In this retrospective, single centre cohort study, recently published in Neurology, Benussi et al., reported clinical and laboratory characteristics, as well as treatment and clinical outcomes of patients admitted for neurological diseases with and without COVID-19. All adult inpatients with confirmed COVID-19, admitted to a Neuro-COVID Unit from February 21, 2020, who had either been discharged or died by April 5, 2020 were included. Demographic, clinical, treatment, and laboratory data were compared (false discovery rate-corrected) to those of neurological patients without COVID-19 admitted in the same period. 173 patients were included, of whom 56 were positive for COVID-19. Patients with COVID-19 were older, had a different distribution of admission diagnoses, including a higher percentage of cerebrovascular disorders (n=43, 76.8% vs n=68, 58.1%), and had a higher quick Sequential Organ Failure Assessment (qSOFA) score on admission. 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. COVID-19 and non-COVID patients with stroke had similar baseline characteristics, but patients with COVID-19 had higher modified 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 regression showed increasing odds of in-hospital death associated with higher qSOFA scores, lower platelet count and higher lactate dehydrogenase on admission. The authors concluded that COVID-19 patients admitted with neurological disease, including stroke, have significantly higher in-hospital mortality, incident delirium and higher disability than patients without COVID-19.
https://n.neurology.org/content/early/2020/05/22/WNL.0000000000009848.long
by Marialuisa Zedde and Francesco Cavallieri
