tetano
Editor, Senior Moderator
J Neurol
. 2024 Apr 24.
doi: 10.1007/s00415-024-12370-9. Online ahead of print. Neuropsychiatric complications of coronavirus disease 2019: Mount Sinai Health System cohort study
Kapil Gururangan[SUP] #[/SUP][SUP] 1 2 [/SUP], Veronica J Peschansky[SUP] #[/SUP][SUP] 1 3 [/SUP], Grace Van Hyfte[SUP] 4 [/SUP], Parul Agarwal[SUP] 1 4 [/SUP], Leah J Blank[SUP] 1 4 [/SUP], Brian Mathew[SUP] 1 [/SUP], Jonathan Goldstein[SUP] 1 [/SUP], Churl-Su Kwon[SUP] 5 [/SUP], Louise McCarthy[SUP] 1 [/SUP], Ariella Cohen[SUP] 1 [/SUP], Andy Ho Wing Chan[SUP] 1 [/SUP], Pojen Deng[SUP] 1 [/SUP], Mandip Dhamoon[SUP] 1 [/SUP], Eveline Gutzwiller[SUP] 1 [/SUP], Qing Hao[SUP] 1 [/SUP], Celestine He[SUP] 1 [/SUP], Britany Klenofsky[SUP] 1 [/SUP], Hernan Nicolas Lemus[SUP] 1 6 [/SUP], Lara Marcuse[SUP] 1 [/SUP], Allison Navis[SUP] 1 [/SUP], Wilson D Heredia Nunez[SUP] 1 [/SUP], Mallory N Luckey[SUP] 1 [/SUP], Emily M Schorr[SUP] 1 7 [/SUP], Anuradha Singh[SUP] 1 [/SUP], Gabriela B Tantillo[SUP] 1 8 [/SUP], Claire Ufongene[SUP] 1 [/SUP], James J Young[SUP] 1 [/SUP], Priti Balchandani[SUP] 9 [/SUP], Joanne R Festa[SUP] 1 10 [/SUP], Georges Naasan[SUP] 1 10 [/SUP], Alexander W Charney[SUP] 11 12 [/SUP], Girish N Nadkarni[SUP] 13 [/SUP], Nathalie Jetté[SUP] 14 15 16 [/SUP]; Sinai NeuroCOVID-19 Study Group
Affiliations
Objective: To describe the frequency of neuropsychiatric complications among hospitalized patients with coronavirus disease 2019 (COVID-19) and their association with pre-existing comorbidities and clinical outcomes.
Methods: We retrospectively identified all patients hospitalized with COVID-19 within a large multicenter New York City health system between March 15, 2020 and May 17, 2021 and randomly selected a representative cohort for detailed chart review. Clinical data, including the occurrence of neuropsychiatric complications (categorized as either altered mental status [AMS] or other neuropsychiatric complications) and in-hospital mortality, were extracted using an electronic medical record database and individual chart review. Associations between neuropsychiatric complications, comorbidities, laboratory findings, and in-hospital mortality were assessed using multivariate logistic regression.
Results: Our study cohort consisted of 974 patients, the majority were admitted during the first wave of the pandemic. Patients were treated with anticoagulation (88.4%), glucocorticoids (24.8%), and remdesivir (10.5%); 18.6% experienced severe COVID-19 pneumonia (evidenced by ventilator requirement). Neuropsychiatric complications occurred in 58.8% of patients; 39.8% experienced AMS; and 19.0% experienced at least one other complication (seizures in 1.4%, ischemic stroke in 1.6%, hemorrhagic stroke in 1.0%) or symptom (headache in 11.4%, anxiety in 6.8%, ataxia in 6.3%). Higher odds of mortality, which occurred in 22.0%, were associated with AMS, ventilator support, increasing age, and higher serum inflammatory marker levels. Anticoagulant therapy was associated with lower odds of mortality and AMS.
Conclusion: Neuropsychiatric complications of COVID-19, especially AMS, were common, varied, and associated with in-hospital mortality in a diverse multicenter cohort at an epicenter of the COVID-19 pandemic.
Keywords: Coronavirus disease 2019; Mount Sinai Health System; NeuroCOVID; Neurological complications; SARS-CoV-2.
. 2024 Apr 24.
doi: 10.1007/s00415-024-12370-9. Online ahead of print. Neuropsychiatric complications of coronavirus disease 2019: Mount Sinai Health System cohort study
Kapil Gururangan[SUP] #[/SUP][SUP] 1 2 [/SUP], Veronica J Peschansky[SUP] #[/SUP][SUP] 1 3 [/SUP], Grace Van Hyfte[SUP] 4 [/SUP], Parul Agarwal[SUP] 1 4 [/SUP], Leah J Blank[SUP] 1 4 [/SUP], Brian Mathew[SUP] 1 [/SUP], Jonathan Goldstein[SUP] 1 [/SUP], Churl-Su Kwon[SUP] 5 [/SUP], Louise McCarthy[SUP] 1 [/SUP], Ariella Cohen[SUP] 1 [/SUP], Andy Ho Wing Chan[SUP] 1 [/SUP], Pojen Deng[SUP] 1 [/SUP], Mandip Dhamoon[SUP] 1 [/SUP], Eveline Gutzwiller[SUP] 1 [/SUP], Qing Hao[SUP] 1 [/SUP], Celestine He[SUP] 1 [/SUP], Britany Klenofsky[SUP] 1 [/SUP], Hernan Nicolas Lemus[SUP] 1 6 [/SUP], Lara Marcuse[SUP] 1 [/SUP], Allison Navis[SUP] 1 [/SUP], Wilson D Heredia Nunez[SUP] 1 [/SUP], Mallory N Luckey[SUP] 1 [/SUP], Emily M Schorr[SUP] 1 7 [/SUP], Anuradha Singh[SUP] 1 [/SUP], Gabriela B Tantillo[SUP] 1 8 [/SUP], Claire Ufongene[SUP] 1 [/SUP], James J Young[SUP] 1 [/SUP], Priti Balchandani[SUP] 9 [/SUP], Joanne R Festa[SUP] 1 10 [/SUP], Georges Naasan[SUP] 1 10 [/SUP], Alexander W Charney[SUP] 11 12 [/SUP], Girish N Nadkarni[SUP] 13 [/SUP], Nathalie Jetté[SUP] 14 15 16 [/SUP]; Sinai NeuroCOVID-19 Study Group
Affiliations
- PMID: 38656620
- DOI: 10.1007/s00415-024-12370-9
Objective: To describe the frequency of neuropsychiatric complications among hospitalized patients with coronavirus disease 2019 (COVID-19) and their association with pre-existing comorbidities and clinical outcomes.
Methods: We retrospectively identified all patients hospitalized with COVID-19 within a large multicenter New York City health system between March 15, 2020 and May 17, 2021 and randomly selected a representative cohort for detailed chart review. Clinical data, including the occurrence of neuropsychiatric complications (categorized as either altered mental status [AMS] or other neuropsychiatric complications) and in-hospital mortality, were extracted using an electronic medical record database and individual chart review. Associations between neuropsychiatric complications, comorbidities, laboratory findings, and in-hospital mortality were assessed using multivariate logistic regression.
Results: Our study cohort consisted of 974 patients, the majority were admitted during the first wave of the pandemic. Patients were treated with anticoagulation (88.4%), glucocorticoids (24.8%), and remdesivir (10.5%); 18.6% experienced severe COVID-19 pneumonia (evidenced by ventilator requirement). Neuropsychiatric complications occurred in 58.8% of patients; 39.8% experienced AMS; and 19.0% experienced at least one other complication (seizures in 1.4%, ischemic stroke in 1.6%, hemorrhagic stroke in 1.0%) or symptom (headache in 11.4%, anxiety in 6.8%, ataxia in 6.3%). Higher odds of mortality, which occurred in 22.0%, were associated with AMS, ventilator support, increasing age, and higher serum inflammatory marker levels. Anticoagulant therapy was associated with lower odds of mortality and AMS.
Conclusion: Neuropsychiatric complications of COVID-19, especially AMS, were common, varied, and associated with in-hospital mortality in a diverse multicenter cohort at an epicenter of the COVID-19 pandemic.
Keywords: Coronavirus disease 2019; Mount Sinai Health System; NeuroCOVID; Neurological complications; SARS-CoV-2.