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Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Hospitalized Patients During the First Year of the COVID-19 Pandemic
Authors :
Anna M. Cervantes-Arslanian, MD Chakradhar Venkata, MD Pria Anand, MD Joseph D. Burns, MD Charlene J. Ong, MD Allison M. LeMahieu, MS Phillip J. Schulte, PhD Tarun D. Singh, MD Alejandro A. Rabinstein, MD Neha Deo, BS Vikas Bansal, MBBS, MPH Karen Boman, BS Juan Pablo Domecq Garces, MD Donna Lee Armaignac, PhD, APRN Amy B. Christie, MD Roman R. Melamed, MD Yasir Tarabichi, MD, MSCR Sreekanth R. Cheruku, MD, MPH Ashish K. Khanna, MD, FCCP, FCCM, FASA Joshua L. Denson, MD, MS Valerie M. Banner-Goodspeed, MPH Harry L. Anderson, III, MD, FACS, FICS, FCCM, FCCP, FAIM Ognjen Gajic, MD, MS Vishakha K. Kumar, MD, MBA Allan Walkey, MD Rahul Kashyap, MD, MBA on behalf of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group Jean-Baptiste Mesland Pierre Henin Hélène Petre Isabelle Buelens Anne-Catherine Gerard Philippe Clevenbergh Rolando Claure-Del Granado Jose A. Mercado Esdenka Vega-Terrazas Maria F. Iturricha-Caceres Ruben Garza Eric Chu Victoria Chan Oscar Y Gavidia Felipe Pachon Yeimy A Sanchez Danijel knežević Mohamed El Kassas Mohamed Badr Ahmed Tawheed Hend Yahia Dimitrios Kantas Vasileios Koulouras Estela Pineda Gabina María Reyes Guillen Helin Archaga Soto Ana Karen Vallecillo Lizardo Csaba Kopitkó Ágnes Bencze István Méhész Zsófia Gerendai, Girish Vadgaonkar Rekha Ediga Shilpa Basety Shwetha Dammareddy Phani Sreeharsha Kasumalla Smitha S. Segu Tuhin Chakraborty Epcebha Joyce Sridhar Papani Mahesh Kamuram Mradul Kumar Daga Munisha Agarwal Ishan Rohtagi Anusha Cherian Sreejith Parameswaran Magesh Parthiban Phaneendra Doddaga Neethi Chandra Puneet Rijhwani Ashish Jain Aviral Gupta Ram Mohan Jaiswal Ambika Tyagi Nimish Mathur Madhav Prabhu Vishal Jakati Mukur Petrolwala Bharat Ladva Surapaneni Krishna Mohan Ekambaram Jyothisree Umamaheswara Raju Janaki Manduva Naresh Kolakani Shreeja Sripathi Sheetal Chaitanya Kamlesh Kumar Agrawal Vijendra Baghel Kirti Kumar Patel Nooshin Dalili Mohsen Nafa Wataru Matsuda Reina Suzuki Michihito Kyo Shu Tahara Mineji Hayakawa Kunihiko Maekawa Masamitsu Sanui Sho Horikita Yuki Itagaki Akira Kodate Yuki Takahashi Koyo Moriki Takuya Shiga Yudai Iwasaki Hidenobu Shigemitsu Yuka Mishima Nobuyuki Nosaka Michio Nagashima Abdulrahman Al-Fares Rene Rodriguez-Gutierrez Jose Gerardo Gonzalez-Gonzalez Alejandro Salcido-Montenegro Adrian Camacho-Ortiz Mariana Janeth Hermosillo Ulloa Fatimah Hassan-Hanga Hadiza Galadanci Abubakar Shehu Gezawa Halima M. S. Kabara Taiwo Gboluwaga Amole Halima Kabir Dalha Gwarzo Haliru Abdullahi S Ibrahim Muhammad Sohaib Asghar Mashaal Syed Syed Anosh Ali Naqvi Igor Borisovich Zabolotskikh, Konstantin Dmitrievich Zybin Sergey Vasilevich Sinkov Tatiana Sergeevna Musaeva Razan K Alamoudi Hassan M. AlSharif Sarah A. Almazwaghi Mohammed S Elsakran Mohamed A Aid Mouaz A Darwich Omnia M Hagag Salah A Ali Alona rocacorba Kathrine Supeña Efren Ray Juane Jenalyn Medina Jowany Baduria Marwa Ridha Amer Mohammed Abdullah Bawazeer, Talal I. Dahhan Eiad Kseibi Abid Shahzad Butt Syed Moazzum Khurshid Muath Rabee Mohammed Abujazar Razan Alghunaim Maal Abualkhair Abeer Turki AlFirm Yaseen M Arabi Sheryl Ann Abdukahil Mohammed A Almazyad Mohammed I Alarifi Jara M Macarambon Ahmad Abdullah Bukhari Hussain A. Albahrani Kazi N Asfina Kaltham M Aldossary Marija Zdravkovic Zoran Todorovic Viseslav Popadic Slobodan Klasnja Ana Andrijevic Srdjan Gavrilovic Vladimir Carapic Bojan Kovacevic Jovana Bojicic Stevanovic Predrag Dejan S Stojakov Duska K Ignjatovic Suzana C Bojic Marina M Bobos Irina B Nenadic Milica S Zaric Marko D Djuric Vladimir R Djukic Santiago Y. Teruel Belen C. Martin Uluhan Sili Huseyin Bilgin Pinar Ay Varsha P Gharpure Usman Raheemi Kenneth W. Dodd Nicholas Goodmanson Kathleen Hesse Paige Bird Chauncey Weinert Nathan Schoenrade Abdulrahman Altaher Esmael Mayar Matthew Aronson Tyler Cooper Monica Logan Brianna Miner Gisele Papo Eric M. Siegal Phyllis Runningen Suzanne Barry Christopher Woll Gregory Wu Erin Carrole Kathryn Burke Mustafa Mohammed Roman R. Melamed David M. Tierney Love A. Patel Vino S. Raj Barite U. Dawud Narayana Mazumder Abbey Sidebottom Alena M. Guenther Benjamin D. Krehbiel Nova J. Schmitz Stacy L. Jepsen Lynn Sipsey Anna Schulte Whitney Wunderlich Cecely Hoyt Abhijit A Raval Andrea Franks Katherine Irby Ronald C. Sanders, Jr. Glenda Hefley Jennifer M. Jarvis Anmol Kharbanda Sunil Jhajhria Zachary Fyffe Stephen Capizzi Bethany Alicie Martha Green Lori Crockarell Amelia Drennan Kathleen Dubuque Tonya Fambrough Nikole Gasaway Briana Krantz Peiman Nebi Jan Orga Margaret Serfass Alina Simion Kimberly Warren Cassie Wheeler CJ Woolman Amy B. Christie Dennis W. Ashley Rajani Adiga Andrew S. Moyer George M. Verghese Andrea Sikora Newsome Christy C. Forehand Rebecca Bruning Timothy W. Jones Moldovan Sabov Fatema Zaidi Fiona Tissavirasingham Dhatri Malipeddi Jarrod M Mosier Karen Lutrick Beth Salvagio Campbell Cathleen Wilson Patrick Rivers Jonathan Brinks Mokenge Ndiva Mongoh Boris Gilson Donna Lee Armaignac Don Parris Maria Pilar Zuniga Ilea Vargas Viviana Boronat Anneka Hutton Navneet Kaur Prashank Neupane Nohemi Sadule-Rios Lourdes M. Rojas Aashish Neupane Priscilla Rivera Carlos Valle Carlos Gregory Vincent Mahesh Amin Mary E Schelle Amanda Steadham Christopher M Howard Cameron McBride Jocelyn Abraham Orlando Garner Katherine Richards Keegan Collins Preethi Antony Sindhu Mathew Valerie C. Danesh Gueorgui Dubrocq Amber L. Davis Marissa J Hammers ill M. McGahey Amanda C. Farris Elisa Priest Robyn Korsmo Lorie Fares Kathy Skiles Susan M. Shor Kenya Burns Corrie A Dowell Gabriela “Hope” Gonzales Melody Flores Lindsay Newman Debora A Wilk Jason Ettlinger Jaccallene Bomar Himani Darji Alejandro Arroliga Alejandro C Arroliga Corrie A. Dowell Gabriela Hope Conzales Debora A. Wilk Paras B. Khandhar Elizabeth Kring Valerie M. Banner-Goodspeed Somnath Bose Lauren E. Kelly Melisa Joseph Marie McGourty Krystal Capers Benjamin Hoenig Maria C. Karamourtopoulos Anica C. Law Elias N. Baedorf Kassis Allan J. Walkey Sushrut S. Waikar Michael A. Garcia Mia Colona Zoe Kibbelaar Michael Leong Daniel Wallman Kanupriya Soni Jennifer Maccarone Joshua Gilman Ycar Devis Joseph Chung Munizay Paracha David N. Lumelsky Madeline DiLorenzo Najla Abdurrahman Shelsey Johnson Maj Andrew M. Hersh CPT Stephanie L Wachs Brittany S. Swigger Stephanie L Wachs Capt Lauren A. Sattler Capt Michael N. Moulton Kimberly Zammit Patrick, J McGrath William Loeffler Maya, R. Chilbert Aaron S. Miller Edwin L. Anderson Rosemary Nagy Ravali R. Inja Pooja A. Nawathe Isabel Pedraza Jennifer Tsing Karen Carr Anila Chaudhary Kathleen Guglielmino Raghavendra Tirupathi Alymer Tang Arshad Safi Cindy Green Jackie Newell Rayan E. Ihle Shelda A. Martin Elaine A. Davis Katja M. Gist Imran A Sayed John Brinton Larisa Strom Kathleen Chiotos Allison M. Blatz Giyoung Lee Ryan H. Burnett Guy I. Sydney Danielle M. Traynor Karissa Nauert Annika Gonzalez Mariel Bagley Anita Santpurkar Salim Surani Joshua White Aftab Khan Rahul Dhahwal Sreekanth Cheruku Farzin Ahmed Christopher Deonarine Ashley Jones Mohammad-Ali Shaikh David Preston Jeanette Chin Vidula Vachharajani Abhijit Duggal Prabalini Rajendram Omar Mehkri Siddharth Dugar Michelle Biehl Gretchen Sacha Stuart Houltham Alexander King Kiran Ashok Bryan Poynter Mary Beukemann Richard Rice Susan Gole Valerie Shaner Adarsh Conjeevaram Michelle Ferrari Narendrakumar Alappan Steven Minear Jaime Hernandez-Montfort Syed Sohaib Nasim Ravi Sunderkrishnan Debasis Sahoo Patrick S. Milligan Sandeep K. Gupta Joy M. Koglin Regina Gibson Lana Johnson Felicia Preston Crimson Scott Bethany Nungester Dana D Byrne Christa A Schorr Katie Grant Katherine L Doktor Maura C Porto Olga Kaplan James E. Siegler, III Brian Schonewald Ashley Woodford Alan Tsai Savina Reid Kuntal Bhowmick Saba Daneshpooy Cyrus Mowdawalla Trishna Akshay Dave Wilhemina Kennedy Connor Crudeli Christopher Ferry Long Nguyen Sneha Modi Niharika Padala Pavan Jitendra Patel Belle Lin Lena Chatterjee Jamie Qiuyun Fan Mandi Liu Rasagna Kota Annesha Banerjee Steven K. Daugherty Sam Atkinson Kelly Shrimpton Sidney Ontai Brian Contreras Uzoma Obinwanko Nneka Amamasi Amir Sharafi Sarah Lee Zahia Esber Chetna Jinjvadia Raquel R Bartz Vijay Krishnamoorthy Bryan Kraft Aaron Pulsipher Eugene Friedman Sachin Mehta Margit Kaufman Gregg Lobel Nisha Gandhi Amr Abdelaty Elizabeth Shaji Kiana Lim Juan Marte Dani Ashley Sosa David P. Yamane Ivy Benjenk Nivedita Prasanna Nicholas Perkins Prera J. Roth Banu Sivaraj Haley Fulton Madison G Herin Marissa Crum Morgan E. Fretwell Emily-Rose Zhou Christine Waller Kara Kallies Jonean Thorsen Alec Fitzsimmons Haley Olsen Heda R. Dapul Sourabh Verma Alan Salas Ariel Daube Michelle Korn Michelle Ramirez Logi Rajagopalan Laura Santos Héctor Collazo Santiago Ricardo Alan Hernandez Norma Smalls Asher G Bercow Mark Shlomovich Christine Crandall Sasko Stojanovski Kristin Johnson Kelly Michienzi Steven Q. Davis Valentina Jovic Max Masuda Amanda Hayes Katharine Nault Michael Smith William Snow Riley Liptak Hannah Durant Valerie Pendleton Alay Nanavati Risa Mrozowsk Namrata Nag Jeff Brauer Ashwin Dharmadhikari Sahib Singh Franco Laghi Ghania Naeem Andrew Wang Kevin Bliden Amit Rout Jaime Barnes Martin Gesheff Asha Thomas Melbin Thomas Alicia R. Liendo Jovan Milosavljevic Kenan Abbasi Nicholas B. Burley Nicole Rapista Samuel Amankwah Sanjay K Poude Saroj Timilsina Sauradeep Sarkar Oluwasayo Akinyosoye Shashi K. Yalamanchili Sheena Moorthy Sonia Sugumar Jonathan Ford Martin C. Taylor Charlotte Dunderdale Alyssa Henshaw Mary K. Brunk Jessica Hagy Shehryar Masood Sushrutha Sridhar Yuk Ming Liu Sarah Zavala Esther Shim Ronald A. Reilkoff Julia A. Heneghan Sarah Eichen Lexie Goertzen Scott Rajala Ghislaine Feussom Ben Tang Christine C. Junia Robert Lichtenberg Hasrat Sidhu Diana Espinoza Shelden Rodrigues Maria Jose Zabala Daniela Goyes Ammu Susheela Buddhi Hatharaliyadda Naveen Rameshkumar Amulya Kasireddy Genessis Maldonado Lisseth Beltran Akshata Chaugule Hassan Khan Namrata Patil Ruhi Patil Rodrigo Cartin-Ceba Ayan Sen Fahimeh Talaei Rahul Kashyap Juan Pablo Domecq Ognjen Gajic Vikas Bansal Aysun Tekin Amos Lal John C. O’Horo Neha N. Deo Mayank Sharma Shahraz Qamar Romil Singh Diana J. Valencia Morales Abigail T. La Nou Marija Bogojevic Simon Zec Devang Sanghavi Pramod Guru Pablo Moreno Franco Karthik Gnanapandithan Hollie Saunders Zachary Fleissner Juan Garcia Alejandra Yu Lee Mateus Siva Naga Yarrarapu Nirmaljot Kaur Abhisekh Giri Mohammed Mustafa Hasan Ashrita Donepudi Syed Anjum Khan Nitesh Kumar Jain Thoyaja Koritala Alexander Bastidas Gabriela Orellana Adriana Briceno Bierwirth Eliana Milazzo Juan Guillermo Sierra Thao Dang Rahul S Nanchal Paul A Bergl Jennifer L Peterson Jessica Timmer Kimberly Welker Travis Yamanaka Nicholas A. Barreras Michael Markos Anita Fareeduddin Rohan Mehta Chakradhar Venkata Miriam Engemann Annamarie Mantese Yasir Tarabichi Adam Perzynski Christine Wang Dhatri Kotekal Adriana C Briceno Bierwirth Gabriela M Orellana Gerardo Catalasan Shohana Ahmed Carlos F Matute Ahmad Hamdan Ivania Salinas Genesis Del Nogal Angel Tejada Anna Eschler Mary Hejna Emily Lewandowski Kristen Kusmierski Clare Martin Jen-Ting Chen Aluko Hope Zoe Tsagaris Elise Ruen Aram Hambardzumyan Nasar A Siddiqi Lesly Jurado Lindsey Tincher Carolyn Brown Prithvi Sendi Meghana Nadiger Balagangadhar Totapally Bhagat S. Aulakh Sandeep Tripathi Jennifer A. Bandy Lisa M. Kreps Dawn R. Bollinger Neha Gupta Brent R Brown Tracy L Jones Kassidy Malone Lauren A Sinko Amy B Harrell Shonda C Ayers Lisa M Settle Taylor J Sears Roger Scott Stienecker Andre G. Melendez Tressa A. Brunner Sue M Budzon Jessica L. Heffernan Janelle M. Souder Tracy L. Miller Andrea G. Maisonneuve Roberta E. Redfern Jessica Shoemaker Jennifer Micham Lynn Kenney Gabriel Naimy Victoria Schauf Sara Utley Holly Balcer Kerry P. J. Pulver Jennifer Yehle Alicia Weeks Terra Inman Majdi Hamarshi Jeannette Ploetz Nick Bennett Kyle Klindworth Moustafa Younis Adham Mohamed Brian L. Delmonaco Anthony Franklin Mitchell Heath Diane Barkas Antonia L. Vilella Sara B. Kutner Kacie Clark Danielle Moore Shina Menon John K McGuire Deana Rich Harry L. Anderson, III Dixy Rajkumar Ali Abunayla Jerrilyn Heiter Howard A. Zaren Stephanie J. Smith Grant C. Lewis Lauren Seames Cheryl Farlow Judy Miller Gloria Broadstreet John Lin Cindy Terrill Brock Montgomery Sydney Reyes Summer Reyes Alex Plattner Anthony Martinez Micheal Allison Aniket Mittal Rafael Ruiz Aleta Skaanland Robert Ross Umang Patel Jordesha Hodge Krunal Kumar Patel Shivani Dalal Himanshu Kavani Sam Joseph Michael A. Bernstein Ian K. Goff Matthew Naftilan Amal Mathew Deborah Williams Sue Murdock Maryanne Ducey Kerianne Nelson Jason Block James Mitchel Connor G O’Brien Sylvan Cox William Marx Ioana Amzuta Asad J. Choudhry Mohammad T. Azam Kristina L Carter Michael A Olmos Brittany M Parker Julio Quintanilla Tara A Craig Brendon J Clough Jeffrey T Jameson Utpal S. Bhalala Joshua Kuehne Melinda Garcia Morgan Beebe Heather Herrera Chris Fiack Stephanie Guo May Vawer Beth Blackburn Caleb Darby Kristy Page Amanda Brown Jessie McAbee Katherine A. Belden Michael Baram Devin M. Weber Rosalie DePaola Yuwei Xia Hudson Carter Aaron Tolley Mary Barletta Mark Steele Laurie Kemble Joshua L. Denson A. Scott Gillet Margo Brown Rachael Stevens Andrew Wetherbie Kevin Tea Mathew Moore Abdurrahman Husain Atul Malhotra Qais Zawaydeh Benjamin J Sines Thomas J Bice Emily A. Vail Susannah Nicholson Rachelle B. Jonas AnnaRose E. Dement William Tang Mark DeRosa Robert E. Villarreal Rajany V. Dy Alfredo Iardino Jill Sharma Richard Czieki Julia Christopher Ryan Lacey Marwan Mashina Kushal Patel Erica C. Bjornstad Nancy M. Tofil Scott House Isabella Aldana Nikhil K. Meena Jose D. Caceres Nikhil K Meena Sarenthia M. Epps Harmeen Goraya Kelsey R. Besett Ryan James Lana Y. Abusalem Akash K. Patel Lana S Hasan Dina Gomaa Michael Goodman Devin Wakefield Anthony Spuzzillo John O. Shinn II Robert MacLaren Azra Bihorac Tezcan Ozrazgat Baslanti George Omalay Haleh Hashemighouchani Julie S. Cupka Matthew M Ruppert Patrick W. McGonagill Colette Galet Janice Hubbard David Wang Lauren Allan Aditya Badheka Madhuradhar Chegondi Usman Nazir Garrett Rampon Jake Riggle Nathan Dismang Vicki Montgomery Janice Sullivan Sarah Morris Jennifer Nason Ozan Akca Rainer Lenhardt Rodrigo S. Cavallazzi Ann Jerde Alexa Black Allison Polidori Haily Griffey Justin Winkler Thomas Brenzel Roger A. Alvarez Amarilys Alarcon-Calderon Marie Anne Sosa Sunita K. Mahabir Mausam J. Patel Pauline Park Andrew Admon Sinan Hanna Rishi Chanderraj Maria Pliakas Ann Wolski Jennifer Cirino Dima Dandachi Hariharan Regunath Maraya N. Camazine Grant. E. Geiger Abdoulie O. Njai Baraa M. Saad Faraaz Ali Shah Byron Chuan Sagar L. Rawal Manal Piracha Joseph E. Tonna Nicholas M. Levin Kayte Suslavich Rachel Tsolinas Zachary T. Fica Chloe R. Skidmore Renee D. Stapleton Anne E. Dixon Olivia Johnson Sara S. Ardren Stephanie Burns Anna Raymond Erika Gonyaw Kevin Hodgdon Chloe Housenger Benjamin Lin Karen McQuesten Heidi Pecott-Grimm Julie Sweet Sebastian Ventrone Nita Khandelwal T. Eoin West Ellen S. Caldwell Lara Lovelace-Macon Navya Garimella Denisse B. Dow Sreekanth R. Cheruku Catherine Chen Murtaza Akhter Rania Abdul Rahman Mary Mulrow Erin M. Wilfong Kelsi Vela Ashish K. Khanna Lynne Harris Bruce Cusson Jacob Fowler David Vaneenenaam Glen McKinney Imoh Udoh Kathleen Johnson Patrick G. Lyons Andrew P Michelson Sara S. Haluf Lauren M. Lynch Nguyet M. Nguyen Aaron Steinberg Nicholas Braus Vishwanath Pattan Jessica Papke Ismail Jimada Nida Mhid Samuel Chakola Kevin Sheth Abdalla Ammar Mahmoud Ammar Victor Torres Lopez Charles Dela Cruz, Akhil Khosla Samir Gautam
Source :
Critical Care Explorations, Vol 4, Iss 4, p e0686 (2022)
Publication Year :
2022
Publisher :
Wolters Kluwer, 2022.
Abstract
OBJECTIVES:. To describe the prevalence, associated risk factors, and outcomes of serious neurologic manifestations (encephalopathy, stroke, seizure, and meningitis/encephalitis) among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:. Prospective observational study. SETTING:. One hundred seventy-nine hospitals in 24 countries within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. PATIENTS:. Hospitalized adults with laboratory-confirmed SARS-CoV-2 infection. INTERVENTIONS:. None. RESULTS:. Of 16,225 patients enrolled in the registry with hospital discharge status available, 2,092 (12.9%) developed serious neurologic manifestations including 1,656 (10.2%) with encephalopathy at admission, 331 (2.0%) with stroke, 243 (1.5%) with seizure, and 73 (0.5%) with meningitis/encephalitis at admission or during hospitalization. Patients with serious neurologic manifestations of COVID-19 were older with median (interquartile range) age 72 years (61.0–81.0 yr) versus 61 years (48.0–72.0 yr) and had higher prevalence of chronic medical conditions, including vascular risk factors. Adjusting for age, sex, and time since the onset of the pandemic, serious neurologic manifestations were associated with more severe disease (odds ratio [OR], 1.49; p < 0.001) as defined by the World Health Organization ordinal disease severity scale for COVID-19 infection. Patients with neurologic manifestations were more likely to be admitted to the ICU (OR, 1.45; p < 0.001) and require critical care interventions (extracorporeal membrane oxygenation: OR, 1.78; p = 0.009 and renal replacement therapy: OR, 1.99; p < 0.001). Hospital, ICU, and 28-day mortality for patients with neurologic manifestations was higher (OR, 1.51, 1.37, and 1.58; p < 0.001), and patients had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, –0.84, –1.34, and –0.84; p < 0.001). CONCLUSIONS:. Encephalopathy at admission is common in hospitalized patients with SARS-CoV-2 infection and is associated with worse outcomes. While serious neurologic manifestations including stroke, seizure, and meningitis/encephalitis were less common, all were associated with increased ICU support utilization, more severe disease, and worse outcomes.
Details
Language :
English
ISSN :
26398028 and 00000000
Volume :
4
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Critical Care Explorations
Publication Type :
Academic Journal
Accession number :
edsdoj.04abe44e191c41fda7414b273b6ea94d
Document Type :
article
Full Text :
https://doi.org/10.1097/CCE.0000000000000686