TY - JOUR
T1 - Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19
AU - Le, Trang T.
AU - Gutiérrez-Sacristán, Alba
AU - Son, Jiyeon
AU - Hong, Chuan
AU - South, Andrew M.
AU - Beaulieu-Jones, Brett K.
AU - Loh, Ne Hooi Will
AU - Luo, Yuan
AU - Morris, Michele
AU - Ngiam, Kee Yuan
AU - Patel, Lav P.
AU - Samayamuthu, Malarkodi J.
AU - Schriver, Emily
AU - Tan, Amelia L.M.
AU - Moore, Jason
AU - Cai, Tianxi
AU - Omenn, Gilbert S.
AU - Avillach, Paul
AU - Kohane, Isaac S.
AU - Aaron, James R.
AU - Agapito, Giuseppe
AU - Albayrak, Adem
AU - Alessiani, Mario
AU - Amendola, Danilo F.
AU - Angoulvant, François
AU - Anthony, Li L.L.J.
AU - Aronow, Bruce J.
AU - Atz, Andrew
AU - Balshi, James
AU - Bell, Douglas S.
AU - Bellasi, Antonio
AU - Bellazzi, Riccardo
AU - Benoit, Vincent
AU - Beraghi, Michele
AU - Bernal Sobrino, José Luis
AU - Bernaux, Mélodie
AU - Bey, Romain
AU - Blanco Martínez, Alvar
AU - Boeker, Martin
AU - Bonzel, Clara Lea
AU - Booth, John
AU - Bosari, Silvano
AU - Bourgeois, Florence T.
AU - Bradford, Robert L.
AU - Brat, Gabriel A.
AU - Bréant, Stéphane
AU - Brown, Nicholas W.
AU - Bryant, William A.
AU - Chen, Jin
AU - Kavuluru, Ramakanth
N1 - Funding Information:
AS is funded by National Institutes of Health (NIH) National Heart Lung, and Blood Institute (NHLBI) K23HL148394 and L40HL148910, and NIH-National Center for Advancing Translational Sciences (NCATS) UL1TR001420. JM is funded by NIH-National Institute of Allergy and Infectious Disease (NIAD) AI11679. LP is funded by NCATS Clinical and Translational Science Award (CTSA) Number UL1TR002366. GO is funded by NIH National Institute of Environmental Health Sciences (NIEHS) P30ES017885 and National Cancer Institute (NCI) U24CA210967. SV is funded by NIH-National Library of Medicine (NLM) R01LM012095 and NCATS UL1TR001857. DM is funded by NCATS CTSA Number UL1-TR001878. ZX is funded by NIH National Institute of Neurological Disorders and Stroke (NINDS) R01NS098023.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
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U2 - 10.1038/s41598-021-99481-9
DO - 10.1038/s41598-021-99481-9
M3 - Article
C2 - 34642371
AN - SCOPUS:85118178744
VL - 11
IS - 1
M1 - 20238
ER -