RT Journal Article
SR Electronic
T1 Clinical characteristics and outcomes of inpatients with neurologic disease and COVID-19 in Brescia, Lombardy, Italy
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e910
OP e920
DO 10.1212/WNL.0000000000009848
VO 95
IS 7
A1 Alberto Benussi
A1 Andrea Pilotto
A1 Enrico Premi
A1 Ilenia Libri
A1 Marcello Giunta
A1 Chiara Agosti
A1 Antonella Alberici
A1 Enrico Baldelli
A1 Matteo Benini
A1 Sonia Bonacina
A1 Laura Brambilla
A1 Salvatore Caratozzolo
A1 Matteo Cortinovis
A1 Angelo Costa
A1 Stefano Cotti Piccinelli
A1 Elisabetta Cottini
A1 Viviana Cristillo
A1 Ilenia Delrio
A1 Massimiliano Filosto
A1 Massimo Gamba
A1 Stefano Gazzina
A1 Nicola Gilberti
A1 Stefano Gipponi
A1 Alberto Imarisio
A1 Paolo Invernizzi
A1 Ugo Leggio
A1 Matilde Leonardi
A1 Paolo Liberini
A1 Martina Locatelli
A1 Stefano Masciocchi
A1 Loris Poli
A1 Renata Rao
A1 Barbara Risi
A1 Luca Rozzini
A1 Andrea Scalvini
A1 Francesca Schiano di Cola
A1 Raffaella Spezi
A1 Veronica Vergani
A1 Irene Volonghi
A1 Nicola Zoppi
A1 Barbara Borroni
A1 Mauro Magoni
A1 Alessandro Pezzini
A1 Alessandro Padovani
YR 2020
UL http://n.neurology.org/content/95/7/e910.abstract
AB Objective To report clinical and laboratory characteristics, treatment, and clinical outcomes of patients admitted for neurologic diseases with and without coronavirus disease 2019 (COVID-19).Methods In this retrospective, single-center cohort study, we included all adult inpatients with confirmed COVID-19 admitted to a neuro-COVID unit beginning February 21, 2020, who had been discharged or died by April 5, 2020. Demographic, clinical, treatment, and laboratory data were extracted from medical records and compared (false discovery rate corrected) to those of neurologic patients without COVID-19 admitted in the same period.Results One hundred seventy-three patients were included in this study, of whom 56 were positive and 117 were negative for COVID-19. Patients with COVID-19 were older (77.0 years, interquartile range [IQR] 67.0–83.8 years vs 70.1 years, IQR 52.9–78.6 years, p = 0.006), had a different distribution regarding admission diagnoses, including cerebrovascular disorders (n = 43, 76.8% vs n = 68, 58.1%), and had a higher quick Sequential Organ Failure Assessment (qSOFA) score on admission (0.9, IQR 0.7–1.1 vs 0.5, IQR 0.4–0.6, p = 0.006). In-hospital mortality rates (n = 21, 37.5% vs n = 5, 4.3%, p < 0.001) and incident delirium (n = 15, 26.8% vs n = 9, 7.7%, p = 0.003) were significantly higher in the COVID-19 group. Patients with COVID-19 and without COVID with stroke had similar baseline characteristics, but patients with COVID-19 had higher modified Rankin Scale scores at discharge (5.0, IQR 2.0–6.0 vs 2.0, IQR 1.0–3.0, p < 0.001), with a significantly lower number of patients with a good outcome (n = 11, 25.6% vs n = 48, 70.6%, p < 0.001). In patients with COVID-19, multivariable regressions showed increasing odds of in-hospital death associated with higher qSOFA scores (odds ratio [OR] 4.47, 95% confidence interval [CI] 1.21–16.5, p = 0.025), lower platelet count (OR 0.98, 95% CI 0.97–0.99, p = 0.005), and higher lactate dehydrogenase (OR 1.01, 95% CI 1.00–1.03, p = 0.009) on admission.Conclusions Patients with COVID-19 admitted with neurologic disease, including stroke, have a significantly higher in-hospital mortality and incident delirium and higher disability than patients without COVID-19.CI=confidence interval; COVID-19=coronavirus disease 2019; IQR=interquartile range; mRS=modified Rankin Scale; NIHSS=NIH Stroke Scale; qSOFA=quick SOFA; SARS–CoV-2=severe acute respiratory syndrome coronavirus 2; SOFA=Sequential Organ Failure Assessment