Patients with clinically diagnosed neurological symptoms associated with COVID-19 are six times more likely to die in hospital than those without neurological complications, according to an interim analysis from the Global Neurological Dysfunction Consortium Study in COVID-19 ( GCS-NeuroCOVID).
An article published in the journal ‘JAMA Network Open’ presents the first results of the worldwide effort to gather information on the incidence, severity and outcomes of the neurological manifestations of COVID-19 disease.
“Very early in the pandemic, it became apparent that quite a number of people who were sick enough to be hospitalized were also developing neurological problems,” recalls lead author Sherry Chou, the consortium’s principal investigator and associate professor of critical care medicine. , neurology and neurosurgery at the University of Pittsburgh School of Medicine, in the United States and the UPMC.
“A year later, we are still fighting an invisible and unknown enemy and, as in any battle, we need information – he explains -: we have to learn all we can about the neurological impacts of COVID-19 in patients who are actively sick and survivors. “
The GCS-NeuroCOVID is the largest cohort study of the neurological manifestations of COVID-19 to date, covering 133 adult patient centers on all continents except Antarctica.
Among a group of 3,744 hospitalized adult patients with COVID-19, 82% had self-reported or clinically captured neurological symptoms. Nearly 4 out of 10 patients reported headaches, and about 3 out of 10 reported having lost their sense of smell or taste. Of the clinically diagnosed syndromes – abnormalities that a GP can observe, regardless of whether the patient is aware of the problem – acute encephalopathy was the most common, affecting nearly half of the patients, followed by coma (17%). ) and cerebrovascular accidents (6%).
Despite initial concerns about the ability of the coronavirus to directly attack the brain and cause brain swelling and inflammation – meningitis and encephalitis – these events were very rare, occurring in less than 1% of patients hospitalized for COVID-19 .
“Acute encephalopathy is by far the most common symptom we see in the clinic,” explains Chou, also associate director of the Pitt Safar Center for Research in Resuscitation. impaired, or they don’t feel like themselves and act confused, delusional, or agitated. “
The researchers analyzed data from three different types of patient cohorts: the “all COVID-19” cohort, which included the 3,055 hospitalized COVID-19 patients, regardless of neurological status; the “neurological” cohort, which included 475 hospitalized COVID-19 patients with clinically confirmed neurological symptoms, compiled by the GCS-NeuroCOVID Consortium; and the “ENERGY” cohort, that is, 214 hospitalized patients with COVID-19 who required the evaluation of a consultative neurologist and gave their consent to participate in the Neuro-COVID Registry of the European Academy of Neurology (ENERGY), a partner formal of the GCS-NeuroCOVID Consortium.
The study found that having a pre-existing neurological condition of any kind, from brain, spinal cord and nerve diseases to chronic migraines, dementia or Alzheimer’s disease, among others, is the strongest predictor of developing neurological complications related to the disease. COVID-19, doubling the risk.
Additionally, having any neurological symptoms related to COVID-19 – from something as seemingly innocuous as loss of smell to major events like strokes – is associated with a six times greater risk of dying.
But even if a patient beats the odds and recovers, their long-term health outlook remains uncertain. “Even if the pandemic is completely eradicated, we are still talking about millions of survivors who need our help,” Chou warns. “It is important to find out what symptoms and health problems these patients have, and there is still a lot of work ahead.”