Neuropsychiatric complications of coronavirus disease 2019: Mount Sinai Health System cohort study.

Autor: Gururangan K; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Peschansky VJ; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA., Van Hyfte G; Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Agarwal P; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Blank LJ; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Mathew B; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Goldstein J; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Kwon CS; Departments of Neurosurgery, Neurology, Epidemiology, and the Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA., McCarthy L; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Cohen A; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Chan AHW; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Deng P; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Dhamoon M; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Gutzwiller E; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Hao Q; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., He C; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Klenofsky B; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Lemus HN; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA., Marcuse L; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Navis A; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Heredia Nunez WD; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Luckey MN; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Schorr EM; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Singh A; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Tantillo GB; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Neurology, Baylor College of Medicine, Houston, TX, USA., Ufongene C; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Young JJ; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Balchandani P; BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Festa JR; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Naasan G; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Charney AW; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Nadkarni GN; Division of Data Driven and Digital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Jetté N; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. nathalie.jette@ahs.ca.; Department of Population Health Science and Policy, Institute of Health Care Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA. nathalie.jette@ahs.ca.; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, 1403 29 Street NW, Calgary, AB, T2N 2T9, Canada. nathalie.jette@ahs.ca.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2024 Jul; Vol. 271 (7), pp. 3991-4007. Date of Electronic Publication: 2024 Apr 24.
DOI: 10.1007/s00415-024-12370-9
Abstrakt: Objective: To describe the frequency of neuropsychiatric complications among hospitalized patients with coronavirus disease 2019 (COVID-19) and their association with pre-existing comorbidities and clinical outcomes.
Methods: We retrospectively identified all patients hospitalized with COVID-19 within a large multicenter New York City health system between March 15, 2020 and May 17, 2021 and randomly selected a representative cohort for detailed chart review. Clinical data, including the occurrence of neuropsychiatric complications (categorized as either altered mental status [AMS] or other neuropsychiatric complications) and in-hospital mortality, were extracted using an electronic medical record database and individual chart review. Associations between neuropsychiatric complications, comorbidities, laboratory findings, and in-hospital mortality were assessed using multivariate logistic regression.
Results: Our study cohort consisted of 974 patients, the majority were admitted during the first wave of the pandemic. Patients were treated with anticoagulation (88.4%), glucocorticoids (24.8%), and remdesivir (10.5%); 18.6% experienced severe COVID-19 pneumonia (evidenced by ventilator requirement). Neuropsychiatric complications occurred in 58.8% of patients; 39.8% experienced AMS; and 19.0% experienced at least one other complication (seizures in 1.4%, ischemic stroke in 1.6%, hemorrhagic stroke in 1.0%) or symptom (headache in 11.4%, anxiety in 6.8%, ataxia in 6.3%). Higher odds of mortality, which occurred in 22.0%, were associated with AMS, ventilator support, increasing age, and higher serum inflammatory marker levels. Anticoagulant therapy was associated with lower odds of mortality and AMS.
Conclusion: Neuropsychiatric complications of COVID-19, especially AMS, were common, varied, and associated with in-hospital mortality in a diverse multicenter cohort at an epicenter of the COVID-19 pandemic.
(© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: