RT Journal Article
SR Electronic
T1 Risk Factors for New Neurologic Diagnoses in Hospitalized Patients with COVID-19: A Case-Control Study in New York City
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 10.1212/CPJ.0000000000200006
DO 10.1212/CPJ.0000000000200006
A1 Thakur, Kiran T.
A1 Chu, Victoria
A1 Hughes, Christy
A1 Kim, Carla Y.
A1 Fleck-Dardarian, Shannon
A1 Barrett, Katherine
A1 Matthews, Elizabeth
A1 Balbi, Alanna
A1 Bilski, Amanda
A1 Chomba, Mashina
A1 Lieberman, Ori
A1 Jacobson, Samuel
A1 Agarwal, Sachin
A1 Roh, David
A1 Park, Soojin
A1 Ssonko, Vivian
A1 Silver, Wendy
A1 Vargas, Wendy
A1 Geneslaw, Andrew
A1 Bell, Michelle
A1 Waters, Brandon
A1 Rao, Agam
A1 Claassen, Jan
A1 Boehme, Amelia
A1 Willey, Joshua
A1 Elkind, Mitch
A1 Sobieszcyzk, Magdalena
A1 Zucker, Jason
A1 McCollum, Andrea
A1 Sejvar, Jim
YR 2022
UL http://cp.neurology.org/content/early/2022/06/02/CPJ.0000000000200006.abstract
AB Background/Objective: There have been numerous reports of neurological manifestations identified in hospitalized patients infected with SARS-CoV-2, the virus that causes COVID-19. Here, we identify the spectrum of associated neurological symptoms and diagnoses, define the time course of their development, examine readmission rates and mortality risk post-hospitalization in a multiethnic urban cohort.Methods: We identify the occurrence of new neurological diagnoses among patients with laboratory-confirmed SARS-CoV-2 infection in New York City. A retrospective cohort study was performed of 532 cases (hospitalized patients with new neurological diagnoses within 6 weeks of positive SARS-CoV-2 laboratory results between March 1, 2020 and August 31, 2020). We compare demographic and clinical features of the 532 cases to 532 COVID-19 positive controls without neurological diagnoses in a case-control study with 1 to 1 matching; and examine hospital-related data and outcomes of death and readmission up to 6 months after acute hospitalization in a secondary case-only analysis.Results: Among the 532 cases, the most common new neurological diagnoses included encephalopathy (478, 89.8%), stroke (66, 12.4%), and seizures (38, 7.1%). In the case-control study, cases were more likely than controls to be male (58.6% vs. 52.8%, p=0.05), have baseline neurological comorbidities (36.3% vs. 13.0%, p<0.0001) and be treated in an intensive care unit (ICU) (62.0% vs. 9.6%, p < 0.0001). Of the 394 (74.1%) cases that survived the acute hospitalization, more than half (220/394, 55.8%) were readmitted within 6 months, with a mortality rate of 23.2% during readmission.Conclusion: Many patients hospitalized with SARS-CoV-2 have new neurological diagnoses, with significant morbidity and mortality post-discharge. Further research is needed to define the impact of neurological diagnoses during acute hospitalization on longitudinal post-COVID-19 related symptoms including neurocognitive impairment.