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Childs Nerv Syst ; 38(9): 1727-1734, 2022 09.
Article in English | MEDLINE | ID: covidwho-1888856


PURPOSE: To evaluate change in the severity of hypoxic-ischemic encephalopathy (HIE) and associated morbidities between pre- and during COVID-19 pandemic periods in Canada. METHODS: We conducted a retrospective cohort study extracting the data from level-3 NICUs participating in Canadian Neonatal Network (CNN). The primary outcome was a composite of death in the first week after birth and/or stage 3 HIE (Sarnat and Sarnat). Secondary outcomes included rate and severity of HIE among admitted neonates, overall mortality, brain injury on magnetic resonance imaging (MRI), neonates requiring resuscitation, organ dysfunction, and therapeutic hypothermia (TH) usage. We included 1591 neonates with gestational age ≥ 36 weeks with HIE during the specified periods: pandemic cohort from April 1st to December 31st of 2020; pre-pandemic cohort between April 1st and December 31st of 2017, 2018, and 2019. We calculated the odds ratio (OR) and confidence intervals (CI). RESULTS: We observed no significant difference in the primary outcome (15% vs. 16%; OR 1.08; 95%CI 0.78-1.48), mortality in the first week after birth (6% vs. 6%; OR 1.10, 95%CI 0.69-1.75), neonates requiring resuscitation, organ dysfunction, TH usage, or rate of brain injury. In the ad hoc analysis, per 1000 live births, there was an increase in the rate of infants with HIE and TH use. CONCLUSIONS: Severity of HIE, associated morbidities, and mortality were not significantly different during the pandemic lockdown compared to a pre-pandemic period in Canada. Anticipated risks and difficulties in accessing healthcare have not increased the mortality and morbidities in neonates with HIE in Canada.

Brain Injuries , COVID-19 , Hypothermia, Induced , Hypoxia-Ischemia, Brain , Brain Injuries/complications , Canada/epidemiology , Cohort Studies , Communicable Disease Control , Humans , Hypoxia-Ischemia, Brain/epidemiology , Hypoxia-Ischemia, Brain/pathology , Hypoxia-Ischemia, Brain/therapy , Infant , Infant, Newborn , Multiple Organ Failure/complications , Multiple Organ Failure/therapy , Pandemics , Retrospective Studies
Neurology ; 95(2): 77-84, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-146855


OBJECTIVE: The emergence of coronavirus disease 2019 (COVID-19) presents a challenge for neurologists caring for patients with preexisting neurologic conditions hospitalized for COVID-19 or for evaluation of patients who have neurologic complications during COVID-19 infection. We conducted a scoping review of the available literature on COVID-19 to assess the potential effect on neurologists in terms of prevalent comorbidities and incidence of new neurologic events in patients hospitalized with COVID-19. METHODS: We searched MEDLINE/PubMed, CINAHL (EBSCO), and Scopus databases for adult patients with preexisting neurologic disease who were diagnosed and hospitalized for COVID-19 or reported incidence of secondary neurologic events following diagnosis of COVID-19. Pooled descriptive statistics of clinical data and comorbidities were examined. RESULTS: Among screened articles, 322 of 4,014 (8.0%) of hospitalized patients diagnosed and treated for COVID-19 had a preexisting neurologic illness. Four retrospective studies demonstrated an increased risk of secondary neurologic complications in hospitalized patients with COVID-19 (incidence of 6%, 20%, and 36.4%, respectively). Inconsistent reporting and limited statistical analysis among these studies did not allow for assessment of comparative outcomes. CONCLUSION: Emerging literature suggests a daunting clinical relationship between COVID-19 and neurologic illness. Neurologists need to be prepared to reorganize their consultative practices to serve the neurologic needs of patients during this pandemic.

Coronavirus Infections/epidemiology , Hospitalization , Nervous System Diseases/epidemiology , Pneumonia, Viral/epidemiology , Respiratory Distress Syndrome/epidemiology , Betacoronavirus , COVID-19 , Cerebrovascular Disorders/epidemiology , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Dementia/epidemiology , Epilepsy/epidemiology , Guillain-Barre Syndrome/epidemiology , Guillain-Barre Syndrome/etiology , Humans , Hypoxia-Ischemia, Brain/epidemiology , Hypoxia-Ischemia, Brain/etiology , Intensive Care Units , Leukoencephalitis, Acute Hemorrhagic/epidemiology , Leukoencephalitis, Acute Hemorrhagic/etiology , Pandemics , Parkinson Disease/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , SARS-CoV-2 , Stroke/epidemiology , Stroke/etiology