Short- and long-term outcome and predictors in an international cohort of patients with neuro COVID-19.

Beghi, Ettore; Helbok, Raimund; Oztturk, Serefnur; Karadas, Omer; Lisnic, Vitalie; Grosu, Oxana; Kovács, Tibor; Dobronyi, Levente; Bereczki, Daniel; Cotelli, Maria Sofia; Turla, Marinella; Davidescu, Eugenia Irene; Popescu, Bogdan Ovidiu; Valzania, Franco; Cavallieri, Franceso; Ulmer, Hanno; Maia, Luis F; Amodt, Anne Hege; Armon, Carmel; Brola, Waldemer; ... (2022). Short- and long-term outcome and predictors in an international cohort of patients with neuro COVID-19. European journal of neurology, 29(6), pp. 1663-1684. Wiley 10.1111/ene.15293

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BACKGROUND

Despite the increasing number of reports on the spectrum of neurological manifestations of COVID-19 (neuro-COVID), few studies have assessed short and long-term outcome of the disease.

METHODS

This is a cohort study enrolling adult patients with neuro-COVID seen in neurological consultation. Data were collected prospectively or retrospectively in the EAN NEuro-covid ReGistrY. The outcome at discharge was measured using the modified Rankin Scale (mRS) and defined as: "stable/improved" if mRS score was equal or lower than pre-morbid score; "worse" if the score was higher than pre-morbid score. Status at 6 months was also recorded. Demographic and clinical variables were assessed as predictors of outcome at discharge and 6 months.

RESULTS

From July 2020 to March 2021, 971 patients from 19 countries were included. 810 (83.4%) were hospitalized. 432 (53.3%) were discharged with worse functional status. Older age, stupor/coma, stroke and ICU admission were predictors of worse outcome at discharge. 132 (16.3%) died in hospital. Older age, cancer, cardiovascular complications, refractory shock, stupor/coma and ICU admission were associated with death. 262 were followed for 6 months. Acute stroke or ataxia, ICU admission and degree of functional impairment at discharge were predictors of worse outcome. 65/221 hospitalized patients (29.4%) and 10/32 non-hospitalized patients (24.4%) experienced persisting neurological symptoms/signs. 10/262 patients (3.8%) developed new neurological complaints during the 6 months of follow-up.

CONCLUSIONS

Neuro-COVID is a severe disease associated with worse functional status at discharge, particularly in older subjects and those with comorbidities and acute complications of infection.

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