Comparison of disease profiles and three-month outcomes of patients with neurological disorders with and without COVID-19: An ambispective cohort study

Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-...

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Bibliographic Details
Main Authors: Kanchana S Pillai, Deepti Vibha, Pranjal Gupta, Pachipala Sudheer, Biswamohan Mishra, Rahul S Oinam, Ayush Mohan, Kamalesh Tayade, Padma Srivastava, Manjari Tripathi, Achal K Srivastava, Rohit Bhatia, Roopa Rajan, Awadh K Pandit, Rajesh K Singh, Arunmozhimaran Elavarasi, Ayush Agarwal, Anu Gupta, Animesh Das, Divya M Radhakrishnan, Bhargavi Ramanujam, Kapil D Soni, Richa Aggarwal, Naveet Wig, Anjan Trikha
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Annals of Indian Academy of Neurology
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Online Access:http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=2;spage=218;epage=223;aulast=Pillai
Description
Summary:Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-CoV-2 infection. Methods: In an ambispective cohort study design, we enrolled patients with and without SARS CoV-2 infection coming to a medical emergency with neurological disorders between April 2020 and September 2020. Demographic, clinical, biochemical, and treatment details of these patients were collected and compared. Their outcomes, both in-hospital and at 3 months were assessed by the modified Rankin Scale (mRS). Results: Two thirty-five patients (235) were enrolled from emergency services with neurological disorders. Of them, 81 (34.5%) were COVID-19 positive. The mean (SD) age was 49.5 (17.3) years, and the majority of the patients were male (63.0%). The commonest neurological diagnosis was acute ischemic stroke (AIS) (43.0%). The in-hospital mortality was higher in the patients who were COVID-19 positive (COVID-19 positive: 29 (35.8%) versus COVID-19 negative: 12 (7.8%), P value: <0.001). The 3 months telephonic follow-up could be completed in 73.2% of the patients (142/194). Four (12.1%) deaths occurred on follow-up in the COVID-19 positive versus fifteen (13.8%) in the COVID-19 negative patients (P value: 1.00). The 3-month mRS was worse in the COVID-19 positive group (P value <0.001). However, this was driven by higher in-hospital morbidity and mortality in COVID-19 positive patients. Conclusion: Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital and 3 months disability.
ISSN:0972-2327
1998-3549