ABSTRACT
Objective: To determine if inpatient neurological consultations differ between COVID-19 and non-COVID-19 respiratory infections. Background: The COVID-19 pandemic has posed challenges to healthcare systems across the world, and neurological complications of COVID-19 have garnered increased concern in medicine and the public. Neurological consultation for patients with viral-mediated disease is common;it is unknown whether the neurologist's approach to inpatient consultation of patients with COVID-19 should be altered. Design/Methods: We performed a retrospective chart analysis of inpatient neurologic consultations at three major hospitals comprising the University of Pennsylvania Health System. We compared the reason for neurologic consultation and final diagnosis of 62 patients with COVID-19 between March 2020 and April 2021 to 56 patients with non-COVID-19 respiratory virus (defined as Influenza A, Influenza B, Respiratory Syncytial Virus, Rhinovirus, or Adenovirus) between January 2019 and January 2020. Secondary metrics included mortality and level of care. A frequency and means analysis were completed to evaluate the relative difference between groups on all primary and secondary metrics. Results: Stroke was the only diagnosis more common in the COVID population as compared to the non-COVID virus population (14% vs. 9%). Neurology was consulted more frequently for altered mental status in the COVID-19 population (27% vs. 18%);however, the ultimate diagnosis was toxic-metabolic encephalopathy due to infection, not a consequence of COVID-19 itself. Neurology was consulted significantly later in the hospital course of COVID-19 (3.1 vs. 0.96 days), despite a higher mortality in the other population (30% vs. 19%). Conclusions: Patients requiring inpatient neurologic consultation with a diagnosis of COVID-19 or another respiratory virus were found to be remarkably similar in terms of their ultimate neurologic diagnosis, with the exception of stroke, which was more common in the COVID-19 population. These results suggest the neurological approach to patients with COVID-19 should be similar to that in patients with other respiratory infections.