Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

Autor: Singh, B., Lant, S., Cividini, S., Cattrall, J.W.S., Goodwin, L.C., Benjamin, L., Michael, B.D., Khawaja, A., Matos, A.D.B., Alkeridy, W., Pilotto, A., Lahiri, D., Rawlinson, R., Mhlanga, S., Lopez, E.C., Sargent, B.F., Somasundaran, A., Tamborska, A., Webb, G., Younas, K., Sami, Y. al, Babu, H., Banks, T., Cavallieri, F., Cohen, M., Davies, E., Dhar, S., Modol, A.F., Farooq, H., Harte, J., Hey, S., Joseph, A., Karthikappallil, D., Kassahun, D., Lipunga, G., Mason, R., Minton, T., Mond, G., Poxon, J., Rabas, S., Soothill, G., Zedde, M., Yenkoyan, K., Brew, B., Contini, E., Cysique, L., Zhang, X., Maggi, P., Pesch, V. van, Lechien, J., Saussez, S., Heyse, A., Ferreira, M.L.B., Soares, C.N., Elicer, I., Eugenin-von Bernhardi, L., Reyes, W.N., Yin, R., Azab, M.A., Abd-Allah, F., Elkady, A., Escalard, S., Corvol, J.C., Delorme, C., Tattevin, P., Bigaut, K., Lorenz, N., Hornuss, D., Hosp, J., Rieg, S., Wagner, D., Knier, B., Lingor, P., Winkler, A.S., Sharifi-Razavi, A., Moein, S.T., SeyedAlinaghi, S., JamaliMoghadamSiahkali, S., Morassi, M., Padovani, A., Giunta, M., Libri, I., Beretta, S., Ravaglia, S., Foschi, M., Calabresi, P., Primiano, G., Servidei, S., Mercuri, N.B., Liguori, C., Pierantozzi, M., Sarmati, L., Boso, F., Garazzino, S., Mariotto, S., Patrick, K.N., Costache, O., Pincherle, A., Klok, F.A., Meza, R., Cabreira, V., Valdoleiros, S.R., Oliveira, V., Kaimovsky, I., Guekht, A., Koh, J., Diaz, E.F., Barrios-Lopez, J.M., Guijarro-Castro, C., Beltran-Corbellini, A., Martinez-Poles, J., Diezma-Martin, A.M., Morales-Casado, M.I., Garcia, S.G., Breville, G., Coen, M., Uginet, M., Bernard-Valnet, R., Pasquier, R. du, Kaya, Y., Abdelnour, L.H., Rice, C., Morrison, H., Defres, S., Huda, S., Enright, N., Hassell, J., D'Anna, L., Benger, M., Sztriha, L., Raith, E., Chinthapalli, K., Nortley, R., Paterson, R., Chandratheva, A., Werring, D.J., Dervisevic, S., Harkness, K., Pinto, A., Jillella, D., Beach, S., Gunasekaran, K., Silva, I.R.F. da, Nalleballe, K., Santoro, J., Scullen, T., Kahn, L., Kim, C.Y., Thakur, K.T., Jain, R., Umapathi, T., Nicholson, T.R., Sejvar, J.J., Hodel, E.M., Smith, C.T., Solomon, T., Brain Infect Global COVID-Neuro Ne
Přispěvatelé: University of Liverpool, Fondation Ophtalmologique Adolphe de Rothschild [Paris], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Les Hôpitaux Universitaires de Strasbourg (HUS), The study was funded by the UK Medical Research Council’s Global Effort on COVID-19 Programme (MR/V033441/1) (https://mrc.ukri.org/), UK National Institute for Health Research (NIHR)- funded Global Health Research Group on Acute Brain Infections (17/63/110) (https://www.nihr.ac.uk/), and the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections (NIHR200907), at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford (Grant Nos. IS-HPU-1112-10117 and NIHR200907). These grants were awarded to TS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: PLOS ONE
PLoS ONE
PLoS ONE, Public Library of Science, 2022, 17 (6), pp.e0263595. ⟨10.1371/journal.pone.0263595⟩
PLoS ONE, 17(6). PUBLIC LIBRARY SCIENCE
PLoS ONE, 2022, 17 (6), pp.e0263595. ⟨10.1371/journal.pone.0263595⟩
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0263595⟩
Popis: Background Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome. Methods We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models. Results We included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67–82]), than encephalopathy (54% [42–65]). Intensive care use was high (38% [35–41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27–32]. The hazard of death was comparatively lower for patients in the WHO European region. Interpretation Neurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission.
Databáze: OpenAIRE
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