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. 2021 Nov;128(11):1687-1703.
doi: 10.1007/s00702-021-02400-5. Epub 2021 Aug 27.

COVID-19 outcomes of 10,881 patients: retrospective study of neurological symptoms and associated manifestations (Philippine CORONA Study)

Adrian I Espiritu #  1   2 , Marie Charmaine C Sy #  3 , Veeda Michelle M Anlacan  3 , Roland Dominic G Jamora  3 ; Philippine CORONA Study Group Investigators
Collaborators, Affiliations

COVID-19 outcomes of 10,881 patients: retrospective study of neurological symptoms and associated manifestations (Philippine CORONA Study)

Adrian I Espiritu et al. J Neural Transm (Vienna). 2021 Nov.

Abstract

Our study aimed to determine the effects of new-onset neurological symptoms (NNS) on clinically relevant outcomes in hospitalized patients with COVID-19 infection. We conducted a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from various regions in the Philippines. We included a total of 10,881 patients with confirmed COVID-19 infection (2008 had NNS while 8873 did not have NNS). The adjusted hazard ratios (aHRs) for mortality among the mild and severe cases were significantly higher by 1.660 (95% CI 1.132-2.435) and by 1.352 (95% CI 1.042-1.752), respectively, in the NNS group compared to those in the non-NNS group. The aHRs for respiratory failure in the NNS group were significantly increased by 1.914 (95% CI 1.346-2.722), by 1.614 (95% CI 1.260-2.068), and by 1.234 (95% CI 1.089-1.398) among the mild, severe, and critical cases, respectively. The aHRs for ICU admission in the NNS group were still significantly higher by 1.973 (95% CI 1.457-2.673) and by 1.831 (95% CI 1.506-2.226) among the mild and severe cases, respectively. Patients who had NNS were not significantly associated with a longer duration of ventilator dependence (adjusted odds ratio (aOR) 0.954, 95% CI 0.772-1.179), longer ICU stay (aOR 0.983, 95% CI 0.772-1.252) and longer hospital admission (aOR 1.045, 95% CI 0.947-1.153). The presence of NNS significantly increases the risk of mortality, respiratory failure and ICU admission among COVID-19 patients. Registration and associated protocol publication: ClinicalTrials.gov website (NCT04386083); Espiritu AI, Sy MCC, Anlacan VMM, Jamora RDG. The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA study): a protocol study. BMJ Open. 2020;10:e040944.

Keywords: COVID-19; Cohort study; Intensive care unit admission; Mortality; New-onset neurological symptoms; Respiratory failure.

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Conflict of interest statement

All authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

Fig. 1
Fig. 1
Flow of patients in the Philippine CORONA study
Fig. 2
Fig. 2
Cumulative hazard by exposure to new-onset neurological symptoms for A mortality, B intensive care unit admission and C respiratory failure
See this image and copyright information in PMC

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