Dimitriadis, Konstantinos and Meis, Jan and Neugebauer, Hermann and Barlinn, Kristian and Neumann, Bernhard and Gahn, Georg and Lochner, Piergiorgio and Knier, Benjamin and Lindemann, Sarah and Suehs, Kurt Wolfram and Szabo, Kristina and Pfefferkorn, Thomas and Schirotzek, Ingo and Freilinger, Tobias and Burc, Bassa and Guenther, Albrecht and Wittstock, Matthias and Schramm, Patrick and Reimann, Gernot and Godau, Jana and Nagy, Gabor and Koenig, Fatima B. and Essig, Fabian and Klinker, Hartwig and Hartmann, Christian and Schmidbauer, Moritz L. and Steinberg, Tim and Lefterova, Lora and Klose, Christina and Boesel, Julian (2022) Neurologic manifestations of COVID-19 in critically ill patients: results of the prospective multicenter registry PANDEMIC. CRITICAL CARE, 26 (1): 217. ISSN 1364-8535, 1466-609X
Full text not available from this repository. (Request a copy)Abstract
Background Neurologic manifestations are increasingly reported in patients with coronavirus disease 2019 (COVID-19). Yet, data on prevalence, predictors and relevance for outcome of neurological manifestations in patients requiring intensive care are scarce. We aimed to characterize prevalence, risk factors and impact on outcome of neurologic manifestations in critically ill COVID-19 patients. Methods In the prospective, multicenter, observational registry study PANDEMIC (Pooled Analysis of Neurologic DisordErs Manifesting in Intensive care of COVID-19), we enrolled COVID-19 patients with neurologic manifestations admitted to 19 German intensive care units (ICU) between April 2020 and September 2021. We performed descriptive and explorative statistical analyses. Multivariable models were used to investigate factors associated with disorder categories and their underlying diagnoses as well as to identify predictors of outcome. Results Of the 392 patients included in the analysis, 70.7% (277/392) were male and the mean age was 65.3 (SD +/- 3.1) years. During the study period, a total of 2681 patients with COVID-19 were treated at the ICUs of 15 participating centers. New neurologic disorders were identified in 350 patients, reported by these centers, suggesting a prevalence of COVID-19-associated neurologic disorders of 12.7% among COVID-19 ICU patients. Encephalopathy (46.2%; 181/392), cerebrovascular (41.0%; 161/392) and neuromuscular disorders (20.4%; 80/392) were the most frequent categories identified. Out of 35 cerebrospinal fluid analyses with reverse transcriptase PCR for SARS-COV-2, only 3 were positive. In-hospital mortality was 36.0% (140/389), and functional outcome (mRS 3 to 5) of surviving patients was poor at hospital discharge in 70.9% (161/227). Intracerebral hemorrhage (OR 6.2, 95% CI 2.5-14.9, p < 0.001) and acute ischemic stroke (OR 3.9, 95% CI 1.9-8.2, p < 0.001) were the strongest predictors of poor outcome among the included patients. Conclusions Based on this well-characterized COVID-19 ICU cohort, that comprised 12.7% of all severe ill COVID-19 patients, neurologic manifestations increase mortality and morbidity. Since no reliable evidence of direct viral affection of the nervous system by COVID-19 could be found, these neurologic manifestations may for a great part be indirect para- or postinfectious sequelae of the infection or severe critical illness. Neurologic ICU complications should be actively searched for and treated.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COMPLICATIONS; ADULTS; STROKE; INJURY; COVID-19; Neurologic manifestations; Intensive care; Critically ill |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 01 Feb 2024 07:49 |
| Last Modified: | 01 Feb 2024 07:49 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58485 |
Actions (login required)
 |
View Item |
