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

2021; Nature Portfolio; Volume: 11; Issue: 1 Linguagem: Inglês

10.1038/s41598-021-99481-9

2045-2322

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

Thermal Regulation in Medicine

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.