Serious Neurologic Manifestations Tied to Worse COVID-19 Outcomes

Doctors checking patient in ward during COVID-19
Male and female doctors in protective suits examining senior man lying on bed. Healthcare workers are examining patient in ward during COVID-19 outbreak. They are working in hospital during pandemic.
For adults hospitalized with SARS-CoV-2 infection, encephalopathy at admission is the most common serious neurologic manifestation.

HealthDay News — For adults hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, encephalopathy at admission is the most common serious neurologic manifestation, all of which are associated with worse outcomes, according to a study published in the April issue of Critical Care Explorations.

Anna M. Cervantes-Arslanian, M.D., from the Boston University School of Medicine, and colleagues conducted a prospective observational study at 179 hospitals in 24 countries involving 16,225 hospitalized adults with laboratory-confirmed SARS-CoV-2 infection during the first year of the COVID-19 pandemic.

The researchers found that 12.9 percent of the patients developed serious neurologic manifestations, including encephalopathy at admission (10.2 percent), stroke (2.0 percent), seizure (1.5 percent), and meningitis/encephalitis at admission or during hospitalization (0.5 percent). Patients with serious neurologic manifestations were older (median age, 72 versus 61 years) and had an increased prevalence of chronic medical conditions, including vascular risk factors. Serious neurologic manifestations were associated with more severe disease (odds ratio, 1.49) after adjustment for age, sex, and time since onset of the pandemic. The likelihood of being admitted to the intensive care unit (ICU) and requiring critical care interventions (extracorporeal membrane oxygenation and renal replacement therapy) was increased for patients with neurologic manifestations (odds ratios, 1.45, 1.78, and 1.99, respectively). Patients with neurologic manifestations had higher hospital, ICU, and 28-day mortality (odds ratios, 1.51, 1.37, and 1.58, respectively), and they had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, −0.84, −1.34, and −0.84, respectively).

“All serious neurologic manifestations are associated with worse outcomes, including an increased risk of death,” the authors write.

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