Neurological

Neurological manifestations of COVID-19 related to higher mortality

Neurological manifestations in inpatients with COVID-19 have been associated with increased mortality. These results from a multi-cohort study were published in JAMA Network Open.

In this study, researchers analyzed data from two large consortia, the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) and the Neuro-COVID Register of the European Academy of Neurology (ENERGY). They assessed the medical history and clinical outcomes of patients with COVID-19 with and without neurological manifestations.

The GCS-NeuroCOVID data consisted of 2 cohorts: all patients (n = 3,055; 57% men; mean age 59.9 years) with COVID-19 at 6 locations and patients (n = 475; 55% men; mean age 62.6 .) Years) with neurological manifestations in 9 locations in the USA. The ENERGY cohort included patients (n = 214; 62% men; mean age 67.0 years) with COVID-19 and neurological manifestations who were hospitalized in 13 locations in Europe.

Continue reading

The most frequently reported symptoms in the GCS-NeuroCOVID general population, the neurological population and the ENERGY cohort were headache (38% vs. 35% vs. 27%) or anosmia or ageusia (28% vs. 20% vs. 23 %). The most commonly confirmed neurological signs or syndromes were acute encephalopathy (50% vs. 53% vs. 24%), coma (17% vs. 25% vs. 10%) and stroke (3% vs. 19% vs. 19%) ).

In the general population with GCS-NeuroCOVID, mortality was increased in patients with pre-existing neurological disorders and neurological manifestations in the hospital.

Hospital mortality was associated with abnormal brainstem reflexes (adjusted odds ratio [aOR], 24.28; 95% CI 7.06-83.5; P <0.001, coma (aOR 7.70; 95% CI 5.65-10.50; P <0.001), clinically confirmed neurological manifestations (aOR 5.99; 95% CI 4.33-8.28; P < 0.001), acute encephalopathy (aOR 5.51; 95% CI 4.01-7.57; p <0.001), abnormal tone (aOR 4.53; 95% CI 1.40-14.60; p = 0, 02), any neurological manifestation (aOR 2.48; 95% CI 1.70–3.62; P <0.001) and patients with increasing age (per 10-year step; aOR 1.74; 95% CI 1.60-1.88; P <0.001) or men (aOR, 1.66.); 95% CI 1.31-2.10; P <0.001).

Clinically confirmed neurological signs or syndromes were associated with a pre-existing neurological disorder (aOR 2.23; 95% CI 1.80-2.75; P <0.001) in men (aOR 1.53; 95% CI 1.30-1 , 82; P <0.001) and with increasing age (per 10-year step, aOR 1.41; 95% CI 1.34-1.48; P <0.001).

This study may have been limited by the differences in nursing protocols between sites.

The study authors concluded that neurological manifestations during COVID-19 infection increase the risk of hospital mortality. Patients with pre-existing neurological syndromes were at an increased risk of presenting with neurological manifestations.

Disclosure: Some authors stated links with biotech, pharmaceutical, and / or device manufacturers. For a full list of the author’s disclosures, see the original reference.

reference

Chou SH, Beghi E, Helbok R, et al .; GCS-NeuroCOVID consortium and ENERGY consortium. Global Incidence of Neurological Manifestations in Patients Admitted to Hospital with COVID-19 – a Report for the GCS-NeuroCOVID Consortium and ENERGY Consortium. JAMA network open. 2021; 4 (5): e2112131. doi: 10.1001 / jamanetworkopen.2021.12131

Related Articles