Abstract Details

Title Neurologic Findings Among Inpatients with COVID-19 at a Safety-Net U.S. Hospital

Topic Infectious Disease

Presentation(s) Infectious Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 004

Objective To characterize the breadth of neurologic findings associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a diverse group of inpatients at an urban, safety-net U.S. medical center.

Background Neurologic manifestations are often seen in patients with coronavirus disease 2019 (COVID-19), and prior studies suggest that infection rates, disease severity, and complications may vary across populations. However, no prior published cohorts describe the breadth of neurologic findings in a racially and socioeconomically diverse inpatient COVID-19 population in the U.S.

Design/Methods Patients were identified through an electronic medical record review from April 15, 2020, until July 1, 2020, at a large safety-net hospital in Boston, Massachusetts, caring primarily for underserved, low-income, and elderly patients. All hospitalized adult patients with positive nasopharyngeal swab or respiratory PCR testing for SARS-CoV-2 during their hospitalization or in the 30 days prior to admission who received an inpatient neurologic or neurocritical care consultation or admission during the study period were enrolled.

Results Seventy-four patients were identified (42/57% male, median age 64 years). The majority of patients self-identified as Black or African-American (38, 51%). The most common neurologic symptoms at presentation to the hospital included altered mental status (39, 53%), fatigue (18, 24%), and headache (18, 18%). Fifteen patients had ischemic strokes (20%). There were 10 in-hospital mortalities, with moderately severe disability among survivors at discharge (14%, median modified Rankin Scale score of 4).

Conclusions Neurologic findings spanned inflammatory, vascular pathologies, sequelae of critical illness and metabolic derangements, possible direct involvement of the nervous system by SARS-CoV-2, and exacerbation of underlying neurologic conditions, highlighting a broad range of possible etiologies of neurologic complications in patients with COVID-19. Further studies are needed to characterize the infectious and post-infectious neurologic complications of COVID-19 in diverse patient populations.

Authors/Disclosures
Pria Anand, MD (Boston University School of Medicine) PRESENTER	Dr. Anand has nothing to disclose.
Lan Zhou, MD, PhD (Hospital for Special Surgery Department of Neurology)	The institution of Dr. Zhou has received research support from NIH.
	No disclosure on file
	No disclosure on file
David M. Greer, MD, FAAN (Boston University School of Medicine)	Dr. Greer has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Thieme, Inc. Dr. Greer has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for multiple. An immediate family member of Dr. Greer has or had stock in Vertex Pharmaceuticals. The institution of Dr. Greer has received research support from NINDS. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has received publishing royalties from a publication relating to health care. Dr. Greer has a non-compensated relationship as a Treasurer-Elect with American Neurological Association that is relevant to AAN interests or activities. Dr. Greer has a non-compensated relationship as a President with Neurocritical Care Society that is relevant to AAN interests or activities.
Anna Marisa Cervantes-Arslanian, MD, FAAN (BU Dept of Neurology)	Dr. Cervantes-Arslanian has nothing to disclose.

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