A Prospective Study of Neurologic Disorders in Hospitalized Patients With COVID-19 in New York City
| Autor: | Brent Flusty, Mirza Omari, Erica Scher, Palak Patel, Koto Ishida, Courtney L. Robertson, Nicole Morgan, D. Ethan Kahn, Sujata Thawani, Mengling Liu, Patricio Millar-Vernetti, Jennifer A. Frontera, Ting Zhou, Molly McNett, Manisha Holmes, Dixon Yang, Taolin Fang, Adam de Havenon, Penina Krieger, Nada Abou-Fayssal, David Friedman, Jose Torres, Raimund Helbok, Matthew Bokhari, Kara Melmed, Sakinah Sabadia, Barry M. Czeisler, Rebecca Lalchan, David K. Menon, Dimitris G. Placantonakis, Andres Andino, Sherry H.-Y. Chou, Steven L. Galetta, Laura J. Balcer, Jose I. Suarez, Thomas Wisniewski, Andre Granger, Michelle E. Schober, Eduard Valdes, Alexandra Kvernland, Joshua Huang, Jonathan Howard, Wendy C. Ziai, Ericka L. Fink, Aaron Lord, Kaitlyn Lillemoe, Stephen Berger, Shraddha Mainali, Josef Gutman, Andrea B. Troxel, Shashank Agarwal, Thomas Snyder, Shadi Yaghi, Daniel Friedman, Ariane Lewis |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Organ Dysfunction Scores Myelitis Spinal Cord Diseases Young Adult 03 medical and health sciences Myelopathy Sex Factors 0302 clinical medicine Intubation Intratracheal medicine Humans Hospital Mortality Prospective Studies 030212 general & internal medicine Young adult Prospective cohort study Stroke Aged Brain Diseases business.industry Hazard ratio Age Factors COVID-19 Middle Aged medicine.disease Patient Discharge Hospitalization Female Neurotoxicity Syndromes New York City Neurology (clinical) Nervous System Diseases business Meningitis 030217 neurology & neurosurgery Encephalitis |
| Zdroj: | Neurology. 96:e575-e586 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0000000000010979 |
| Popis: | ObjectiveTo determine the prevalence and associated mortality of well-defined neurologic diagnoses among patients with coronavirus disease 2019 (COVID-19), we prospectively followed hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–positive patients and recorded new neurologic disorders and hospital outcomes.MethodsWe conducted a prospective, multicenter, observational study of consecutive hospitalized adults in the New York City metropolitan area with laboratory-confirmed SARS-CoV-2 infection. The prevalence of new neurologic disorders (as diagnosed by a neurologist) was recorded and in-hospital mortality and discharge disposition were compared between patients with COVID-19 with and without neurologic disorders.ResultsOf 4,491 patients with COVID-19 hospitalized during the study timeframe, 606 (13.5%) developed a new neurologic disorder in a median of 2 days from COVID-19 symptom onset. The most common diagnoses were toxic/metabolic encephalopathy (6.8%), seizure (1.6%), stroke (1.9%), and hypoxic/ischemic injury (1.4%). No patient had meningitis/encephalitis or myelopathy/myelitis referable to SARS-CoV-2 infection and 18/18 CSF specimens were reverse transcriptase PCR negative for SARS-CoV-2. Patients with neurologic disorders were more often older, male, white, hypertensive, diabetic, intubated, and had higher sequential organ failure assessment (SOFA) scores (all p < 0.05). After adjusting for age, sex, SOFA scores, intubation, history, medical complications, medications, and comfort care status, patients with COVID-19 with neurologic disorders had increased risk of in-hospital mortality (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.17–1.62, p < 0.001) and decreased likelihood of discharge home (HR 0.72, 95% CI 0.63–0.85, p < 0.001).ConclusionsNeurologic disorders were detected in 13.5% of patients with COVID-19 and were associated with increased risk of in-hospital mortality and decreased likelihood of discharge home. Many observed neurologic disorders may be sequelae of severe systemic illness. |
| Databáze: | OpenAIRE |
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