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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...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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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 |
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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 |
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