Park Jaeseok, Kwon Yong-Shik, Kim Hyun-Ah, Kwon Doo-Hyuk, Hwang Jihye, Jang Seong-Hwa, Park Hyungjong, Sohn Sung-Il, Choi Huimahn Alex, Hong Jeong-Ho
Department of Internal Medicine, Division of Pulmonology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea.
Division of Infectious Disease, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea.
J Clin Med. 2021 May 25;10(11):2281. doi: 10.3390/jcm10112281.
Clinical implications of neurological problems during intensive care unit (ICU) care for coronavirus disease 2019 (COVID-19) patients are unknown. This study aimed to describe the clinical implications of preexisting neurological comorbidities and new-onset neurological complications in ICU patients with COVID-19. ICU patients who were isolated and treated for COVID-19 between 19 February 2020 and 3 May 2020, from one tertiary hospital and one government-designated branch hospital were included. Clinical data including previous neurological disorders were extracted from electronic medical records. All neurological complications were evaluated by neurointensivists. Multiple logistic regression analysis was performed to investigate independent factors in ICU mortality. The median age of 52 ICU patients with COVID-19 was 73 years. Nineteen (36.5%) patients had preexisting neurological comorbidities, and new-onset neurological complications occurred in 23 (44.2%) during ICU admission. Patients with preexisting neurological comorbidities required tracheostomy more frequently and more ventilator and ICU days than those without. Patients with new-onset neurological complications experienced more medical complications and had higher ICU severity score and ICU mortality rates. New-onset neurological complications remained an independent factor for ICU mortality. Many COVID-19 patients in the ICU have preexisting neurological comorbidities, making them at a high risk of new-onset neurological complications.
2019冠状病毒病（COVID-19）患者在重症监护病房（ICU）治疗期间出现神经问题的临床意义尚不清楚。本研究旨在描述COVID-19的ICU患者中既往存在的神经合并症和新发神经并发症的临床意义。纳入了2020年2月19日至2020年5月3日期间在一家三级医院和一家政府指定分院隔离并治疗COVID-19的ICU患者。从电子病历中提取包括既往神经疾病在内的临床数据。所有神经并发症均由神经重症专家进行评估。进行多因素逻辑回归分析以研究ICU死亡率的独立因素。52例COVID-19的ICU患者的中位年龄为73岁。19例（36.5%）患者有既往神经合并症，23例（44.2%）在ICU住院期间出现新发神经并发症。与没有既往神经合并症的患者相比，有既往神经合并症的患者更频繁地需要气管切开术，使用呼吸机和在ICU住院的天数更多。出现新发神经并发症的患者有更多的医疗并发症，ICU严重程度评分更高，ICU死亡率也更高。新发神经并发症仍然是ICU死亡率的独立因素。ICU中的许多COVID-19患者有既往神经合并症，这使他们有发生新发神经并发症的高风险。
