onset of the clinical symptomatic phase. The key is to prevent a patient from progressing to this severe infection from mild infection. We are sharing our experience on prevention and management of COVID-19.

  • infection
  • intervention
  • brain
  • stroke

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  • Contributors BH designed the framework and also participated in revision. YZ drafted the clinical course, temporal profile, neurological symptoms of COVID-19 and revised the whole manuscript. WL drafted the experience on COVID-19 management and revised the whole manuscript. DW participated in the design of framework and revised the whole manuscript. HJ, LM, YL, CH, QH, JC, SC and MW revised the whole manuscript.

  • Funding This work was supported by the National Key Research and Development Program of China (No. 2018YFC1312200 to BH), the National Natural Science Foundation of China (No. 81820108010 to BH).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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