Neurological comorbidity and severity of COVID-19

Romagnolo, Alberto, Balestrino, Roberta, Imbalzano, Gabriele, Ciccone, Giovannino, Riccardini, Franco, Artusi, Carlo Alberto, Bozzali, Marco, Ferrero, Bruno, Montalenti, Elisa, Montanaro, Elisa, Rizzone, Mario Giorgio, Vaula, Giovanna, Zibetti, Maurizio and Lopiano, Leonardo (2020) Neurological comorbidity and severity of COVID-19. Journal of Neurology. ISSN 0340-5354

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Abstract

Objective
Neurological symptoms of COVID-19 patients have been recently described. However, no comprehensive data have been reported on pre-existing neurological comorbidities and COVID-19. This study aims at evaluating the prevalence of neurological comorbidities, and their association with COVID-19 severity.

Methods
We evaluated all consecutive patients admitted to the Emergency Room (ER) of our hospital between the 3rd March and the 14th April 2020, and diagnosed with COVID-19. Data on neurological and non-neurological diseases were extracted, as well as data on demographic characteristics and on severity degree of COVID-19. The prevalence of neurological comorbidities was calculated, and multivariate binary logistic regression analyses were used to estimate the association between neurological diseases and COVID-19 severity.

Results
We included 344 patients. Neurological comorbidities accounted for 22.4% of cases, with cerebrovascular diseases and cognitive impairment being the most frequent. Neurological comorbidity resulted independently associated with severe COVID-19 (OR 2.305; p = 0.012), as well as male gender (p = 0.001), older age (p = 0.001), neoplastic diseases (p = 0.039), and arterial hypertension (p = 0.045). When neurological comorbidity was associated with non-neurological comorbidities, the OR for severe COVID-19 rose to 7.394 (p = 0.005). Neurological patients, in particular cerebrovascular and cognitively impaired ones, received more respiratory support indication.

Conclusion
Neurological comorbidities represent a significant determinant of COVID-19 severity, deserving a thorough evaluation since the earliest phases of infection. The vulnerability of patients affected by neurological diseases should suggest a greater attention in targeting this population for proactive viral screening.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 10 Dec 2020 09:40
Last Modified: 10 Dec 2020 09:45
URI: http://sro.sussex.ac.uk/id/eprint/95621

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