Neurological phenotypes among
COVID-19 positive cases

Neurological complications can worsen outcome among hospitalized COVID-19 patients, though the prevalence of neurological phenotypes across geographically diverse populations warrants evaluation.

 

To examine the prevalence of neurological conditions among hospitalized COVID-19 patients in multi-national populations.

 

Importance and objective

  • 35,177 COVID-19 patients
  • 348 hospitals
  • 6 countries
  • 3 continents
  • January 2020 - early September 2020
  • PHASE 1.1

 

EHR data of a multi-national, geographically diverse population

Hospitalized patients with positive SARS-CoV-2 polymerase chain reaction (PCR) test, both with and without severe COVID-19 disease.

 

 

Exposures

Define "severity"

Severe Illness Category Clinical Events
Diagnoses Acute Respiratory Distress Syndrome, Ventilator-associated pneumonia
Procedures Insertion of endotracheal tube; invasive mechanical ventilation
Laboratory results PaCO2, PaO2
Medications General anesthetics; benzodiazepine derivatives; muscle relaxants; other hypnotics and sedatives; adrenergic and dopaminergic agents; other cardiac stimulants; other respiratory system products; phosphodiesterase inhibitors; platelet aggregation inhibitors excluding heparin; 

Meet at least one of the clinical events

Frequency of each disease category and 3-digit International Classification of Disease (ICD) code of neurological diseases by countries, sites, time before and after admission for COVID-19 related hospitalization, and COVID-19 severity.

 

Outcomes

Workflow

34,647 patient characteristics

Is there a difference in prevalence of ICD-10 codes between before and after admission?

\frac{\textrm{number of COVID-19 positive cases diagnosed with X}}{\textrm{total number of COVID-19 positive cases at site Y}}

(X, Y)

Do sites that report more neurological code X

report more severe cases or more never severe cases?

During COVID-19-related hospitalization, severe patients had more neurological diagnoses than those without severe disease.

 

  • 1.22 times more disorders of consciousness (95% CI: 1.16-1.27)
  • 1.24 times more other cerebrovascular diseases (95% CI: 1.05-1.45)
  • 1.36 times more nontraumatic intracerebral / intracranial hemorrhage (95% CI: 1.10-1.67)
  • 1.72 times more myopathy (95% CI: 1.51-1.95)

Key findings

to paper

Thanks!

Association of COVID-19 and Neurological Phenotypes

By Trang Le

Association of COVID-19 and Neurological Phenotypes

15-min presentation to the 4CE consortium, 2020-10-02

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