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Neurological Manifestations Are Prevalent Among Patients Hospitalised With COVID-19
Neurological
manifestations are prevalent among patients hospitalised with
coronavirus disease 2019 (COVID-19), and are associated with higher
in-hospital mortality, according to a study published in JAMA Network Open.
Patients with clinically diagnosed neurological symptoms associated with COVID-19 were 6 times more likely to die in the hospital than those without the neurological complications, according to an interim analysis from the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID).
“Very early on in the pandemic, it became apparent that a good number of people who were sick enough to be hospitalised also developed neurological problems,” said lead author Sherry Chou, MD, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. “A year later, we are still fighting an unknown invisible enemy and, like in any battle, we need intel -- we have to learn as much as we can about neurological impacts of COVID-19 in patients who are actively sick and in survivors.”
The GCS-NeuroCOVID is the largest cohort study of neurological manifestations of COVID-19 to date, spanning 133 adult patient sites in all continents except Antarctica.
Among one group of 3,744 hospitalised adult patients with COVID-19, 82% had self-reported or clinically captured neurological symptoms. Nearly 4 out of 10 patients reported having headaches, and approximately 3 out of 10 said they lost their sense of smell or taste. Of the clinically diagnosed syndromes, acute encephalopathy was most common, affecting nearly half of the patients, followed by coma (17%) and strokes (6%).
Despite early concerns about the virus’ ability to directly attack the brain and cause brain swelling and inflammation (meningitis and encephalitis), those events were very rare, occurring in less than 1% of hospitalised COVID-19 patients.
“Acute encephalopathy is by far the most common symptom that we see in the clinic,” said Dr. Chou. “Those patients may be in an altered sensory state or have impaired consciousness, or they don’t feel like themselves and act confused, delirious or agitated.”
The researchers analyzed data from three different types of patient cohorts: the “all COVID-19” cohort, which included all 3,055 hospitalised patients with COVID-19, irrespective of their neurological status; the “neurological” cohort, which included 475 hospitalised patients with clinically confirmed neurological symptoms compiled by the GCS-NeuroCOVID Consortium; and the “ENERGY” cohort, which included 214 hospitalised patients who required evaluation by a consulting neurologist and provided consent to participate in the European Academy of Neurology Neuro-COVID Registry (ENERGY), a formal partner of the GCS-NeuroCOVID Consortium.
The study found that having a pre-existing neurological condition of any kind was the strongest predictor of developing COVID-19-related neurological complications,(that is us) increasing the risk by 2-fold. In addition, having any neurological symptoms related to COVID-19 was associated with a 6-fold higher risk of dying in the hospital.
“Even if the pandemic is completely eradicated, we are still talking about millions of survivors who need our help,” said Dr. Chou. “It is important to find out what symptoms and health problems those patients are facing, and there is still plenty of work for years to come.”
Reference: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779759
SOURCE: University of Pittsburgh
Patients with clinically diagnosed neurological symptoms associated with COVID-19 were 6 times more likely to die in the hospital than those without the neurological complications, according to an interim analysis from the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID).
“Very early on in the pandemic, it became apparent that a good number of people who were sick enough to be hospitalised also developed neurological problems,” said lead author Sherry Chou, MD, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. “A year later, we are still fighting an unknown invisible enemy and, like in any battle, we need intel -- we have to learn as much as we can about neurological impacts of COVID-19 in patients who are actively sick and in survivors.”
The GCS-NeuroCOVID is the largest cohort study of neurological manifestations of COVID-19 to date, spanning 133 adult patient sites in all continents except Antarctica.
Among one group of 3,744 hospitalised adult patients with COVID-19, 82% had self-reported or clinically captured neurological symptoms. Nearly 4 out of 10 patients reported having headaches, and approximately 3 out of 10 said they lost their sense of smell or taste. Of the clinically diagnosed syndromes, acute encephalopathy was most common, affecting nearly half of the patients, followed by coma (17%) and strokes (6%).
Despite early concerns about the virus’ ability to directly attack the brain and cause brain swelling and inflammation (meningitis and encephalitis), those events were very rare, occurring in less than 1% of hospitalised COVID-19 patients.
“Acute encephalopathy is by far the most common symptom that we see in the clinic,” said Dr. Chou. “Those patients may be in an altered sensory state or have impaired consciousness, or they don’t feel like themselves and act confused, delirious or agitated.”
The researchers analyzed data from three different types of patient cohorts: the “all COVID-19” cohort, which included all 3,055 hospitalised patients with COVID-19, irrespective of their neurological status; the “neurological” cohort, which included 475 hospitalised patients with clinically confirmed neurological symptoms compiled by the GCS-NeuroCOVID Consortium; and the “ENERGY” cohort, which included 214 hospitalised patients who required evaluation by a consulting neurologist and provided consent to participate in the European Academy of Neurology Neuro-COVID Registry (ENERGY), a formal partner of the GCS-NeuroCOVID Consortium.
The study found that having a pre-existing neurological condition of any kind was the strongest predictor of developing COVID-19-related neurological complications,(that is us) increasing the risk by 2-fold. In addition, having any neurological symptoms related to COVID-19 was associated with a 6-fold higher risk of dying in the hospital.
“Even if the pandemic is completely eradicated, we are still talking about millions of survivors who need our help,” said Dr. Chou. “It is important to find out what symptoms and health problems those patients are facing, and there is still plenty of work for years to come.”
Reference: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779759
SOURCE: University of Pittsburgh
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