Neuro-COVID frequency and short-term outcome in the Northern Portuguese population

Autores da FMUP

• Renato Emílio Santos Silva

  Autor

• Ana Azevedo Cardoso Oliveira

  Autor

• Clara Maria Pires Costa De Bastos Monteiro

  Autor

• Elsa Irene Peixoto Azevedo Silva

  Autor

• Mónica Maria Bessa Correia

  Autor

Participantes de fora da FMUP

• Oliveira, V
• Seabra, M
• Rodrigues, R
• Carvalho, V
• Mendes, M
• Pereira, D
• Caldeiras, C
• Martins, B
• Lima, MJ
• Varela, R
• Malheiro, S
• Abreu, M
• Loureiro, JL
• Cruz, VT
• Silva, MR
• Magalh?es, R.
• Silva, M.
• Maia, LF

Unidades de investigação

• Biomedicina

• Ciências da Saúde Pública e Forenses, e Educação Médica

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Neurociências Clínicas e Saúde Mental

Abstract

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.

Keywords

• COVID-19; neurological manifestations; frequency; NeuroCOVID; Population