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Altered mental status is a predictor of poor outcomes in COVID-19 patients: A cohort study.
Attia, Abdallah S; Hussein, Mohammad; Aboueisha, Mohamed A; Omar, Mahmoud; Youssef, Mohanad R; Mankowski, Nicholas; Miller, Michael; Munshi, Ruhul; Swinford, Aubrey; Kline, Adam; Nguyen, Therese; Toraih, Eman; Duchesne, Juan; Kandil, Emad.
  • Attia AS; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Hussein M; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Aboueisha MA; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Omar M; Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
  • Youssef MR; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Mankowski N; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Miller M; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Munshi R; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Swinford A; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Kline A; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Nguyen T; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Toraih E; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Duchesne J; Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
  • Kandil E; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
PLoS One ; 16(10): e0258095, 2021.
Article in English | MEDLINE | ID: covidwho-1450730
ABSTRACT

INTRODUCTION:

Several studies have described typical clinical manifestations, including fever, cough, diarrhea, and fatigue with COVID-19 infection. However, there are limited data on the association between the presence of neurological manifestations on hospital admission, disease severity, and outcomes. We sought to investigate this correlation to help understand the disease burden.

METHODS:

We delivered a multi-center retrospective study of positive laboratory-confirmed COVID-19 patients. Clinical presentation, laboratory values, complications, and outcomes data were reported. Our findings of interest were Intensive Care Unit (ICU) admission, intubation, mechanical ventilation, and in-hospital mortality.

RESULTS:

A total of 502 patients with a mean age of 60.83 ± 15.5 years, of them 71 patients (14.14%) presented with altered mental status, these patients showed higher odds of ICU admission (OR = 2.06, 95%CI = 1.18 to 3.59, p = 0.01), mechanical ventilation (OR = 3.28, 95%CI = 1.86 to 5.78, p < 0.001), prolonged (>4 days) mechanical ventilation (OR = 4.35, 95%CI = 1.89 to 10, p = 0.001), acute kidney injury (OR = 2.18, 95%CI = 1.28 to 3.74, p = 0.004), and mortality (HR = 2.82, 95%CI = 1.49 to 5.29, p = 0.01).

CONCLUSION:

This cohort study found that neurological presentations are associated with higher odds of adverse events. When examining patients with neurological manifestations, clinicians should suspect COVID-19 to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Mental Disorders Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0258095

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Mental Disorders Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0258095