Clinical characteristics and outcomes of inpatients with neurologic disease and COVID-19 in Brescia, Lombardy, Italy

被引：150

作者：

Benussi, Alberto ^{[1
,2
]}

Pilotto, Andrea ^{[1
,2
]}

Premi, Enrico ^{[3
]}

Libri, Ilenia ^{[1
]}

Giunta, Marcello ^{[1
]}

Agosti, Chiara ^{[2
]}

Alberici, Antonella ^{[2
]}

Baldelli, Enrico ^{[1
]}

Benini, Matteo ^{[5
]}

Bonacina, Sonia ^{[1
]}

Brambilla, Laura ^{[6
]}

Caratozzolo, Salvatore ^{[2
]}

Cortinovis, Matteo ^{[1
]}

Costa, Angelo ^{[3
]}

Piccinelli, Stefano Cotti ^{[1
]}

Cottini, Elisabetta ^{[2
]}

Cristillo, Viviana ^{[1
]}

Delrio, Ilenia ^{[3
]}

Filosto, Massimiliano ^{[2
]}

Gamba, Massimo ^{[3
]}

Gazzina, Stefano ^{[4
]}

Gilberti, Nicola ^{[3
]}

Gipponi, Stefano ^{[2
]}

Imarisio, Alberto ^{[1
]}

Invernizzi, Paolo ^{[8
]}

Leggio, Ugo ^{[4
]}

Leonardi, Matilde ^{[7
]}

Liberini, Paolo ^{[2
]}

Locatelli, Martina ^{[1
]}

Masciocchi, Stefano ^{[1
]}

Poli, Loris ^{[2
]}

Rao, Renata ^{[2
]}

Risi, Barbara ^{[1
]}

Rozzini, Luca ^{[1
,2
]}

Scalvini, Andrea ^{[1
]}

di Cola, Francesca Schiano ^{[1
]}

Spezi, Raffaella ^{[3
]}

Vergani, Veronica ^{[3
]}

Volonghi, Irene ^{[2
]}

Zoppi, Nicola ^{[1
]}

Borroni, Barbara ^{[1
,2
]}

Magoni, Mauro ^{[3
]}

Pezzini, Alessandro ^{[1
,2
]}

Padovani, Alessandro ^{[1
,2
]}

机构：

[1] Univ Brescia, Neurol Unit, Dept Clin & Expt Sci, Brescia, Italy

[2] ASST Spedali Civili, Neurol Unit, Dept Neurol & Vis Sci, Brescia, Italy

[3] ASST Spedali Civili, Vasc Neurol Unit, Dept Neurol & Vis Sci, Brescia, Italy

[4] ASST Spedali Civili, Neurophysiol Unit, Dept Neurol & Vis Sci, Brescia, Italy

[5] Univ Bologna, Neurol Unit, Bologna, Italy

[6] Fdn IRCCS Neurol Inst Carlo Besta, Dept Neuroimmunol & Neuromuscular Dis, Publ Hlth & Disabil Unit, Milan, Italy

[7] Fdn IRCCS Neurol Inst Carlo Besta, Neurol, Publ Hlth & Disabil Unit, Milan, Italy

[8] Fdn Poliambulanza Hosp, Neurol Unit, Brescia, Italy

来源：

NEUROLOGY | 2020年 / 95卷 / 07期

关键词：

CORONAVIRUS;

D O I：

10.1212/WNL.0000000000009848

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective To report clinical and laboratory characteristics, treatment, and clinical outcomes of patients admitted for neurologic diseases with and without coronavirus disease 2019 (COVID-19). Methods In this retrospective, single-center cohort study, we included all adult inpatients with confirmed COVID-19 admitted to a neuro-COVID unit beginning February 21, 2020, who had been discharged or died by April 5, 2020. Demographic, clinical, treatment, and laboratory data were extracted from medical records and compared (false discovery rate corrected) to those of neurologic patients without COVID-19 admitted in the same period. Results One hundred seventy-three patients were included in this study, of whom 56 were positive and 117 were negative for COVID-19. Patients with COVID-19 were older (77.0 years, interquartile range [IQR] 67.0-83.8 years vs 70.1 years, IQR 52.9-78.6 years, p = 0.006), had a different distribution regarding admission diagnoses, including cerebrovascular disorders (n = 43, 76.8% vs n = 68, 58.1%), and had a higher quick Sequential Organ Failure Assessment (qSOFA) score on admission (0.9, IQR 0.7-1.1 vs 0.5, IQR 0.4-0.6, p = 0.006). In-hospital mortality rates (n = 21, 37.5% vs n = 5, 4.3%, p < 0.001) and incident delirium (n = 15, 26.8% vs n = 9, 7.7%, p = 0.003) were significantly higher in the COVID-19 group. Patients with COVID-19 and without COVID with stroke had similar baseline characteristics, but patients with COVID-19 had highermodified Rankin Scale scores at discharge (5.0, IQR 2.0-6.0 vs 2.0, IQR 1.0-3.0, p < 0.001), with a significantly lower number of patients with a good outcome (n = 11, 25.6% vs n = 48, 70.6%, p < 0.001). In patients with COVID-19, multivariable regressions showed increasing odds of inhospital death associated with higher qSOFA scores (odds ratio [OR] 4.47, 95% confidence interval [CI] 1.21-16.5, p = 0.025), lower platelet count (OR 0.98, 95% CI 0.97-0.99, p = 0.005), and higher lactate dehydrogenase (OR 1.01, 95% CI 1.00-1.03, p = 0.009) on admission. Conclusions Patients withCOVID-19 admittedwith neurologic disease, including stroke, have a significantly higher in-hospitalmortality and incident deliriumand higher disability than patients without COVID-19.

引用

页码：E910 / E920

页数：11

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