Neurological complications frequently occur in hospitalized COVID-19 patients and are associated with higher in-hospital mortality in comparison to patients who do not develop neurologic complications, according to findings from a global multi-cohort study.

This is the largest cohort study of neurological manifestations of COVID-19 to date, which included patients with clinically diagnosed or laboratory-confirmed COVID-19 at 28 centers, representing 13 countries and 4 continents. The study included consecutive patients in three cohorts who were hospitalized with Covid-19 between March 2020 and October 2020. The study population was derived from 2 large consortia: the Global Consortium Study of Neurologic Dysfunction in COVID-19 (GCS-NeuroCOVID) and the European Academy of Neurology (EAN) Neuro-COVID Registry (ENERGY). The findings are published online May 11, 2021 in JAMA Network Open.

Some key observations of the study 

• 82% of 3,744 hospitalized COVID-19 patients developed neurological manifestations.
• Overall, 80% of these patients exhibited at least 1 new neurological symptom, sign, or syndrome, and 55% had at least 1 neurological sign or syndrome captured on clinical evaluation.
• The most common self-reported symptom was headache (37%). The incidence of self-reported  anosmia (loss of smell) or ageusia (loss of taste) was 26%. 
• Acute encephalopathy (49%) was the most commonly seen neurological sign or syndrome followed by coma (17%) and stroke (6%). The least common were meningitis and/or encephalitis (0.5%). 
• Presence of clinically captured neurologic signs and/or syndromes was associated with a 6-fold increased risk of dying during hospitalization.
• Having a pre-existing neurological condition doubled the risk of developing Covid-related neurological complications. 

(Source: JAMA Network Open, published May 11, 2021) 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA