JAMA Network Open (05/11/21) DOI: 10.1001/jamanetworkopen.2021.12131
Chou, Sherry H.-Y.; Beghi, Ettore; Helbok, Raimund; et al.
Neurological manifestations are common among patients hospitalized with COVID-19, according to new research, and are associated with an increased risk for in-hospital mortality. The cohort study — which involved 3,744 patients hospitalized with COVID-19 in 13 countries on four continents — sought to determine the neurological incidence of neurological manifestations of COVID-19 and investigate their relationship with in-hospital mortality. Patients were divided into three cohorts. Overall, 82% of the patients had self-reported or clinically captured neurological symptoms. The most frequently self-reported symptoms were headache (37%) and amnosia or ageusia (26%), while the most prevalent neurological signs or syndromes were acute encephalopathy (49%) coma (17%), and stroke (6%). The incidence of meningitis or encephalitis were rare, affecting less than 1% of hospitalized COVID-19 patients. After adjusting for study site, age, sex, race, and ethnicity, the presence of clinically captured neurologic signs or syndromes was associated with a higher risk of mortality while hospitalized (adjusted odds ratio, 5.99). In addition, the risk for developing neurological signs or syndromes was linked with having preexisting neurological disorders (adjusted odds ratio, 2.23). "Using a global network with standardized protocols and common data elements is critical to facilitate further studies to understand COVID-19 neurological manifestations, including disease progression, associations with long-term outcomes, pathobiological mechanisms, and societal impact," the authors conclude.