OBJECTIVE: Neurological complications can worsen outcomes in COVID-19. We defined the prevalence of a wide range of neurological conditions among patients hospitalized with COVID-19 in geographically diverse multinational populations. METHODS: Using electronic health record (EHR) data from 348 participating hospitals across 6 countries and 3 continents between January and September 2020, we performed a cross-sectional study of hospitalized adult and pediatric patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test, both with and without severe COVID-19. We assessed the frequency of each disease category and 3-character International Classification of Disease (ICD) code of neurological diseases by countries, sites, time before and after admission for COVID-19, and COVID-19 severity. RESULTS: Among the 35,177 hospitalized patients with SARS-CoV-2 infection, there was increased prevalence of disorders of consciousness (5.8%, 95% confidence interval [CI]: 3.7%-7.8%, p FDR <.001) and unspecified disorders of the brain (8.1%, 95%CI: 5.7%-10.5%, p FDR <.001), compared to pre-admission prevalence. During hospitalization, patients who experienced severe COVID-19 status had 22% (95%CI: 19%-25%) increase in the relative risk (RR) of disorders of consciousness, 24% (95%CI: 13%-35%) increase in other cerebrovascular diseases, 34% (95%CI: 20%-50%) increase in nontraumatic intracranial hemorrhage, 37% (95%CI: 17%-60%) increase in encephalitis and/or myelitis, and 72% (95%CI: 67%-77%) increase in myopathy compared to those who never experienced severe disease. INTERPRETATION: Using an international network and common EHR data elements, we highlight an increase in the prevalence of central and peripheral neurological phenotypes in patients hospitalized with SARS-CoV-2 infection, particularly among those with severe disease.
OBJECTIVE: Neurological complications can worsen outcomes in COVID-19. We defined the prevalence of a wide range of neurological conditions among patients hospitalized with COVID-19 in geographically diverse multinational populations. METHODS: Using electronic health record (EHR) data from 348 participating hospitals across 6 countries and 3 continents between January and September 2020, we performed a cross-sectional study of hospitalized adult and pediatric patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test, both with and without severe COVID-19. We assessed the frequency of each disease category and 3-character International Classification of Disease (ICD) code of neurological diseases by countries, sites, time before and after admission for COVID-19, and COVID-19 severity. RESULTS: Among the 35,177 hospitalized patients with SARS-CoV-2 infection, there was increased prevalence of disorders of consciousness (5.8%, 95% confidence interval [CI]: 3.7%-7.8%, p FDR <.001) and unspecified disorders of the brain (8.1%, 95%CI: 5.7%-10.5%, p FDR <.001), compared to pre-admission prevalence. During hospitalization, patients who experienced severe COVID-19 status had 22% (95%CI: 19%-25%) increase in the relative risk (RR) of disorders of consciousness, 24% (95%CI: 13%-35%) increase in other cerebrovascular diseases, 34% (95%CI: 20%-50%) increase in nontraumatic intracranial hemorrhage, 37% (95%CI: 17%-60%) increase in encephalitis and/or myelitis, and 72% (95%CI: 67%-77%) increase in myopathy compared to those who never experienced severe disease. INTERPRETATION: Using an international network and common EHR data elements, we highlight an increase in the prevalence of central and peripheral neurological phenotypes in patients hospitalized with SARS-CoV-2 infection, particularly among those with severe disease.
Authors: Yichi Zhang; Tianrun Cai; Sheng Yu; Kelly Cho; Chuan Hong; Jiehuan Sun; Jie Huang; Yuk-Lam Ho; Ashwin N Ananthakrishnan; Zongqi Xia; Stanley Y Shaw; Vivian Gainer; Victor Castro; Nicholas Link; Jacqueline Honerlaw; Sicong Huang; David Gagnon; Elizabeth W Karlson; Robert M Plenge; Peter Szolovits; Guergana Savova; Susanne Churchill; Christopher O'Donnell; Shawn N Murphy; J Michael Gaziano; Isaac Kohane; Tianxi Cai; Katherine P Liao Journal: Nat Protoc Date: 2019-11-20 Impact factor: 13.491
Authors: Ross W Paterson; Rachel L Brown; Laura Benjamin; Ross Nortley; Sarah Wiethoff; Tehmina Bharucha; Dipa L Jayaseelan; Guru Kumar; Rhian E Raftopoulos; Laura Zambreanu; Vinojini Vivekanandam; Anthony Khoo; Ruth Geraldes; Krishna Chinthapalli; Elena Boyd; Hatice Tuzlali; Gary Price; Gerry Christofi; Jasper Morrow; Patricia McNamara; Benjamin McLoughlin; Soon Tjin Lim; Puja R Mehta; Viva Levee; Stephen Keddie; Wisdom Yong; S Anand Trip; Alexander J M Foulkes; Gary Hotton; Thomas D Miller; Alex D Everitt; Christopher Carswell; Nicholas W S Davies; Michael Yoong; David Attwell; Jemeen Sreedharan; Eli Silber; Jonathan M Schott; Arvind Chandratheva; Richard J Perry; Robert Simister; Anna Checkley; Nicky Longley; Simon F Farmer; Francesco Carletti; Catherine Houlihan; Maria Thom; Michael P Lunn; Jennifer Spillane; Robin Howard; Angela Vincent; David J Werring; Chandrashekar Hoskote; Hans Rolf Jäger; Hadi Manji; Michael S Zandi Journal: Brain Date: 2020-10-01 Impact factor: 13.501
Authors: Gabriel A Brat; Griffin M Weber; Nils Gehlenborg; Paul Avillach; Nathan P Palmer; Luca Chiovato; James Cimino; Lemuel R Waitman; Gilbert S Omenn; Alberto Malovini; Jason H Moore; Brett K Beaulieu-Jones; Valentina Tibollo; Shawn N Murphy; Sehi L' Yi; Mark S Keller; Riccardo Bellazzi; David A Hanauer; Arnaud Serret-Larmande; Alba Gutierrez-Sacristan; John J Holmes; Douglas S Bell; Kenneth D Mandl; Robert W Follett; Jeffrey G Klann; Douglas A Murad; Luigia Scudeller; Mauro Bucalo; Katie Kirchoff; Jean Craig; Jihad Obeid; Vianney Jouhet; Romain Griffier; Sebastien Cossin; Bertrand Moal; Lav P Patel; Antonio Bellasi; Hans U Prokosch; Detlef Kraska; Piotr Sliz; Amelia L M Tan; Kee Yuan Ngiam; Alberto Zambelli; Danielle L Mowery; Emily Schiver; Batsal Devkota; Robert L Bradford; Mohamad Daniar; Christel Daniel; Vincent Benoit; Romain Bey; Nicolas Paris; Patricia Serre; Nina Orlova; Julien Dubiel; Martin Hilka; Anne Sophie Jannot; Stephane Breant; Judith Leblanc; Nicolas Griffon; Anita Burgun; Melodie Bernaux; Arnaud Sandrin; Elisa Salamanca; Sylvie Cormont; Thomas Ganslandt; Tobias Gradinger; Julien Champ; Martin Boeker; Patricia Martel; Loic Esteve; Alexandre Gramfort; Olivier Grisel; Damien Leprovost; Thomas Moreau; Gael Varoquaux; Jill-Jênn Vie; Demian Wassermann; Arthur Mensch; Charlotte Caucheteux; Christian Haverkamp; Guillaume Lemaitre; Silvano Bosari; Ian D Krantz; Andrew South; Tianxi Cai; Isaac S Kohane Journal: NPJ Digit Med Date: 2020-08-19
Authors: Gianpaolo Toscano; Francesco Palmerini; Sabrina Ravaglia; Luigi Ruiz; Paolo Invernizzi; M Giovanna Cuzzoni; Diego Franciotta; Fausto Baldanti; Rossana Daturi; Paolo Postorino; Anna Cavallini; Giuseppe Micieli Journal: N Engl J Med Date: 2020-04-17 Impact factor: 91.245
Authors: James E Siegler; Pere Cardona; Juan F Arenillas; Blanca Talavera; Ana N Guillen; Alba Chavarría-Miranda; Mercedes de Lera; Priyank Khandelwal; Ivo Bach; Pratit Patel; Amit Singla; Manuel Requena; Marc Ribo; Dinesh V Jillella; Srikant Rangaraju; Raul G Nogueira; Diogo C Haussen; Alejandro R Vazquez; Xabier Urra; Ángel Chamorro; Luis S Román; Jesse M Thon; Ryna Then; Emma Sanborn; Natalia P de la Ossa; Mònica Millàn; Isaac N Ruiz; Ossama Y Mansour; Mohammed Megahed; Cristina Tiu; Elena O Terecoasa; Răzvan A Radu; Thanh N Nguyen; Gioacchino Curiale; Artem Kaliaev; Alexandra L Czap; Jacob Sebaugh; Alicia M Zha; David S Liebeskind; Santiago Ortega-Gutierrez; Mudassir Farooqui; Ameer E Hassan; Laurie Preston; Mary S Patterson; Saif Bushnaq; Osama Zaidat; Tudor G Jovin Journal: Int J Stroke Date: 2020-09-30 Impact factor: 5.266