Neurological Complications and Outcomes in Critically Ill Patients With COVID-19: Results From International Neurological Study Group From the COVID-19 Critical Care Consortium.

Autor:	Ahmad SA; Department of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Mayasi Y; Department of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Kelly TL; School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia., White N; School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia., Suen J; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Faculty of Medicine University of Queensland, Brisbane, QLD, Australia., Battaglini D; Anesthesia and Intensive Care, IRCCS Policlinico San Martino, Genoa, Italy.; Department of Medicine, University of Barcelona, Barcelona, Spain., Bassi GL; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Faculty of Medicine University of Queensland, Brisbane, QLD, Australia.; Queensland University of Technology, Brisbane, QLD, Australia.; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain., Fraser JF; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Faculty of Medicine University of Queensland, Brisbane, QLD, Australia.; Queensland University of Technology, Brisbane, QLD, Australia.; Critical Care Medicine, UnitingCare Health, Brisbane, QLD, Australia., Premraj L; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Griffith University School of Medicine, Gold Coast, QLD, Australia., Arora RC; Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, USA.; Division of Cardiac Surgery, Department of Surgery, Case Western Reserve University, Cleveland, OH, USA., Bastos D; Hospital Sao Camilo de Esteio, Esteio, Brazil., Whitman G; Department of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Griffee M; Department of Anesthesiology and Perioperative Medicine, University of Utah, Salt Lake City, UT, USA., Fanning JP; Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.; Faculty of Medicine University of Queensland, Brisbane, QLD, Australia.; Critical Care Medicine, UnitingCare Health, Brisbane, QLD, Australia., Robba C; Anesthesia and Intensive Care, IRCCS Policlinico San Martino, Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy., Cho SM; Department of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jazyk:	angličtina
Zdroj:	The Neurohospitalist [Neurohospitalist] 2024 Oct 15, pp. 19418744241292487. Date of Electronic Publication: 2024 Oct 15.
DOI:	10.1177/19418744241292487
Abstrakt:	Background: In this COVID-19 Critical Care Consortium (CCCC) sub-study, we qualified neurological complications associated with SARS-CoV2 infection. Methods: The CCCC is an international, multicenter study. Eligible patients were COVID-19 patients admitted to intensive care units (ICU) across 23 centers between 1/7/2020 to 6/23/2022. Incidence of neurological complications was estimated as number of events per hospital days and per admission using Poisson regression. Associations between neurological complications and risk factors were assessed using multivariable Poisson regression. Results: 713 patients were included. Median age = 56 years (interquartile range (IQR) = 45-65). Neurological complications reported in 61/480 patients (12.7%) with the majority being ischemic stroke (2.9%), intracranial hemorrhage (ICH) (2.8%), and seizures (2.6%). Multivariable analysis for neurological complications per admitted days showed comorbid neurological conditions (incidence rate ratio (IRR) = 6.35, 2.57-15.7) were an independent risk factor for ischemic stroke. Extracorporeal membrane oxygenation (IRR = 5.32, 1.52-18.6), low-middle income countries (LMIC) vs high income countries (HIC) (IRR = 4.70, 1.62-13.7), and age >55 (IRR = 3.66, 1.23-10.9) were independent risk factors for ICH. Co-morbid neurological conditions (IRR = 3.43, 1.11-10.6), LMIC vs HIC (IRR = 8.69, 2.15-35.2), July-December 2020 vs January-June 2020 (IRR = 0.17, 0.04-0.69) and age >55 (IRR = 4.05, 1.15-14.3) were independent risk factors for seizure. Conclusions: Decision-making should incorporate salient risk factors to inform management of SARS-CoV2 infection and avoid neurological complications. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2024.)
Databáze:	MEDLINE
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