Neurological complications in patients with COVID Common, fatal

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Eight out of 10 patients hospitalized with COVID-19 develop neurological complications and these patients are much more likely to die in hospital compared to their counterparts without neurological complications, according to a global study.

The findings of the global consortium study on neurological dysfunction in COVID-19 (GCS-NeuroCOVID) reveal that 82% of hospitalized COVID-19 patients had neurological manifestations and a six-fold mortality risk.

“We now know that neurological conditions are common in hospitalized patients with COVID-19 and, in this extensive study, we can see the impact of neurological conditions,” she told lead researcher Sherry Chou, MD, MSc. Medscape Medical News.

“Without really knowing if the neurological conditions directly cause the death of these patients, we see that patients with neurological conditions with COVID-19 were more likely to die while in the hospital,” said Chou, an associate professor of critical care medicine, neurology, and neurosurgery at the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

“The challenge we have for ourselves as doctors and scientists is to find out why and how we can prevent it,” he added.

The conclusions were published online May 11 a JAMA network open.

Long way to go

Among 3744 patients hospitalized with COVID-19, 82% developed neurological manifestations. The most common self-reported neurological symptoms were headache (37%) and anosmia (loss of smell) or ageusia (loss of taste) (26%).

The most common neurological signs and / or syndromes were acute encephalopathy (49%), coma (17%) and stroke (6%). Meningitis and / or encephalitis were rare (0.5%).

After adjusting for relevant cofactors, including age, sex, and race / ethnicity, the presence of clinically captured neurological signs and / or syndromes was associated with a six-fold increased risk of dying in hospital ( odds ratio adjusted [aOR], 5.99; 95% CI, 4.33 – 8.28).

“Having a pre-existing neurological condition of any kind with more reliability and stronger prediction of the development of COVID-19-related neurological complications. The risk is more than double compared to those who do not have a pre-existing neurological condition,” Chou said. .

“For hospitalized patients with COVID-19 who develop neurological problems, it can take a long time to recover. Many of these patients continue to treat these symptoms and disabilities long after they have overcome COVID,” he said.

“Even if the pandemic is completely eradicated, we are still talking about millions of survivors who need our help,” Chou added in a press release.

“It’s important to find out what symptoms and health issues these patients face and there’s still a lot of work to be done over the next few years,” he said.

The study is supported by the National Institutes of Health, the National Center for the Advancement of Translation Sciences, and the University of Pittsburgh Dean’s Faculty Award. Chou has no relevant disclosures.

JAMA Netw Open. Published May 11, 2021. Full text

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