Prognostic Indicators and Outcomes of Hospitalised COVID-19 Patients with Neurological Disease: A Systematic Review and Individual Patient Data Meta-Analysis

Singh, Bhagteshwar; Lant, Suzannah; Cividini, Sofia; Cattrall, Jonathan W. S.; Goodwin, Lynsey; Benjamin, Laura; Michael, Benedict; Khawaja, Ayaz; Matos, Aline MB; Alkeridy, Walid; Padovani, Alessandro; Lahiri, Durjoy; Thirugnanam, Umapathi; Dua, Tarun; Nicholson, Timothy; Sejvar, James J.; Hodel, Eva Maria; Group, Brain Infections Global COVID-Neuro Network Study; Smith, Catrin Tudur; Solomon, Tom

doi:10.2139/ssrn.3834310

Cited by 9 publications

(12 citation statements)

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“…SARS-CoV-2 infection has been associated with several neurologic symptoms and manifestations due to both CNS and PNS involvement, ranging from nonspecific symptoms (headache, myalgia, dizziness, fatigue) to cerebrovascular disease, encephalitis, movement disorders, myelitis, cranial and peripheral neuropathies ( Moro et al, 2020 ; Romoli et al, 2020 ). Based on systematic reviews and individual patient data meta-analysis, 7.8% (95% CI 1.6–31.2) of hospitalized people with COVID-19 had neurological disease ( Singh et al, 2021 ).…”

Section: Neurologic Manifestations Of Human Coronavirus Infectionmentioning

confidence: 99%

Neurologic complications of coronavirus and other respiratory viral infections

Cavallieri

Sellner

Zedde

et al. 2022

Handbook of Clinical Neurology

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Section: Neurologic Manifestations Of Human Coronavirus Infectionmentioning

confidence: 99%

Neurologic complications of coronavirus and other respiratory viral infections

Cavallieri

Sellner

Zedde

et al. 2022

Handbook of Clinical Neurology

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“…We suspect that this reflects a global uncertainty in distinguishing between these conditions, which, in clinical practice, is also challenging due to complex and overlapping clinical presentations. However, with encephalopathy among the most common neurological manifestation of COVID-19 [ 2 , 16 ], and requiring primarily supportive rather than immunosuppressive treatment [ 18 ], further work should focus on designing tools to help clinicians differentiate between these syndromes.…”

Section: Discussionmentioning

confidence: 99%

“…Up to a third of all adults infected with SARS-CoV-2 develop neurological or psychiatric symptoms within the first six months of infection [ 1 ] and half of hospitalised patients with such manifestations have poor prognosis [ 2 ]. Yet, the global study of neurological complications of SARS-CoV-2 infection is challenging, due to the relative rarity of individual disease entities and complexities of making neurological diagnoses, which is amplified by limited access to neurological expertise, workforce and diagnostic investigations [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study

Tamborska

Wood

Westenberg

et al. 2023

Journal of the Neurological Sciences

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“…COVID association for subacute and chronic disorders, such as Guillain-Barré syndrome and cognitive impairment, was defined as occurrence within 6 weeks from acute infection, according to a previous study. 4 Data Collection Demographics, comorbidities, clinical characteristics of COVID-19 and neurologic disorders, and outcomes were collected by the centers involved in this study. All data were securely stored in an electronic case report form developed with the Integrated Clinical Trial Environment platform by Advice Pharma, which acted as Contract Research Organization of this study.…”

Section: Study Definitionsmentioning

confidence: 99%

“…2,3 These "neuro-COVID" disorders have been described with a variable frequency of approximately 8%, ranging from 1% to more than 30% in different studies. 4,5 Most available studies provided robust data on the frequency of neuro-COVID disorders and in-hospital mortality. 6,7 Nonetheless, important issues need to be addressed about the incidence of neuro-COVID disorders over time, the effect of treatments or vaccines, and their long-term outcome.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants

et al. 2023

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Background and ObjectiveA variety of neurological disorders has been reported as presentations or complications of COVID-19 infection. The objective of this study was to determine their incidence dynamics and long-term functional outcome.MethodsThe Neuro-COVID Italy study was a multicentre, observational, cohort study with ambispective recruitment and prospective follow-up. Consecutive hospitalized patients presenting new neurological disorders associated with COVID-19 infection (neuro-COVID), independently from respiratory severity, were systematically screened and actively recruited by neurology specialists in 38 centers in Italy and the Republic of San Marino. The primary outcomes were incidence of neuro-COVID cases during the first 70 weeks of the pandemic (March 2020 to June 2021) and long-term functional outcome at 6 months, categorized as full recovery, mild symptoms, disabling symptoms or death.ResultsAmong 52759 hospitalized COVID patients, 1865 patients presenting 2881 new neurological disorders associated with COVID-19 infection (neuro-COVID) were recruited. Incidence of neuro-COVID cases significantly declined over time, comparing the first three pandemic waves (8.4%, 95% CI [7.9, 8.9]; 5.0%, 95% CI [4.7, 5.3]; 3.3%, 95% CI [3.0, 3.6], respectively; p = 0.027). The most frequent neurological disorders were acute encephalopathy (25.2%), hyposmia-hypogeusia (20.2%), acute ischemic stroke (18.4%) and cognitive impairment (13.7%). The onset of neurological disorders was more common in the prodromic phase (44.3%) or during the acute respiratory illness (40.9%), except for cognitive impairment whose onset prevailed during recovery (48.4%). A good functional outcome was achieved by the majority of neuro-COVID patients (64.6%) during follow-up (median 6.7 months) and the proportion of good outcome increased throughout the study period (r = 0.29, 95% CI [0.05, 0.50]; p = 0.019). Mild residual symptoms were frequently reported (28.1%), while disabling symptoms were common only in stroke survivors (47.6%).DiscussionIncidence of COVID-associated neurologic disorders decreased during the pre-vaccination phase of the pandemic. Long-term functional outcome was favourable in most neuro-COVID disorders, although mild symptoms commonly lasted over 6 months after infection.

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Prognostic Indicators and Outcomes of Hospitalised COVID-19 Patients with Neurological Disease: A Systematic Review and Individual Patient Data Meta-Analysis

Cited by 9 publications

References 0 publications

Neurologic complications of coronavirus and other respiratory viral infections

Neurologic complications of coronavirus and other respiratory viral infections

Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study

Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants

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