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Neurological manifestations in patients hospitalized with COVID-19: A retrospective analysis from a large cohort in Northern Italy.
Travi, Giovanna; Rossotti, Roberto; Merli, Marco; D'Amico, Federico; Chiappetta, Stefania; Giussani, Giuditta; Panariello, Adelaide; Corradin, Matteo; Vecchi, Marta; Raimondi, Alessandro; Baiguera, Chiara; Nocita, Benedetta; Epis, Oscar Massimiliano; Tarsia, Paolo; Galbiati, Filippo; Colombo, Fabrizio; Fumagalli, Roberto; Scaglione, Francesco; Moreno, Mauro; Percudani, Mauro Emilio; Agostoni, Elio Clemente; Puoti, Massimo.
  • Travi G; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Rossotti R; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Merli M; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • D'Amico F; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Chiappetta S; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Giussani G; Department of Neurology and Stroke Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Panariello A; Department of Mental Health and Addiction Services, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Corradin M; Healthcare Management Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Vecchi M; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Raimondi A; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Baiguera C; Department of Infectious Diseases Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Nocita B; Department of Internal Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Epis OM; Rheumatology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Tarsia P; Pneumology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Galbiati F; Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Colombo F; Department of Internal Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Fumagalli R; Department of Anesthesia and Critical Care, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Scaglione F; School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
  • Moreno M; Chemical-Clinical and Microbiological Analysis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Percudani ME; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
  • Agostoni EC; Healthcare Management Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Puoti M; Department of Mental Health and Addiction Services, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Eur J Neurosci ; 53(8): 2912-2922, 2021 04.
Article in English | MEDLINE | ID: covidwho-1096760
ABSTRACT
SARS-CoV2 infection is a systemic disease that may involve multiple organs, including the central nervous system (CNS). Aims of our study are to describe prevalence and clinical features of neurological manifestations, mortality and hospital discharge in subjects hospitalized with COVID-19. All individuals admitted for to our hospital COVID-19 were retrospectively included. Patients were classified according to the symptoms at hospital entry in (1) isolated respiratory, (2) combined respiratory and neurologic, (3) isolated neurologic and (4) stroke manifestations. Descriptive statistics and nonparametric tests to compare the groups were calculated. Kaplan Meier probability curves and multivariable Cox regression models for survival and hospital discharge were applied. The analysis included 901 patients 42.6% showed a severe or critical disease with an overall mortality of 21.2%. At least one neurological symptom or disease was observed in 30.2% of subjects ranging from dysgeusia/anosmia (9.1%) to postinfective diseases (0.8%). Patients with respiratory symptoms experienced a more severe disease and a higher in-hospital mortality compared to those who showed only neurologic symptoms. Kaplan Meier estimates displayed a statistically significant different survival among groups (p = 0.003) subjects with stroke had the worst. After adjusting for risk factors such as age, sex and comorbidity, individuals with isolated neurologic manifestations exhibited a better survival (aHR 0.398, 95% CI [0.206, 0.769], p = 0.006). Neurologic manifestations in COVID-19 are common but heterogeneous and mortality in subjects with isolated neurologic manifestations seems lower than in those with respiratory symptoms.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Nervous System Diseases Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur J Neurosci Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: Ejn.15159

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Nervous System Diseases Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur J Neurosci Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: Ejn.15159