Background and aims With the COVID-19 pandemic, attempts have been made to use various tools for prognostic purposes, however, the clinical manifestations that can act positively or negatively have not been taken into account. Methods Descriptive and retrospective study carried out from April to June 2020 in Veracruz, Mexico, which analyzes adult patients with a diagnosis of COVID-19 pneumonia confirmed, in which the most prevalent neurological symptoms are evaluated, in order to find symptoms that act as severity and prognosis factors. Results We analyzed 100 patients with COVID-19 pneumonia; 46 women and 54 men, with a mean age of 49.4 (± 19.3). The most frequent neurological symptoms were: headache (83%), anosmia (75%), dysgeusia (75%), myalgia (68%) and somnolence (50%). Somnolence and anosmia were more frequent in severe pneumonia than in mild pneumonia [(67.4 vs. 35.2%; p = 0.002) and (84.8 vs. 66.7%; p = 0.041); respectively]. By simple and multiple logistic regression analysis, it was found that the neurological manifestations associated with severe pneumonia, risk of intubation and death were: anosmia, somnolence, encephalopathy and age over 70 years, in contrast to neurological manifestations with a protective effect against severe pneumonia, intubation and death were: dysgeusia and age under 40 years.