Neurological syndromes are associated with increased risk of mortality in patients with COVID-19

12^th International Conference on Stroke, Neurology and Cerebrovascular Diseases

August 18-19, 2021 | Webinar

David Altschul

Albert Einstein College of Medicine, USA

Scientific Tracks Abstracts: JND

Abstract :

Objective: The SARS-Cov2 virus is protean in its manifestations, affecting nearly every organ system. However, nervous system involvement and its impact on disease outcome are poorly characterized. The objective of the study is to determine if neurological syndromes are associated with increased risk of inpatient mortality. Methods: 581 hospitalized patients with confi rmed SARS-Cov2 infection, neurological involvement and brain-imaging were compared to hospitalized non-neurological COVID-19 patients. Four patterns of neurological manifestations were identifi ed –acute stroke, new or recrudescent seizures, altered mentation with normal imaging, and neuro-COVID-19 complex. Factors present on admission were analyzed as potential predictors of in-hospital mortality, including sociodemographic variables, preexisting comorbidities, vital-signs, laboratory values, and pattern of neurological manifestations. Signifi cant predictors were incorporated into a disease-severity score. Patients with neurological manifestations were matched with patients of the same age and disease severity to assess the risk of death. Results: 4711 patients with confi rmed SARS-Cov2 infection were admitted to one medical system in New York City during a 6-week period. Of these, 581 (12%) had neurological issues of suffi cient concern to warrant neuro-imaging. These patients were compared to 1743 non-neurological COVID-19 patients matched for age and disease-severity admitted during the same period. Patients with altered mentation (n=258, p =0.04, OR 1.39, CI 1.04 – 1.86) or radiologically confi rmed stroke (n=55, p = 0.001, OR 3.1, CI 1.65-5.92) had a higher risk of mortality than age and severity-matched controls. Conclusions: The incidence of altered mentation or stroke on admission predicts a modest but signifi cantly higher risk of in-hospital mortality independent of disease severity. While other biomarker factors also predict mortality, measures to identify and treat such patients may be important in reducing overall mortality of COVID-19.

Biography :

Associate Professor of Neurosurgery and Radiology at Albert Einstein College of Medicine, Surgical Director of the Comprehensive Stroke Center at Montefi ore Medical Center, Chief of the Division of Cerebrovascular Neurosurgery Leo M. Davidoff Department of Neurosurgery, Associate Residency Program Director of Neurosurgery Residency in neurosurgery at Montefi ore Medical Center Fellowship in endovascular neurosurgery at Mt. Sinai Medical center.