Risk Factors for New Neurologic Diagnoses in Hospitalized Patients With COVID-19: A Case-Control Study in New York City.


Journal

Neurology. Clinical practice
ISSN: 2163-0402
Titre abrégé: Neurol Clin Pract
Pays: United States
ID NLM: 101577149

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 22 02 2022
accepted: 26 04 2022
entrez: 16 11 2022
pubmed: 17 11 2022
medline: 17 11 2022
Statut: ppublish

Résumé

There have been numerous reports of neurologic manifestations identified in hospitalized patients infected with SARS-CoV-2, the virus that causes COVID-19. Here, we identify the spectrum of associated neurologic symptoms and diagnoses, define the time course of their development, and examine readmission rates and mortality risk posthospitalization in a multiethnic urban cohort. We identify the occurrence of new neurologic diagnoses among patients with laboratory-confirmed SARS-CoV-2 infection in New York City. A retrospective cohort study was performed on 532 cases (hospitalized patients with new neurologic diagnoses within 6 weeks of positive SARS-CoV-2 laboratory results between March 1, 2020, and August 31, 2020). We compare demographic and clinical features of the 532 cases with 532 controls (hospitalized COVID-19 patients without neurologic diagnoses) in a case-control study with one-to-one matching and examine hospital-related data and outcomes of death and readmission up to 6 months after acute hospitalization in a secondary case-only analysis. Among the 532 cases, the most common new neurologic diagnoses included encephalopathy (478, 89.8%), stroke (66, 12.4%), and seizures (38, 7.1%). In the case-control study, cases were more likely than controls to be male (58.6% vs 52.8%, Hospitalized patients with SARS-CoV-2 and new neurologic diagnoses have significant morbidity and mortality postdischarge. Further research is needed to define the effect of neurologic diagnoses during acute hospitalization on longitudinal post-COVID-19-related symptoms including neurocognitive impairment.

Sections du résumé

Background and Objectives UNASSIGNED
There have been numerous reports of neurologic manifestations identified in hospitalized patients infected with SARS-CoV-2, the virus that causes COVID-19. Here, we identify the spectrum of associated neurologic symptoms and diagnoses, define the time course of their development, and examine readmission rates and mortality risk posthospitalization in a multiethnic urban cohort.
Methods UNASSIGNED
We identify the occurrence of new neurologic diagnoses among patients with laboratory-confirmed SARS-CoV-2 infection in New York City. A retrospective cohort study was performed on 532 cases (hospitalized patients with new neurologic diagnoses within 6 weeks of positive SARS-CoV-2 laboratory results between March 1, 2020, and August 31, 2020). We compare demographic and clinical features of the 532 cases with 532 controls (hospitalized COVID-19 patients without neurologic diagnoses) in a case-control study with one-to-one matching and examine hospital-related data and outcomes of death and readmission up to 6 months after acute hospitalization in a secondary case-only analysis.
Results UNASSIGNED
Among the 532 cases, the most common new neurologic diagnoses included encephalopathy (478, 89.8%), stroke (66, 12.4%), and seizures (38, 7.1%). In the case-control study, cases were more likely than controls to be male (58.6% vs 52.8%,
Discussion UNASSIGNED
Hospitalized patients with SARS-CoV-2 and new neurologic diagnoses have significant morbidity and mortality postdischarge. Further research is needed to define the effect of neurologic diagnoses during acute hospitalization on longitudinal post-COVID-19-related symptoms including neurocognitive impairment.

Identifiants

pubmed: 36382116
doi: 10.1212/CPJ.0000000000200006
pii: CPJ-2022-200006
pmc: PMC9647816
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e66-e74

Subventions

Organisme : NIAID NIH HHS
ID : K23 AI150378
Pays : United States

Informations de copyright

© 2022 American Academy of Neurology.

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Auteurs

Kiran T Thakur (KT)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Victoria T Chu (VT)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Christine Hughes (C)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Carla Y Kim (CY)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Shannon Fleck-Derderian (S)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Catherine E Barrett (CE)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Elizabeth Matthews (E)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Alanna Balbi (A)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Amanda Bilski (A)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Mashina Chomba (M)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Ori Lieberman (O)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Samuel D Jacobson (SD)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Sachin Agarwal (S)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

David Roh (D)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Soojin Park (S)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Vivian Ssonko (V)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Wendy G Silver (WG)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Wendy D Vargas (WD)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Andrew Geneslaw (A)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Michelle Bell (M)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Brandon Waters (B)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Agam Rao (A)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Jan Claassen (J)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Amelia Boehme (A)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Joshua Z Willey (JZ)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Mitchell S V Elkind (MSV)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Magdalena E Sobieszczyk (ME)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Jason Zucker (J)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Andrea McCollum (A)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

James Sejvar (J)

Department of Neurology (KTT, CYK, EM, A. Balbi, A. Bilski, MC, OL, SDJ, SA, DR, SP, VS, WGS, WDV, AG, MB, BW, JC, A. Boehme, JZW, MSVE), Columbia University Irving Medical Center-New York Presbyterian Hospital; United States Centers for Disease Control and Prevention (VTC, CH, SF-D, CEB, AR, AM, JS), Atlanta, GA; Department of Pediatrics (AG), Columbia University Irving Medical Center-New York Presbyterian Hospital; and Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center-New York Presbyterian Hospital (MES, JZ), New York.

Classifications MeSH