HealthDay News – Toxic Metabolic Encephalopathy (TME) occurs in 12 percent of hospitalized patients with COVID-19 and is associated with an increased risk of hospital mortality, according to a study published online March 16 in Neurocritical Care.
Jennifer A. Frontera, MD of New York University’s Grossman School of Medicine in New York City and colleagues conducted a retrospective observational cohort study of patients with COVID-19 hospitalized in four New York hospitals to determine its prevalence, etiology, and Mortality Rates Associated With TME.
Overall, 12 percent of 4,491 patients were diagnosed with COVID-19 TME, of whom 78 percent developed encephalopathy immediately prior to hospitalization. The researchers found that septic encephalopathy, hypoxic ischemic encephalopathy (HIE), and uremic encephalopathy were the most common causes (62, 59 and 28 percent, respectively). Patients with TME were older than those without and were more likely to have had dementia or a psychiatric history; They were intubated more often, had longer hospital stays, and were discharged home less often. TME was also associated with an increased risk of death in hospital when patients with comfort care were excluded and after adjusting for confounding factors (30 versus 16 percent; adjusted risk ratio 1.24). The highest risk of hospital death was seen for TME due to hypoxemia (42 percent of patients with HIE died versus 16 percent of patients without HIE; adjusted hazard ratio, 1.56).
“The dramatic effect of common causes of encephalopathy on COVID-19 mortality suggests we may need to take more aggressive countermeasures – oxygen supplementation, early dialysis for kidney failure, and fluids to counter the low blood pressure seen in sepsis,” Frontera said in a Explanation.
Abstract / full text
COVID19 General Infectious Disease General Neurology