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. 2022 Mar-Apr;25(2):218-223.
doi: 10.4103/aian.aian_602_21. Epub 2022 Mar 1.

Comparison of Disease Profiles and Three-Month Outcomes of Patients with Neurological Disorders with and without COVID-19: An Ambispective Cohort Study

Kanchana S Pillai  1 , Deepti Vibha  1 , Pranjal Gupta  1 , Pachipala Sudheer  1 , Biswamohan Mishra  1 , Rahul S Oinam  1 , Ayush Mohan  1 , Kamalesh Tayade  1 , Padma Srivastava  1 , Manjari Tripathi  1 , Achal K Srivastava  1 , Rohit Bhatia  1 , Roopa Rajan  1 , Awadh K Pandit  1 , Rajesh K Singh  1 , Arunmozhimaran Elavarasi  1 , Ayush Agarwal  1 , Anu Gupta  1 , Animesh Das  1 , Divya M Radhakrishnan  1 , Bhargavi Ramanujam  1 , Kapil D Soni  2 , Richa Aggarwal  2 , Naveet Wig  3 , Anjan Trikha  2
Affiliations

Comparison of Disease Profiles and Three-Month Outcomes of Patients with Neurological Disorders with and without COVID-19: An Ambispective Cohort Study

Kanchana S Pillai et al. Ann Indian Acad Neurol. 2022 Mar-Apr.

Abstract

Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-CoV-2 infection.

Methods: In an ambispective cohort study design, we enrolled patients with and without SARS CoV-2 infection coming to a medical emergency with neurological disorders between April 2020 and September 2020. Demographic, clinical, biochemical, and treatment details of these patients were collected and compared. Their outcomes, both in-hospital and at 3 months were assessed by the modified Rankin Scale (mRS).

Results: Two thirty-five patients (235) were enrolled from emergency services with neurological disorders. Of them, 81 (34.5%) were COVID-19 positive. The mean (SD) age was 49.5 (17.3) years, and the majority of the patients were male (63.0%). The commonest neurological diagnosis was acute ischemic stroke (AIS) (43.0%). The in-hospital mortality was higher in the patients who were COVID-19 positive (COVID-19 positive: 29 (35.8%) versus COVID-19 negative: 12 (7.8%), P value: <0.001). The 3 months telephonic follow-up could be completed in 73.2% of the patients (142/194). Four (12.1%) deaths occurred on follow-up in the COVID-19 positive versus fifteen (13.8%) in the COVID-19 negative patients (P value: 1.00). The 3-month mRS was worse in the COVID-19 positive group (P value <0.001). However, this was driven by higher in-hospital morbidity and mortality in COVID-19 positive patients.

Conclusion: Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital and 3 months disability.

Keywords: 3- months follow-up; Ambispective cohort study; COVID-19 neurology; in-hospital mortality; modified Rankin Scale.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram showing patient enrollment and follow-up
Figure 2
Figure 2
Shift analysis showing modified Rankin Scale (mRS) at 3 months in the COVID-19 positive and COVID-19 negative groups
See this image and copyright information in PMC

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