Cargando…

Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants

BACKGROUND AND OBJECTIVES: A variety of neurologic disorders have been reported as presentations or complications of coronavirus disease 2019 (COVID-19) infection. The objective of this study was to determine their incidence dynamics and long-term functional outcome. METHODS: The Neuro-COVID Italy s...

Descripción completa

Detalles Bibliográficos
Autores principales: Beretta, Simone, Cristillo, Viviana, Camera, Giorgia, Morotti Colleoni, Carlo, Pellitteri, Gaia, Viti, Beatrice, Bianchi, Elisa, Gipponi, Stefano, Grimoldi, Maria, Valente, Mariarosaria, Guttmann, Susanna, Cotelli, Maria Sofia, Palumbo, Pasquale, Gelosa, Giorgio, Meletti, Stefano, Schenone, Cristina, Ottaviani, Donatella, Filippi, Massimo, Zini, Andrea, Basilico, Paola, Tancredi, Lucia, Cortelli, Pietro, Braga, Massimiliano, De Giuli, Valeria, Servidei, Serenella, Paolicelli, Damiano, Verde, Federico, Caproni, Stefano, Pisani, Antonio, Lo Re, Vincenzina, Massacesi, Luca, Roccatagliata, Daria Valeria, Manganotti, Paolo, Spitaleri, Daniele, Formenti, Anna, Piccoli, Marta, Marino, Silvia, Polverino, Paola, Aguglia, Umberto, Ornello, Raffaele, Perego, Elisabetta, Siciliano, Gabriele, Merlo, Paola, Capobianco, Marco, Pantoni, Leonardo, Lugaresi, Alessandra, Angelocola, Stefania, De Rosa, Anna, Sessa, Maria, Beghi, Ettore, Agostoni, Elio Clemente, Monaco, Salvatore, Padovani, Alessandro, Priori, Alberto, Silani, Vincenzo, Tedeschi, Gioacchino, Ferrarese, Carlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501088/
https://www.ncbi.nlm.nih.gov/pubmed/37414564
http://dx.doi.org/10.1212/WNL.0000000000207534
_version_ 1785106050669608960
author Beretta, Simone
Cristillo, Viviana
Camera, Giorgia
Morotti Colleoni, Carlo
Pellitteri, Gaia
Viti, Beatrice
Bianchi, Elisa
Gipponi, Stefano
Grimoldi, Maria
Valente, Mariarosaria
Guttmann, Susanna
Cotelli, Maria Sofia
Palumbo, Pasquale
Gelosa, Giorgio
Meletti, Stefano
Schenone, Cristina
Ottaviani, Donatella
Filippi, Massimo
Zini, Andrea
Basilico, Paola
Tancredi, Lucia
Cortelli, Pietro
Braga, Massimiliano
De Giuli, Valeria
Servidei, Serenella
Paolicelli, Damiano
Verde, Federico
Caproni, Stefano
Pisani, Antonio
Lo Re, Vincenzina
Massacesi, Luca
Roccatagliata, Daria Valeria
Manganotti, Paolo
Spitaleri, Daniele
Formenti, Anna
Piccoli, Marta
Marino, Silvia
Polverino, Paola
Aguglia, Umberto
Ornello, Raffaele
Perego, Elisabetta
Siciliano, Gabriele
Merlo, Paola
Capobianco, Marco
Pantoni, Leonardo
Lugaresi, Alessandra
Angelocola, Stefania
De Rosa, Anna
Sessa, Maria
Beghi, Ettore
Agostoni, Elio Clemente
Monaco, Salvatore
Padovani, Alessandro
Priori, Alberto
Silani, Vincenzo
Tedeschi, Gioacchino
Ferrarese, Carlo
author_facet Beretta, Simone
Cristillo, Viviana
Camera, Giorgia
Morotti Colleoni, Carlo
Pellitteri, Gaia
Viti, Beatrice
Bianchi, Elisa
Gipponi, Stefano
Grimoldi, Maria
Valente, Mariarosaria
Guttmann, Susanna
Cotelli, Maria Sofia
Palumbo, Pasquale
Gelosa, Giorgio
Meletti, Stefano
Schenone, Cristina
Ottaviani, Donatella
Filippi, Massimo
Zini, Andrea
Basilico, Paola
Tancredi, Lucia
Cortelli, Pietro
Braga, Massimiliano
De Giuli, Valeria
Servidei, Serenella
Paolicelli, Damiano
Verde, Federico
Caproni, Stefano
Pisani, Antonio
Lo Re, Vincenzina
Massacesi, Luca
Roccatagliata, Daria Valeria
Manganotti, Paolo
Spitaleri, Daniele
Formenti, Anna
Piccoli, Marta
Marino, Silvia
Polverino, Paola
Aguglia, Umberto
Ornello, Raffaele
Perego, Elisabetta
Siciliano, Gabriele
Merlo, Paola
Capobianco, Marco
Pantoni, Leonardo
Lugaresi, Alessandra
Angelocola, Stefania
De Rosa, Anna
Sessa, Maria
Beghi, Ettore
Agostoni, Elio Clemente
Monaco, Salvatore
Padovani, Alessandro
Priori, Alberto
Silani, Vincenzo
Tedeschi, Gioacchino
Ferrarese, Carlo
author_sort Beretta, Simone
collection PubMed
description BACKGROUND AND OBJECTIVES: A variety of neurologic disorders have been reported as presentations or complications of coronavirus disease 2019 (COVID-19) infection. The objective of this study was to determine their incidence dynamics and long-term functional outcome. METHODS: The Neuro-COVID Italy study was a multicenter, observational, cohort study with ambispective recruitment and prospective follow-up. Consecutive hospitalized patients presenting new neurologic disorders associated with COVID-19 infection (neuro-COVID), independently from respiratory severity, were systematically screened and actively recruited by neurology specialists in 38 centers in Italy and the Republic of San Marino. The primary outcomes were incidence of neuro-COVID cases during the first 70 weeks of the pandemic (March 2020–June 2021) and long-term functional outcome at 6 months, categorized as full recovery, mild symptoms, disabling symptoms, or death. RESULTS: Among 52,759 hospitalized patients with COVID-19, 1,865 patients presenting 2,881 new neurologic disorders associated with COVID-19 infection (neuro-COVID) were recruited. The incidence of neuro-COVID cases significantly declined over time, comparing the first 3 pandemic waves (8.4%, 95% CI 7.9–8.9; 5.0%, 95% CI 4.7–5.3; 3.3%, 95% CI 3.0–3.6, respectively; p = 0.027). The most frequent neurologic disorders were acute encephalopathy (25.2%), hyposmia-hypogeusia (20.2%), acute ischemic stroke (18.4%), and cognitive impairment (13.7%). The onset of neurologic disorders was more common in the prodromic phase (44.3%) or during the acute respiratory illness (40.9%), except for cognitive impairment whose onset prevailed during recovery (48.4%). A good functional outcome was achieved by most patients with neuro-COVID (64.6%) during follow-up (median 6.7 months), and the proportion of good outcome increased throughout the study period (r = 0.29, 95% CI 0.05–0.50; p = 0.019). Mild residual symptoms were frequently reported (28.1%) while disabling symptoms were common only in stroke survivors (47.6%). DISCUSSION: Incidence of COVID-associated neurologic disorders decreased during the prevaccination phase of the pandemic. Long-term functional outcome was favorable in most neuro-COVID disorders, although mild symptoms commonly lasted more than 6 months after infection.
format Online
Article
Text
id pubmed-10501088
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-105010882023-09-15 Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants Beretta, Simone Cristillo, Viviana Camera, Giorgia Morotti Colleoni, Carlo Pellitteri, Gaia Viti, Beatrice Bianchi, Elisa Gipponi, Stefano Grimoldi, Maria Valente, Mariarosaria Guttmann, Susanna Cotelli, Maria Sofia Palumbo, Pasquale Gelosa, Giorgio Meletti, Stefano Schenone, Cristina Ottaviani, Donatella Filippi, Massimo Zini, Andrea Basilico, Paola Tancredi, Lucia Cortelli, Pietro Braga, Massimiliano De Giuli, Valeria Servidei, Serenella Paolicelli, Damiano Verde, Federico Caproni, Stefano Pisani, Antonio Lo Re, Vincenzina Massacesi, Luca Roccatagliata, Daria Valeria Manganotti, Paolo Spitaleri, Daniele Formenti, Anna Piccoli, Marta Marino, Silvia Polverino, Paola Aguglia, Umberto Ornello, Raffaele Perego, Elisabetta Siciliano, Gabriele Merlo, Paola Capobianco, Marco Pantoni, Leonardo Lugaresi, Alessandra Angelocola, Stefania De Rosa, Anna Sessa, Maria Beghi, Ettore Agostoni, Elio Clemente Monaco, Salvatore Padovani, Alessandro Priori, Alberto Silani, Vincenzo Tedeschi, Gioacchino Ferrarese, Carlo Neurology Research Article BACKGROUND AND OBJECTIVES: A variety of neurologic disorders have been reported as presentations or complications of coronavirus disease 2019 (COVID-19) infection. The objective of this study was to determine their incidence dynamics and long-term functional outcome. METHODS: The Neuro-COVID Italy study was a multicenter, observational, cohort study with ambispective recruitment and prospective follow-up. Consecutive hospitalized patients presenting new neurologic disorders associated with COVID-19 infection (neuro-COVID), independently from respiratory severity, were systematically screened and actively recruited by neurology specialists in 38 centers in Italy and the Republic of San Marino. The primary outcomes were incidence of neuro-COVID cases during the first 70 weeks of the pandemic (March 2020–June 2021) and long-term functional outcome at 6 months, categorized as full recovery, mild symptoms, disabling symptoms, or death. RESULTS: Among 52,759 hospitalized patients with COVID-19, 1,865 patients presenting 2,881 new neurologic disorders associated with COVID-19 infection (neuro-COVID) were recruited. The incidence of neuro-COVID cases significantly declined over time, comparing the first 3 pandemic waves (8.4%, 95% CI 7.9–8.9; 5.0%, 95% CI 4.7–5.3; 3.3%, 95% CI 3.0–3.6, respectively; p = 0.027). The most frequent neurologic disorders were acute encephalopathy (25.2%), hyposmia-hypogeusia (20.2%), acute ischemic stroke (18.4%), and cognitive impairment (13.7%). The onset of neurologic disorders was more common in the prodromic phase (44.3%) or during the acute respiratory illness (40.9%), except for cognitive impairment whose onset prevailed during recovery (48.4%). A good functional outcome was achieved by most patients with neuro-COVID (64.6%) during follow-up (median 6.7 months), and the proportion of good outcome increased throughout the study period (r = 0.29, 95% CI 0.05–0.50; p = 0.019). Mild residual symptoms were frequently reported (28.1%) while disabling symptoms were common only in stroke survivors (47.6%). DISCUSSION: Incidence of COVID-associated neurologic disorders decreased during the prevaccination phase of the pandemic. Long-term functional outcome was favorable in most neuro-COVID disorders, although mild symptoms commonly lasted more than 6 months after infection. Lippincott Williams & Wilkins 2023-08-29 /pmc/articles/PMC10501088/ /pubmed/37414564 http://dx.doi.org/10.1212/WNL.0000000000207534 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Beretta, Simone
Cristillo, Viviana
Camera, Giorgia
Morotti Colleoni, Carlo
Pellitteri, Gaia
Viti, Beatrice
Bianchi, Elisa
Gipponi, Stefano
Grimoldi, Maria
Valente, Mariarosaria
Guttmann, Susanna
Cotelli, Maria Sofia
Palumbo, Pasquale
Gelosa, Giorgio
Meletti, Stefano
Schenone, Cristina
Ottaviani, Donatella
Filippi, Massimo
Zini, Andrea
Basilico, Paola
Tancredi, Lucia
Cortelli, Pietro
Braga, Massimiliano
De Giuli, Valeria
Servidei, Serenella
Paolicelli, Damiano
Verde, Federico
Caproni, Stefano
Pisani, Antonio
Lo Re, Vincenzina
Massacesi, Luca
Roccatagliata, Daria Valeria
Manganotti, Paolo
Spitaleri, Daniele
Formenti, Anna
Piccoli, Marta
Marino, Silvia
Polverino, Paola
Aguglia, Umberto
Ornello, Raffaele
Perego, Elisabetta
Siciliano, Gabriele
Merlo, Paola
Capobianco, Marco
Pantoni, Leonardo
Lugaresi, Alessandra
Angelocola, Stefania
De Rosa, Anna
Sessa, Maria
Beghi, Ettore
Agostoni, Elio Clemente
Monaco, Salvatore
Padovani, Alessandro
Priori, Alberto
Silani, Vincenzo
Tedeschi, Gioacchino
Ferrarese, Carlo
Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants
title Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants
title_full Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants
title_fullStr Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants
title_full_unstemmed Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants
title_short Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants
title_sort incidence and long-term functional outcome of neurologic disorders in hospitalized patients with covid-19 infected with pre-omicron variants
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501088/
https://www.ncbi.nlm.nih.gov/pubmed/37414564
http://dx.doi.org/10.1212/WNL.0000000000207534
work_keys_str_mv AT berettasimone incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT cristilloviviana incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT cameragiorgia incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT morotticolleonicarlo incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT pellitterigaia incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT vitibeatrice incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT bianchielisa incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT gipponistefano incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT grimoldimaria incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT valentemariarosaria incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT guttmannsusanna incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT cotellimariasofia incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT palumbopasquale incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT gelosagiorgio incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT melettistefano incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT schenonecristina incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT ottavianidonatella incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT filippimassimo incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT ziniandrea incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT basilicopaola incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT tancredilucia incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT cortellipietro incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT bragamassimiliano incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT degiulivaleria incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT servideiserenella incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT paolicellidamiano incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT verdefederico incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT capronistefano incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT pisaniantonio incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT lorevincenzina incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT massacesiluca incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT roccatagliatadariavaleria incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT manganottipaolo incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT spitaleridaniele incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT formentianna incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT piccolimarta incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT marinosilvia incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT polverinopaola incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT agugliaumberto incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT ornelloraffaele incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT peregoelisabetta incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT sicilianogabriele incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT merlopaola incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT capobiancomarco incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT pantonileonardo incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT lugaresialessandra incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT angelocolastefania incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT derosaanna incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT sessamaria incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT beghiettore incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT agostonielioclemente incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT monacosalvatore incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT padovanialessandro incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT priorialberto incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT silanivincenzo incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT tedeschigioacchino incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT ferraresecarlo incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants
AT incidenceandlongtermfunctionaloutcomeofneurologicdisordersinhospitalizedpatientswithcovid19infectedwithpreomicronvariants