Comparison of disease profiles and three-month outcomes of patients with neurological disorders with and without COVID-19: An ambispective cohort study

• Published in: Annals of the Indian Academy of Neurology Vol. 25; no. 2; pp. 218 - 223
• Main Authors: Pillai, Kanchana, Vibha, Deepti, Gupta, Pranjal, Sudheer, Pachipala, Mishra, Biswamohan, Oinam, Rahul, Mohan, Ayush, Tayade, Kamalesh, Srivastava, Padma, Tripathi, Manjari, Srivastava, Achal, Bhatia, Rohit, Rajan, Roopa, Pandit, Awadh, Singh, Rajesh, Elavarasi, Arunmozhimaran, Agarwal, Ayush, Gupta, Anu, Das, Animesh, Radhakrishnan, Divya, Ramanujam, Bhargavi, Soni, Kapil, Aggarwal, Richa, Wig, Naveet, Trikha, Anjan
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.03.2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: 3- months follow-up; ambispective cohort study; Cohort analysis; Coronaviruses; COVID-19; covid-19 neurology; in-hospital mortality; Infections; Ischemia; modified rankin scale; Morbidity; Mortality; Nervous system diseases; Neurologic manifestations of general diseases; Neurological diseases; Neurological disorders; Original; Patient outcomes; Patients; Risk factors; Severe acute respiratory syndrome coronavirus 2; Statistics; India; in-hospital mortality; modified Rankin Scale; Ambispective cohort study; COVID-19 neurology; 3- months follow-up
• ISSN: 0972-2327; 1998-3549
• DOI: 10.4103/aian.aian_602_21

Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-CoV-2 infection. Methods: In an ambispective cohort study design, we enrolled patients with and without SARS CoV-2 infection coming to a medical emergency with neurological disorders between April 2020 and September 2020. Demographic, clinical, biochemical, and treatment details of these patients were collected and compared. Their outcomes, both in-hospital and at 3 months were assessed by the modified Rankin Scale (mRS). Results: Two thirty-five patients (235) were enrolled from emergency services with neurological disorders. Of them, 81 (34.5%) were COVID-19 positive. The mean (SD) age was 49.5 (17.3) years, and the majority of the patients were male (63.0%). The commonest neurological diagnosis was acute ischemic stroke (AIS) (43.0%). The in-hospital mortality was higher in the patients who were COVID-19 positive (COVID-19 positive: 29 (35.8%) versus COVID-19 negative: 12 (7.8%), P value: <0.001). The 3 months telephonic follow-up could be completed in 73.2% of the patients (142/194). Four (12.1%) deaths occurred on follow-up in the COVID-19 positive versus fifteen (13.8%) in the COVID-19 negative patients (P value: 1.00). The 3-month mRS was worse in the COVID-19 positive group (P value <0.001). However, this was driven by higher in-hospital morbidity and mortality in COVID-19 positive patients. Conclusion: Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital and 3 months disability.