Short‐ and long‐term outcome and predictors in an international cohort of patients with neuro‐COVID‐19

Background and purpose Despite the increasing number of reports on the spectrum of neurological manifestations of COVID‐19 (neuro‐COVID), few studies have assessed short‐ and long‐term outcome of the disease. Methods This is a cohort study enrolling adult patients with neuro‐COVID seen in neurologic...

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Published in:European journal of neurology 2022-06, Vol.29 (6), p.1663-1684
Main Authors: Beghi, Ettore, Helbok, Raimund, Ozturk, Serefnur, Karadas, Omer, Lisnic, Vitalie, Grosu, Oxana, Kovács, Tibor, Dobronyi, Levente, Bereczki, Daniel, Cotelli, Maria Sofia, Turla, Marinella, Davidescu, Eugenia Irene, Popescu, Bogdan Ovidiu, Valzania, Franco, Cavallieri, Francesco, Ulmer, Hanno, Maia, Luis F., Amodt, Anne Hege, Armon, Carmel, Brola, Waldemer, Victoria, Gryb, Riahi, Anis, Krehan, Ingomar, Oertzen, Tim, Azab, Mohammed A, Crean, Michael, Lolich, Maria, Lima, Maria João, Sellner, Johann, Perneczky, Julian, Jenkins, Tom, Meoni, Sara, Bianchi, Elisa, Moro, Elena, Bassetti, Claudio L. A., Ural, Onur, Kara, Iskender, Ozturk, Bilgin, Gavriliuc, Mihail, Odainic, Olesea, Civelli, Patrizia, Bianchi, Marta, Bunea, Teodora, Sandu, Georgiana, Toschi, Giulia, Oliveira, Vanessa, Dias, Alexandre, Jung, Simon, Hoepner, Robert, Boldingh, Marion, Agajany, Netta, Wolfson, Sharon, Michał, Lipowski, Marjiana, Lesiv, Derbali, Hajer, Seabra, Mafalda, Carvalho, Vanessa, Flemmen, Heidi Øyen, Yasuda, Clarissa Lin, Taba, Pille, Yassin, Osama, Kiteva‐Trenchevska, Gordana
Format: Article
Language:English
Subjects:
Adult
Aged
Ataxia
Cohort Studies
Coma
Complications
COVID-19
COVID-19 - complications
Demographic variables
Hospitalization
Humans
Infectious Diseases
Intensive Care Units
neurological disorders
Neurology
Original
outcome
Patients
predictors
Retrospective Studies
SARS-CoV-2
Signs and symptoms
Stroke
Stroke - epidemiology
Stroke - therapy
Stupor
Viral diseases
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Summary:Background and purpose Despite the increasing number of reports on the spectrum of neurological manifestations of COVID‐19 (neuro‐COVID), few studies have assessed short‐ and long‐term outcome of the disease. Methods This is a cohort study enrolling adult patients with neuro‐COVID seen in neurological consultation. Data were collected prospectively or retrospectively in the European Academy of Neurology NEuro‐covid ReGistrY ((ENERGY). The outcome at discharge was measured using the modified Rankin Scale and defined as ‘stable/improved’ if the modified Rankin Scale score was equal to or lower than the pre‐morbid score, ‘worse’ if the score was higher than the pre‐morbid score. Status at 6 months was also recorded. Demographic and clinical variables were assessed as predictors of outcome at discharge and 6 months. Results From July 2020 to March 2021, 971 patients from 19 countries were included. 810 (83.4%) were hospitalized. 432 (53.3%) were discharged with worse functional status. Older age, stupor/coma, stroke and intensive care unit (ICU) admission were predictors of worse outcome at discharge. 132 (16.3%) died in hospital. Older age, cancer, cardiovascular complications, refractory shock, stupor/coma and ICU admission were associated with death. 262 were followed for 6 months. Acute stroke or ataxia, ICU admission and degree of functional impairment at discharge were predictors of worse outcome. 65/221 hospitalized patients (29.4%) and 10/32 non‐hospitalized patients (24.4%) experienced persisting neurological symptoms/signs. 10/262 patients (3.8%) developed new neurological complaints during the 6 months of follow‐up. Conclusions Neuro‐COVID is a severe disease associated with worse functional status at discharge, particularly in older subjects and those with comorbidities and acute complications of infection. From July 2020 to March 2021, 971 patients from 19 countries were included. 810 (83.4%) were hospitalized during the acute phase of the COVID‐19 infection, of whom 432 (53.3%) were discharged with worse functional status and 132 (16.3%) died in hospital. 262 were followed for 6 months: 75/262 patients (28.6%) experienced persisting neurological symptoms/signs, whilst 10/262 patients (3.8%) developed new neurological complaints during the 6 months of follow‐up.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.15293