Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19

• Main Author: Le, Trang T.
• Publication Date: 2021
• Other Authors: Gutiérrez-Sacristán, Alba, Son, Jiyeon, Hong, Chuan, South, Andrew M., Beaulieu-Jones, Brett K., Loh, Ne Hooi Will, Luo, Yuan, Morris, Michele, Ngiam, Kee Yuan, Patel, Lav P., Samayamuthu, Malarkodi J., Schriver, Emily, Tan, Amelia L. M., Moore, Jason, Cai, Tianxi, Omenn, Gilbert S., Avillach, Paul, Kohane, Isaac S., Aaron, James R., Agapito, Giuseppe, Albayrak, Adem, Alessiani, Mario, Amendola, Danilo F. [UNESP], Angoulvant, François, Anthony, Li L. L. J., Aronow, Bruce J., Atz, Andrew, Balshi, James, Bell, Douglas S., Bellasi, Antonio, Bellazzi, Riccardo, Benoit, Vincent, Beraghi, Michele, Bernal Sobrino, José Luis, Bernaux, Mélodie, Bey, Romain, Blanco Martínez, Alvar, Boeker, Martin, Bonzel, Clara-Lea, Booth, John, Bosari, Silvano, Bourgeois, Florence T., Bradford, Robert L., Brat, Gabriel A., Bréant, Stéphane, Brown, Nicholas W., Bryant, William A., Bucalo, Mauro, Burgun, Anita, Cannataro, Mario, Carmona, Aldo, Caucheteux, Charlotte, Champ, Julien, Chen, Krista, Chen, Jin, Chiovato, Luca, Chiudinelli, Lorenzo, Cimino, James J., Colicchio, Tiago K., Cormont, Sylvie, Cossin, Sébastien, Craig, Jean B., Cruz Bermúdez, Juan Luis, Cruz Rojo, Jaime, Dagliati, Arianna, Daniar, Mohamad, Daniel, Christel, Davoudi, Anahita, Devkota, Batsal, Dubiel, Julien, Esteve, Loic, Fan, Shirley, Follett, Robert W., Gaiolla, Paula S. A. [UNESP], Ganslandt, Thomas, García Barrio, Noelia, Garmire, Lana X., Gehlenborg, Nils, Geva, Alon, Gradinger, Tobias, Gramfort, Alexandre, Griffier, Romain, Griffon, Nicolas, Grisel, Olivier, Hanauer, David A., Haverkamp, Christian, He, Bing, Henderson, Darren W., Hilka, Martin, Holmes, John H., Horki, Petar, Huling, Kenneth M., Hutch, Meghan R., Issitt, Richard W., Jannot, Anne Sophie, Jouhet, Vianney, Kavuluru, Ramakanth, Keller, Mark S., Kirchoff, Katie, Klann, Jeffrey G., Krantz, Ian D., Kraska, Detlef, Krishnamurthy, Ashok K., L’Yi, Sehi, Leblanc, Judith, Leite, Andressa R. R. [UNESP], Lemaitre, Guillaume, Lenert, Leslie, Leprovost, Damien, Liu, Molei, Lozano-Zahonero, Sarah, Lynch, Kristine E., Mahmood, Sadiqa, Maidlow, Sarah, Makoudjou Tchendjou, Adeline C., Malovini, Alberto, Mandl, Kenneth D., Mao, Chengsheng, Maram, Anupama, Martel, Patricia, Masino, Aaron J., Matheny, Michael E., Maulhardt, Thomas, Mazzitelli, Maria, McDuffie, Michael T., Mensch, Arthur, Ashraf, Fatima, Milano, Marianna, Minicucci, Marcos F. [UNESP], Moal, Bertrand, Moraleda, Cinta, Morris, Jeffrey S., Moshal, Karyn L., Mousavi, Sajad, Murad, Douglas A., Murphy, Shawn N., Naughton, Thomas P., Neuraz, Antoine, Norman, James B., Obeid, Jihad, Okoshi, Marina P. [UNESP], Olson, Karen L., Orlova, Nina, Ostasiewski, Brian D., Palmer, Nathan P., Paris, Nicolas, Pedrera Jimenez, Miguel, Pfaff, Emily R., Pillion, Danielle, Prokosch, Hans U., Prudente, Robson A. [UNESP], Quirós González, Víctor, Ramoni, Rachel B., Raskin, Maryna, Rieg, Siegbert, Roig Domínguez, Gustavo, Rojo, Pablo, Sáez, Carlos, Salamanca, Elisa, Sandrin, Arnaud, Santos, Janaina C. C. [UNESP], Savino, Maria, Schuettler, Juergen, Scudeller, Luigia, Sebire, Neil J., Balazote, Pablo Serrano, Serre, Patricia, Serret-Larmande, Arnaud, Shakeri, Zahra, Silvio, Domenick, Sliz, Piotr, Sonday, Charles, Spiridou, Anastasia, Tan, Bryce W. Q., Tan, Byorn W. L., Tanni, Suzana E. [UNESP], Taylor, Deanne M., Terriza-Torres, Ana I., Tibollo, Valentina, Tippmann, Patric, Torti, Carlo, Trecarichi, Enrico M., Tseng, Yi-Ju, Vallejos, Andrew K., Varoquaux, Gael, Vella, Margaret, Vie, Jill-Jênn, Vitacca, Michele, Wagholikar, Kavishwar B., Waitman, Lemuel R., Wassermann, Demian, Weber, Griffin M., William, Yuan, Yehya, Nadir, Zambelli, Alberto, Zhang, Harrison G., Zoeller, Daniela, Zucco, Chiara, Visweswaran, Shyam, Mowery, Danielle L., Xia, Zongqi
• Format: Article
• Language: eng
• Source: Repositório Institucional da UNESP
• Download full: http://dx.doi.org/10.1038/s41598-021-99481-9; http://hdl.handle.net/11449/229804

Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participating hospitals across 6 countries and 3 continents (January–September 2020) for a cross-sectional analysis. We assessed the frequency of International Classification of Disease code of neurological conditions by countries, healthcare systems, time before and after admission for COVID-19 and COVID-19 severity. Among 35,177 hospitalized patients with SARS-CoV-2 infection, there was an increase in the proportion with disorders of consciousness (5.8%, 95% confidence interval [CI] 3.7–7.8%, pFDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, pFDR < 0.001) when compared to the pre-admission proportion. During hospitalization, the relative risk of disorders of consciousness (22%, 19–25%), cerebrovascular diseases (24%, 13–35%), nontraumatic intracranial hemorrhage (34%, 20–50%), encephalitis and/or myelitis (37%, 17–60%) and myopathy (72%, 67–77%) were higher for patients with severe COVID-19 when compared to those who never experienced severe COVID-19. Leveraging a multinational network to capture standardized EHR data, we highlighted the increased prevalence of central and peripheral neurological phenotypes in patients hospitalized with COVID-19, particularly among those with severe disease.