Neurological Manifestations of SARS-CoV-2 Infection: Protocol for a Sub-analysis of the COVID-19 Critical Care Consortium Observational Study

doi:10.3389/fmed.2022.930217

. 2022 Jul 22:9:930217.

doi: 10.3389/fmed.2022.930217. eCollection 2022.

Neurological Manifestations of SARS-CoV-2 Infection: Protocol for a Sub-analysis of the COVID-19 Critical Care Consortium Observational Study

Denise Battaglini^{1

2}, Lavienraj Premraj^{3

4}, Matthew Griffee⁵, Samuel Huth^{4

6}, Jonathon Fanning^{4

6}, Glenn Whitman⁷, Diego Bastos Porto⁸, Rakesh Arora^{9

10}, Lucian Durham¹¹, Eric Gnall^{12

13}, Marcelo Amato¹⁴, Virginie Williams¹⁵, Alexandre Noel¹⁵, Sabrina Araujo De Franca¹⁵, Gordan Samoukovic¹⁶, Bambang Pujo¹⁷, David Kent¹⁸, Eva Marwali¹⁹, Abdulrahman Al-Fares^{20

21}, Stephanie-Susanne Stecher²², Mauro Panigada²³, Marco Giani^{24

25}, Giuseppe Foti^{24

25}, Paolo Pelosi^{1

26}, Antonio Pesenti^{23

27}, Nicole Marie White²⁸, Gianluigi Li Bassi^{4

6

29}, Jacky Suen⁴, John F Fraser^{4

30}, Chiara Robba^{1

26}, Sung-Min Cho⁷

Affiliations

¹ Anesthesia and Intensive Care, San Martino Policlinico Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) for Oncology and Neurosciences, Genoa, Italy.
² Department of Medicine, University of Barcelona, Barcelona, Spain.
³ Griffith University School of Medicine, Gold Coast, QLD, Australia.
⁴ Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.
⁵ Department of Anesthesiology and Perioperative Medicine, University of Utah, Salt Lake City, UT, United States.
⁶ Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
⁷ Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
⁸ Hospital Sao Camilo de Esteio, Esteio, Brazil.
⁹ Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
¹⁰ Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, MB, Canada.
¹¹ Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States.
¹² Division of Cardiovascular Diseases, Lankenau Medical Center and Lankenau Institute of Medical Research, Wynnewood, PA, United States.
¹³ Jefferson Medical College, Philadelphia, PA, United States.
¹⁴ Laboratório de Pneumologia LIM-09, Disciplina de Pneumologia, Heart Institute (Incor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
¹⁵ Équipe de Recherche en Soins Intensifs (ERESI), Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Coeur-de-Montréal, 5400 boulevard Gouin Ouest, K-3000, Montreal, QC, Canada.
¹⁶ Division of Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada.
¹⁷ Department of Anesthesiology and Reanimation, Dr. Soetomo Academic Hospital, Surabaya, Indonesia.
¹⁸ Institute for Clinical Research and Health Policy Studies, Tufts Medical Center/Tufts University School of Medicine, Boston, MA, United States.
¹⁹ Pediatric Cardiac Intensive Care Division, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
²⁰ Kuwait Extracorporeal Life Support Program, Ministry of Health, Kuwait City, Kuwait.
²¹ Department of Anesthesia and Critical Care Medicine, Al-Amiri Hospital, Kuwait City, Kuwait.
²² Department of Medicine 2, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
²³ Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
²⁴ Emergency Department, Azienda Socio Sanitaria Territoriale (ASST) Monza - San Gerardo Hospital, Monza, Italy.
²⁵ University of Milano-Bicocca, Milan, Italy.
²⁶ Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
²⁷ Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
²⁸ Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
²⁹ Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain.
³⁰ Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia.

PMID: 35935771
PMCID: PMC9355612
DOI: 10.3389/fmed.2022.930217

Neurological Manifestations of SARS-CoV-2 Infection: Protocol for a Sub-analysis of the COVID-19 Critical Care Consortium Observational Study

Denise Battaglini et al. Front Med (Lausanne). 2022.

. 2022 Jul 22:9:930217.

doi: 10.3389/fmed.2022.930217. eCollection 2022.

Authors

Affiliations

¹ Anesthesia and Intensive Care, San Martino Policlinico Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) for Oncology and Neurosciences, Genoa, Italy.
² Department of Medicine, University of Barcelona, Barcelona, Spain.
³ Griffith University School of Medicine, Gold Coast, QLD, Australia.
⁴ Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.
⁵ Department of Anesthesiology and Perioperative Medicine, University of Utah, Salt Lake City, UT, United States.
⁶ Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
⁷ Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
⁸ Hospital Sao Camilo de Esteio, Esteio, Brazil.
⁹ Section of Cardiac Surgery, Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
¹⁰ Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, MB, Canada.
¹¹ Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States.
¹² Division of Cardiovascular Diseases, Lankenau Medical Center and Lankenau Institute of Medical Research, Wynnewood, PA, United States.
¹³ Jefferson Medical College, Philadelphia, PA, United States.
¹⁴ Laboratório de Pneumologia LIM-09, Disciplina de Pneumologia, Heart Institute (Incor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
¹⁵ Équipe de Recherche en Soins Intensifs (ERESI), Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Coeur-de-Montréal, 5400 boulevard Gouin Ouest, K-3000, Montreal, QC, Canada.
¹⁶ Division of Critical Care Medicine, McGill University Health Centre, Montreal, QC, Canada.
¹⁷ Department of Anesthesiology and Reanimation, Dr. Soetomo Academic Hospital, Surabaya, Indonesia.
¹⁸ Institute for Clinical Research and Health Policy Studies, Tufts Medical Center/Tufts University School of Medicine, Boston, MA, United States.
¹⁹ Pediatric Cardiac Intensive Care Division, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
²⁰ Kuwait Extracorporeal Life Support Program, Ministry of Health, Kuwait City, Kuwait.
²¹ Department of Anesthesia and Critical Care Medicine, Al-Amiri Hospital, Kuwait City, Kuwait.
²² Department of Medicine 2, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
²³ Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
²⁴ Emergency Department, Azienda Socio Sanitaria Territoriale (ASST) Monza - San Gerardo Hospital, Monza, Italy.
²⁵ University of Milano-Bicocca, Milan, Italy.
²⁶ Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
²⁷ Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
²⁸ Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
²⁹ Institut d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain.
³⁰ Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia.

PMID: 35935771
PMCID: PMC9355612
DOI: 10.3389/fmed.2022.930217

Abstract

Introduction: Neurological manifestations and complications in coronavirus disease-2019 (COVID-19) patients are frequent. Prior studies suggested a possible association between neurological complications and fatal outcome, as well as the existence of potential modifiable risk factors associated to their occurrence. Therefore, more information is needed regarding the incidence and type of neurological complications, risk factors, and associated outcomes in COVID-19.

Methods: This is a pre-planned secondary analysis of the international multicenter observational study of the COVID-19 Critical Care Consortium (which collected data both retrospectively and prospectively from the beginning of COVID-19 pandemic) with the aim to describe neurological complications in critically ill COVID-19 patients and to assess the associated risk factors, and outcomes. Adult patients with confirmed COVID-19, admitted to Intensive Care Unit (ICU) will be considered for this analysis. Data collected in the COVID-19 Critical Care Consortium study includes patients' pre-admission characteristics, comorbidities, severity status, and type and severity of neurological complications. In-hospital mortality and neurological outcome were collected at discharge from ICU, and at 28-days.

Ethics and dissemination: The COVID-19 Critical Care Consortium main study and its amendments have been approved by the Regional Ethics Committee of participating sites. No further approval is required for this secondary analysis.

Trial registration number: ACTRN12620000421932.

Keywords: COVID-19; disability; neurological complications; neurological outcome; stroke.

Copyright © 2022 Battaglini, Premraj, Griffee, Huth, Fanning, Whitman, Bastos Porto, Arora, Durham, Gnall, Amato, Williams, Noel, De Franca, Samoukovic, Pujo, Kent, Marwali, Al-Fares, Stecher, Panigada, Giani, Foti, Pelosi, Pesenti, White, Li Bassi, Suen, Fraser, Robba, Cho and the COVID-19 Critical Care Consortium.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Modified Rankin Scale (mRS). The Modified Rankin Score (mRS) is a 6-point disability scale with possible scores ranging from 0 to 6 (from 0 = no symptoms to 6 = dead). A score of 0–3 indicate mild to moderate disability and a score of 4–5 indicate severe disability. From Wade (22).

See this image and copyright information in PMC

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References

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1. Chou SH-Y, Beghi E, Helbok R, Moro E, Sampson J, Altamirano V, et al. . Global incidence of neurological manifestations among patients hospitalized with COVID-19—a report for the GCS-NeuroCOVID consortium and the ENERGY consortium. JAMA Netw Open. (2021) 4:e2112131. 10.1001/jamanetworkopen.2021.12131 - DOI - PMC - PubMed
1. Yassin A, Nawaiseh M, Shaban A, Alsherbini K, El-Salem K, Soudah O, et al. . Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. BMC Neurol. (2021) 21:138. 10.1186/s12883-021-02161-4 - DOI - PMC - PubMed
1. Huth SF, Cho S-M, Robba C, Highton D, Battaglini D, Bellapart J, et al. . Neurological manifestations of coronavirus disease 2019: a comprehensive review and meta-analysis of the first 6 months of pandemic reporting. Front Neurol. (2021) 12:664599. 10.3389/fneur.2021.664599 - DOI - PMC - PubMed
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[1] Wong CKH, Wong JYH, Tang EHM, Au CH, Wai AKC. Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis. Sci Rep. (2020) 10:19765. 10.1038/s41598-020-74988-9 - DOI - PMC - PubMed

[2] Wong CKH, Wong JYH, Tang EHM, Au CH, Wai AKC. Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis. Sci Rep. (2020) 10:19765. 10.1038/s41598-020-74988-9 - DOI - PMC - PubMed

[3] Chou SH-Y, Beghi E, Helbok R, Moro E, Sampson J, Altamirano V, et al. . Global incidence of neurological manifestations among patients hospitalized with COVID-19—a report for the GCS-NeuroCOVID consortium and the ENERGY consortium. JAMA Netw Open. (2021) 4:e2112131. 10.1001/jamanetworkopen.2021.12131 - DOI - PMC - PubMed

[4] Chou SH-Y, Beghi E, Helbok R, Moro E, Sampson J, Altamirano V, et al. . Global incidence of neurological manifestations among patients hospitalized with COVID-19—a report for the GCS-NeuroCOVID consortium and the ENERGY consortium. JAMA Netw Open. (2021) 4:e2112131. 10.1001/jamanetworkopen.2021.12131 - DOI - PMC - PubMed

[5] Yassin A, Nawaiseh M, Shaban A, Alsherbini K, El-Salem K, Soudah O, et al. . Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. BMC Neurol. (2021) 21:138. 10.1186/s12883-021-02161-4 - DOI - PMC - PubMed

[6] Yassin A, Nawaiseh M, Shaban A, Alsherbini K, El-Salem K, Soudah O, et al. . Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. BMC Neurol. (2021) 21:138. 10.1186/s12883-021-02161-4 - DOI - PMC - PubMed

[7] Huth SF, Cho S-M, Robba C, Highton D, Battaglini D, Bellapart J, et al. . Neurological manifestations of coronavirus disease 2019: a comprehensive review and meta-analysis of the first 6 months of pandemic reporting. Front Neurol. (2021) 12:664599. 10.3389/fneur.2021.664599 - DOI - PMC - PubMed

[8] Huth SF, Cho S-M, Robba C, Highton D, Battaglini D, Bellapart J, et al. . Neurological manifestations of coronavirus disease 2019: a comprehensive review and meta-analysis of the first 6 months of pandemic reporting. Front Neurol. (2021) 12:664599. 10.3389/fneur.2021.664599 - DOI - PMC - PubMed

[9] Misra S, Kolappa K, Prasad M, Radhakrishnan D, Thakur KT, Solomon T, et al. . Frequency of neurologic manifestations in COVID-19. Neurology. (2021) 97:e2269–81. 10.1212/WNL.0000000000012930 - DOI - PMC - PubMed

[10] Misra S, Kolappa K, Prasad M, Radhakrishnan D, Thakur KT, Solomon T, et al. . Frequency of neurologic manifestations in COVID-19. Neurology. (2021) 97:e2269–81. 10.1212/WNL.0000000000012930 - DOI - PMC - PubMed

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Neurological Manifestations of SARS-CoV-2 Infection: Protocol for a Sub-analysis of the COVID-19 Critical Care Consortium Observational Study

Affiliations

Neurological Manifestations of SARS-CoV-2 Infection: Protocol for a Sub-analysis of the COVID-19 Critical Care Consortium Observational Study

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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