Abstract Details

Title COVID-19 in Patients With Pre-existing Neurologic Disorders: Clinical Course and Outcomes

Topic General Neurology

Presentation(s) General Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 020

Objective

To assess the clinical course and outcomes of COVID-19 in patients with pre-existing neurologic disorders and the impact of COVID-19 on neurologic disorder during and after COVID-19.

Background In March of 2020, as COVID-19 increased in the United States, several risk factors for severe COVID-19 emerged, including age, hypertension, diabetes, and immunocompromised state. Neurologic disorders were not among these risk factors, and no information existed on the course and outcomes of COVID-19 in patients with various neurologic disorders.

Design/Methods

After receiving IRB approval, a structured questionnaire was distributed via various media platforms between April-October 2020 to the US neurologists and neurology trainees with questions pertaining to their patients with pre-existing neurologic disorders who had COVID-19 infection confirmed either by SARS-Co-V2 PCR or IgG test.

Results Over a 6-month period, 66 patients, (age range 1-94, mean 49.2 years, 39 females, 27 males) were submitted, with most frequent neurologic disorders being chronic migraine (23%), epilepsy (12%) and multiple sclerosis (MS) (11%). Of these, 58% had a mild-to-moderate course of COVID-19 requiring no hospitalization, 41% required hospitalization or intensive care unit admission, and 5 patients died (2 were in their 90s with a history of stroke, 2 in their 60s with malignancy, and one 31-year-old male with MS.) COVID-19 resulted in exacerbation of the underlying neurologic disorder during or after COVID-19 in 57% of patients. Common persistent symptoms after COVID-19 included fatigue, exercise intolerance and headache.

Conclusions

In this cohort, majority of patients with pre-existing neurologic disorders had a mild-to-moderate course of COVID-19 requiring no hospitalization, but many experienced exacerbation of their pre-existing neurologic disorder during or after COVID-19 and had persistent symptoms of fatigue, exercise intolerance and headache. Large prospective studies are needed to determine which neurologic disorders present a significant risk in order to protect the most vulnerable patient population.

Authors/Disclosures
Svetlana Blitshteyn, MD, FAAN (Dysautonomia Clinic) PRESENTER	Dr. Blitshteyn has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSL Behring. Dr. Blitshteyn has received publishing royalties from a publication relating to health care. Dr. Blitshteyn has received personal compensation in the range of $500-$4,999 for serving as a Healthcare Expert with Agency for Healthcare Quality and Research, US Health and Human Services.
	No disclosure on file
Mia T. Minen, MD, FAAN (NYULMC Neurology)	The institution of Dr. Minen has received research support from NIH. Dr. Minen has received intellectual property interests from a discovery or technology relating to health care. Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a First Contact-Primary Care Advisory Board Member with American Headache Society . Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PCORI grant on migraine evidence based map for stakeholders with ECRI .
Akanksha Sharma, MD	Dr. Sharma has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Generation Care Hospice. Dr. Sharma has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Servier . Dr. Sharma has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Curio Science. Dr. Sharma has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Sharma has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MDPI. Dr. Sharma has or had stock in Roon. The institution of Dr. Sharma has received research support from Chimerix. The institution of Dr. Sharma has received research support from Novocure. Dr. Sharma has a non-compensated relationship as a Advisory Board with Elevate Med that is relevant to AAN interests or activities.
Maria Diaz Ordonez, MD (Memorial Sloan Kettering Cancer Center)	The institution of Dr. Diaz Ordonez has received research support from Pfizer.
Samantha K. Holden, MD, MS, FAAN (University of Colorado School of Medicine)	The institution of Dr. Holden has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cognition Therapeutics.
Katherine A. Zarroli, MD (University of Florida - Jacksonville)	Dr. Zarroli has nothing to disclose.
Deepti Chrusciel, MD (Department of Neurology OUHSC)	Dr. Chrusciel has nothing to disclose.
Tania Reyna, MD, FAAN (University of Texas at San Antonio)	Dr. Reyna has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astrazeneca. Dr. Reyna has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics .
Carrie Landess, MD (Carrie Landess MD PA)	Dr. Landess has received personal compensation for serving as an employee of Carrie Landess MD PA.
Megan T. Donnelly, DO (Novant Health)	Dr. Donnelly has received personal compensation for serving as an employee of Novant Health. Dr. Donnelly has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for AndHealth. Dr. Donnelly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Donnelly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Donnelly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Donnelly has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Impel. Dr. Donnelly has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Donnelly has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Pfizer. Dr. Donnelly has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Donnelly has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Axsome. Dr. Donnelly has a non-compensated relationship as a Communications Director with Southern Headache Society that is relevant to AAN interests or activities.
Karima Benameur, MD (Emory University)	Dr. Benameur has nothing to disclose.

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