Abstract Details

Title Neurologic Manifestations Associated with COVID-19 in Hospitalized Patients

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Neurocritical Care Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 040

Objective To identify major phenotypes of neurologic manifestations and their prevalence in hospitalized patients infected with severe acute respiratory syndrome corona virus disease 2019 (COVID-19).

Background Emerging evidence suggests COVID-19 presentation is not limited to the respiratory system but may have multi-organ involvement including dysfunctions of the nervous system. However, little is known about the major phenotypes, prevalence, and impact of nervous system involvement on patient outcomes.

Design/Methods We are the coordinating center and part of the GCS-Neuro COVID consortium tier 1 pragmatic study. We prospectively screened 127 consecutive patients admitted to a large academic hospital from 03/22/2020 to 09/05/2020. Adults age ≥ 18 years old admitted to the hospital with suspected or confirmed COVID19 infection were included. Eight patients met exclusion criteria of severe pre-existing baseline neurologic dysfunction such as coma or vegetative state that limit detection of new or worsening neurologic symptoms.

Results Of the total cohort of 119 patients (mean age 63.4 years, 48% women), 73 (61.3%) exhibited new/worsening neurologic symptoms. The most common phenotype was acute encephalopathy (44%), followed by headache (40%), abnormal smell/taste (23%), and new movement abnormalities (21%). Other neurologic manifestations included clinical or electrographic seizures (10%), coma (4%), and intracerebral hemorrhage (3%). Neurologic symptoms began an average of 6.2 days after respiratory symptoms (range 0 to 48), although 2 patients developed neurologic symptoms before respiratory symptoms. COVID-19 patients with neurologic symptoms were less likely to have a favorable outcome at discharge (24.6%) with mRS (0-1) compared to those without neurological symptoms (61.9%).

Conclusions Neurologic manifestations in patients infected with COVID-19 are prevalent and have significant impact on patient outcomes at acute hospital discharge in this single-center study. Further studies are underway to better characterize neurologic symptoms as well as follow-up to determine the long-term impact of COVID-19 on patient outcome and recovery.

Authors/Disclosures
Aleksandra Safonova, MD (Johns Hopkins Hospital) PRESENTER	Dr. Safonova has nothing to disclose.
Nicole Paul	Nicole Paul 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. Chou has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSL-Behring. Dr. Chou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CSL-Behring. The institution of Dr. Chou has received research support from NIH/NINDS. The institution of Dr. Chou has received research support from University of Pittsburgh.

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