Department of Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, United States of America.
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
PLoS One. 2021 Oct 5;16(10):e0258095. doi: 10.1371/journal.pone.0258095. eCollection 2021.
Several studies have described typical clinical manifestations, including fever, cough, diarrhea, and fatigue with COVID-19 infection. However, there are limited data on the association between the presence of neurological manifestations on hospital admission, disease severity, and outcomes. We sought to investigate this correlation to help understand the disease burden.
We delivered a multi-center retrospective study of positive laboratory-confirmed COVID-19 patients. Clinical presentation, laboratory values, complications, and outcomes data were reported. Our findings of interest were Intensive Care Unit (ICU) admission, intubation, mechanical ventilation, and in-hospital mortality.
A total of 502 patients with a mean age of 60.83 ± 15.5 years, of them 71 patients (14.14%) presented with altered mental status, these patients showed higher odds of ICU admission (OR = 2.06, 95%CI = 1.18 to 3.59, p = 0.01), mechanical ventilation (OR = 3.28, 95%CI = 1.86 to 5.78, p < 0.001), prolonged (>4 days) mechanical ventilation (OR = 4.35, 95%CI = 1.89 to 10, p = 0.001), acute kidney injury (OR = 2.18, 95%CI = 1.28 to 3.74, p = 0.004), and mortality (HR = 2.82, 95%CI = 1.49 to 5.29, p = 0.01).
This cohort study found that neurological presentations are associated with higher odds of adverse events. When examining patients with neurological manifestations, clinicians should suspect COVID-19 to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.
几项研究描述了 COVID-19 感染的典型临床表现，包括发热、咳嗽、腹泻和疲劳。然而，关于入院时存在神经系统表现与疾病严重程度和结局之间的关联的数据有限。我们试图调查这种相关性，以帮助了解疾病负担。
我们进行了一项多中心回顾性研究，纳入了阳性实验室确诊的 COVID-19 患者。报告了临床特征、实验室值、并发症和结局数据。我们感兴趣的发现是入住重症监护病房（ICU）、插管、机械通气和院内死亡率。
共有 502 名患者，平均年龄为 60.83 ± 15.5 岁，其中 71 名（14.14%）患者出现精神状态改变，这些患者入住 ICU 的可能性更高（OR = 2.06，95%CI = 1.18 至 3.59，p = 0.01），需要机械通气（OR = 3.28，95%CI = 1.86 至 5.78，p < 0.001），需要延长（>4 天）机械通气（OR = 4.35，95%CI = 1.89 至 10，p = 0.001），急性肾损伤（OR = 2.18，95%CI = 1.28 至 3.74，p = 0.004）和死亡率（HR = 2.82，95%CI = 1.49 至 5.29，p = 0.01）。
这项队列研究发现，神经系统表现与不良事件的可能性更高相关。当检查有神经系统表现的患者时，临床医生应怀疑 COVID-19，以避免延迟诊断或误诊，失去治疗和预防进一步传播的机会。
