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Neuro‐COVID frequency and short‐term outcome in the Northern Portuguese population
Author(s) -
Oliveira Vanessa,
Seabra Mafalda,
Rodrigues Rita,
Carvalho Vanessa,
Mendes Michel,
Pereira Diogo,
Caldeiras Catarina,
Martins Bárbara,
Silva Renata,
Azevedo Ana,
Lima Maria João,
Monteiro Catarina,
Varela Ricardo,
Malheiro Sofia,
Abreu Miguel,
Azevedo Elsa,
Leal Loureiro José,
Tedim Cruz Vítor,
Silva Mário Rui,
Magalhães Rui,
Silva Carolina,
Maia Luís F.,
Correia Manuel
Publication year - 2021
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14874
Subject(s) - medicine , case fatality rate , pediatrics , delirium , population , covid-19 , retrospective cohort study , epidemiology , intensive care medicine , disease , environmental health , infectious disease (medical specialty)
Background and purpose COVID‐19‐related acute neurological phenotypes are being increasingly recognised, with neurological complications reported in more than 30% of hospitalised patients. However, multicentric studies providing a population‐based perspective are lacking. Methods We conducted a retrospective multicentric study at five hospitals in Northern Portugal, representing 45.1% of all hospitalised patients in this region, between 1 March and 30 June 2020. Results Among 1261 hospitalised COVID‐19 patients, 457 (36.2%) presented neurological manifestations, corresponding to a rate of 357 per 1000 in the North Region. Patients with neurologic manifestations were younger (68.0 vs. 71.2 years, p = 0.002), and the most frequent neurological symptoms were headache (13.4%), delirium (10.1%), and impairment of consciousness (9.7%). Acute well‐defined central nervous system (CNS) involvement was found in 19.1% of patients, corresponding to a rate of 217 per 1000 hospitalised patients in the whole region. Assuming that all patients with severe neurological events were hospitalised, we extrapolated our results to all COVID‐19 patients in the region, estimating that 116 will have a severe neurological event, corresponding to a rate of nine per 1000 (95% CI = 7–11). Overall case fatality in patients presenting neurological manifestations was 19.8%, increasing to 32.6% among those with acute well‐defined CNS involvement. Conclusions We characterised the population of hospitalised COVID‐19 patients in Northern Portugal and found that neurological symptoms are common and associated with a high degree of disability at discharge. CNS involvement with criteria for in‐hospital admission was observed in a significant proportion of patients. This knowledge provides the tools for adequate health planning and for improving COVID‐19 multidisciplinary patient care.