New onset neurologic events in people with COVID-19 in 3 regions in China.

Adolescent Adult Aged Aged, 80 and over Betacoronavirus COVID-19 Central Nervous System Diseases / epidemiology Child Child, Preschool China / epidemiology Cohort Studies Coronavirus Infections / complications Female Humans Infant Infant, Newborn Male Middle Aged Pandemics Pneumonia, Viral / complications Retrospective Studies Risk Factors SARS-CoV-2 Young Adult

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
15 09 2020
Historique:
received: 29 04 2020
accepted: 02 06 2020
pubmed: 20 6 2020
medline: 26 9 2020
entrez: 20 6 2020
Statut: ppublish

Résumé

To investigate new-onset neurologic impairments associated with coronavirus disease 2019 (COVID-19). A retrospective multicenter cohort study was conducted between January 18 and March 20, 2020, including people with confirmed COVID-19 from 56 hospitals officially designated in 3 Chinese regions; data were extracted from medical records. New-onset neurologic events as assessed by neurology consultants based on manifestations, clinical examination, and investigations were noted, in which critical events included disorders of consciousness, stroke, CNS infection, seizures, and status epilepticus. We enrolled 917 people with average age 48.7 years and 55% were male. The frequency of new-onset critical neurologic events was 3.5% (32/917) overall and 9.4% (30/319) among those with severe or critical COVID-19. These were impaired consciousness (n = 25) or stroke (n = 10). The risk of critical neurologic events was highly associated with age above 60 years and previous history of neurologic conditions. Noncritical events were seen in fewer than 1% (7/917), including muscle cramp, unexplained headache, occipital neuralgia, tic, and tremor. Brain CT in 28 people led to new findings in 9. Findings from lumbar puncture in 3 with suspected CNS infection, unexplained headache, or severe occipital neuralgia were unremarkable. People with COVID-19 aged over 60 and with neurologic comorbidities were at higher risk of developing critical neurologic impairment, mainly impaired consciousness and cerebrovascular accidents. Brain CT should be considered when new-onset brain injury is suspected, especially in people under sedation or showing an unexplained decline in consciousness. Evidence of direct acute insult of severe acute respiratory syndrome coronavirus 2 to the CNS is lacking.

Identifiants

DOI: 10.1212/WNL.0000000000010034 PMID: 32554771
pubmed: 32554771
pii: WNL.0000000000010034
doi: 10.1212/WNL.0000000000010034
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1479-e1487

Informations de copyright

© 2020 American Academy of Neurology.

Auteurs

Weixi Xiong (W)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-6835-8664

Jie Mu (J)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0002-9773-3838

Jian Guo (J)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-5635-8851

Lu Lu (L)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0003-3717-5237

Dan Liu (D)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-6791-1704

Jianfei Luo (J)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0002-0639-8991

Nian Li (N)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Jing Liu (J)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-8707-9177

Dan Yang (D)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-5959-1202

Hui Gao (H)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-5096-7023

Yingying Zhang (Y)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Mintao Lin (M)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Sisi Shen (S)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0003-0620-3696

Hesheng Zhang (H)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0003-4489-2103

Lei Chen (L)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Gang Wang (G)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Fengming Luo (F)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Weimin Li (W)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Shengli Chen (S)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-7702-4842

Li He (L)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.

Josemir W Sander (JW)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands.
ORCID: 0000-0001-6041-9661

Dong Zhou (D)

From the Departments of Neurology (W.X., J.M., J.G., L.L., H.G., Y.Z., M.L., S.S., H.Z., L.C., L.H., D.Z.), Pulmonary & Critical Care Medicine (D.L., G.W., W.L.), and Medical Affairs (N.L.), West China Hospital of Sichuan University, Chengdu; Department of Gastrointestinal Surgery (J. Luo), Renmin Hospital of Wuhan University; Department of Neurology (J. Liu, D.Y., S.C.), Chongqing Three Gorges Central Hospital, Chongqing; NIHR University College London Hospitals Biomedical Research Centre (J.W.S.), UCL Queen Square Institute of Neurology, Queen Square, London, UK; Chalfont Centre for Epilepsy (J.W.S.), Chalfont St Peter, UK; and Stichting Epilepsie Instellingen Nederland (SEIN) (J.W.S.), Heemstede, Netherlands. zhoudong66@yahoo.de.
ORCID: 0000-0001-7101-4125

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › New onset neurologic events in people with...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › New onset neurologic events in people with...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › New onset neurologic events in people with...
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questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › New onset neurologic events in people with...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › New onset neurologic events in people with...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › New onset neurologic events in people with...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › New onset neurologic events in people with...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Enfant d'âge préscolaire › New onset neurologic events in people with...
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questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › New onset neurologic events in people with...
questionsmedicales.fr › Infection › Maladies virales › Infections à virus à ARN › Infections à Nidovirales › Infections à Coronaviridae › Infections à coronavirus › New onset neurologic events in people with...
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questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › New onset neurologic events in people with...
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