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. 2021 Jun 17;3(3):fcab135.
doi: 10.1093/braincomms/fcab135. eCollection 2021.

The wide spectrum of COVID-19 neuropsychiatric complications within a multidisciplinary centre

Cécile Delorme  1 , Marion Houot  1 , Charlotte Rosso  1 , Stéphanie Carvalho  1 , Thomas Nedelec  1 , Redwan Maatoug  1 , Victor Pitron  2 , Salimata Gassama  3 , Sara Sambin  1 , Stéphanie Bombois  4 , Bastien Herlin  5 , Gaëlle Ouvrard  6 , Gaëlle Bruneteau  3 , Adèle Hesters  3 , Ana Zenovia Gales  7 , Bruno Millet  1 , Foudil Lamari  8 , Stéphane Lehericy  1 , Vincent Navarro  1 , Benjamin Rohaut  1 , Sophie Demeret  3 , Thierry Maisonobe  3 , Marion Yger  9 , Bertrand Degos  10 , Louise-Laure Mariani  1 , Christophe Bouche  2 , Nathalie Dzierzynski  11 , Bruno Oquendo  12 , Flora Ketz  13 , An-Hung Nguyen  14 , Aurélie Kas  15 , Catherine Lubetzki  1 , Jean-Yves Delattre  1 , Jean-Christophe Corvol  1 ; CoCo-Neurosciences Study Group
Collaborators, Affiliations

The wide spectrum of COVID-19 neuropsychiatric complications within a multidisciplinary centre

Cécile Delorme et al. Brain Commun. .

Abstract

A variety of neuropsychiatric complications has been described in association with COVID-19 infection. Large scale studies presenting a wider picture of these complications and their relative frequency are lacking. The objective of our study was to describe the spectrum of neurological and psychiatric complications in patients with COVID-19 seen in a multidisciplinary hospital centre over 6 months. We conducted a retrospective, observational study of all patients showing neurological or psychiatric symptoms in the context of COVID-19 seen in the medical and university neuroscience department of Assistance Publique Hopitaux de Paris-Sorbonne University. We collected demographic data, comorbidities, symptoms and severity of COVID-19 infection, neurological and psychiatric symptoms, neurological and psychiatric examination data and, when available, results from CSF analysis, MRI, EEG and EMG. A total of 249 COVID-19 patients with a de novo neurological or psychiatric manifestation were included in the database and 245 were included in the final analyses. One-hundred fourteen patients (47%) were admitted to the intensive care unit and 10 (4%) died. The most frequent neuropsychiatric complications diagnosed were encephalopathy (43%), critical illness polyneuropathy and myopathy (26%), isolated psychiatric disturbance (18%) and cerebrovascular disorders (16%). No patients showed CSF evidence of SARS-CoV-2. Encephalopathy was associated with older age and higher risk of death. Critical illness neuromyopathy was associated with an extended stay in the intensive care unit. The majority of these neuropsychiatric complications could be imputed to critical illness, intensive care and systemic inflammation, which contrasts with the paucity of more direct SARS-CoV-2-related complications or post-infection disorders.

Keywords: COVID-19; critical illness neuropathy; encephalitis; encephalopathy.

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Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Neuropsychiatric symptoms and their delays since Covid-19 onset. (A) Neuropsychiatric symptoms repartition. For each symptom, the number and percentage of non-missing patients is given below. (B) Delay between symptom and COVID onset for each symptom. Median, first and third quartiles are represented. The number of subjects with the symptom as well as the percentage of available delays among them are given below.
Figure 2
Figure 2
Final neuropsychiatric diagnoses and their delays since Covid-19 onset. (A) Neuropsychiatric syndromes repartition. For each syndrome, the number and percentage of non-missing patients is given below. (B) Delay between syndrome and COVID onset for each syndrome. Median, first and third quartiles are represented. The number of subjects with the syndrome as well as the percentage of available delays among them are given below.
Figure 3
Figure 3
Statistical associations between neuropsychiatric syndromes and risk factors. Correlation matrix between neuropsychiatric syndromes, comorbidities and other related variables. Shades of red indicates a positive correlation. The variables were clustered by minimizing the single linkage distance.
See this image and copyright information in PMC

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