Abstract Details

Title Acute Hospital Outcomes COVID-19 Associated Neurological Dysfunction

Topic Infectious Disease

Presentation(s) S31 - Infectious Disease: Stroke and Infectious Diseases (4:08 PM-4:16 PM)

Poster/Presentation
Number 002

Objective

Determine outcomes of hospitalized adult patients with severe acute respiratory syndrome coronavirus disease-2019 (COVID-19) and neurological dysfunction.

Background

Emerging data suggest a wide range of neurological symptoms associated with COVID-19. Outcomes of patients with neurological dysfunctions and COVID-19 is unknown.

Design/Methods

A prospective cohort of 127 consecutive adult (age>18) patients admitted with suspected or confirmed COVID-19 infection to single academic hospital from 30/22/2020-09/05/2020 were included. We are part of the GCS-NeuroCOVID consortium. Eight patients met exclusion criteria of severe pre-existing baseline neurologic dysfunction that limit detection of new or worsening symptoms. Neurological dysfunctions were systematically recorded. Global outcome is measured by modified Rankin Score (mRS) at hospital discharge. Between-group differences were compared using parametric or non-parametric test based on data distribution.

Results

The final cohort consisted of 119 COVID-19 subjects where 73 (61%) had new neurological dysfunction. Patients with neurological dysfunctions had similar mean age (63.4 vs. 59.3 years) and gender distribution (52% vs. 50% male) compared to those without neurological dysfunction. Presence of neurological dysfunction is associated with need for mechanical ventilation (39.7% vs. 10.9%, p=.0007), longer median ICU (4 vs. 0 days, p=.0004) and hospital lengths of stay (12.5 vs. 6 days, p=.0007), worse functional outcome at discharge (mRS 3 vs. 1, p=.002) and non-home discharge destination (43% vs. 70%, p=.002). Neurological symptoms may be associated with higher incidence of do-not-resuscitate code status (27% vs. 13%, p=0.058) but did not impact in-hospital mortality (17.8% vs. 8.7%, p=0.19).

Conclusions

COVID-19 patients with new or worsened neurological dysfunction are more likely to require mechanical ventilation, had longer ICU and hospital length of stay, and worse global functional outcome at discharge. Relatively low mortality rate makes this study under-powered to detect a between-group mortality difference. Future studies are needed to determine long-term outcome impacts of neurological dysfunction associated with COVID-19.

Authors/Disclosures
Nicole Paul PRESENTER	Nicole Paul has nothing to disclose.
Aleksandra Safonova, MD (Johns Hopkins Hospital)	Dr. Safonova has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Aditya Sharma	Mr. Sharma has nothing to disclose.
	No disclosure on file
Charith Ratnayake	Mr. Ratnayake has nothing to disclose.
Carlos Villamizar Rosales, MD (UPMC)	Dr. Villamizar Rosales has nothing to disclose.
Sherry Hsiang-Yi Chou, MD (Departmnt of Neurology, Northwestern Feinberg School of Medicine)	Dr. Hsiang-Yi Chou has received personal compensation for serving as an employee of NIH. An immediate family member of Dr. Hsiang-Yi Chou has received personal compensation for serving as an employee of Wells Fargo. Dr. Hsiang-Yi Chou has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Grace Therapeutics. The institution of Dr. Hsiang-Yi Chou has received research support from The Neurocritical Care Society. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Board of Director member with United Council of Neurologic Specialties that is relevant to AAN interests or activities. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Co-chair/chair-elect, the Neurocritical Care Committee with American Heart Association, the Stroke Council that is relevant to AAN interests or activities. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Co-chair/chair ellect, the Neurocritical Care Special Interest Group with American Neurologic Association that is relevant to AAN interests or activities.

��ɫ��

��ɫ��