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. 2023 Jun 15;12(12):4065.
doi: 10.3390/jcm12124065.

Neurological Manifestations and Complications of the Central Nervous System as Risk Factors and Predictors of Mortality in Patients Hospitalized with COVID-19: A Cohort Study

Ana Luisa Corona-Nakamura  1 , Martha Judith Arias-Merino  2 , Rayo Morfín-Otero  3 , Guillermo Rodriguez-Zavala  1 , Alfredo León-Gil  1 , Juan Ramsés Camarillo-Escalera  1 , Idarmis Brisseida Reyes-Cortés  1 , María Gisela Valdovinos-Ortega  1 , Erick René Nava-Escobar  1 , Ana María de la Paz Villaseñor-Corona  1 , Mario Alberto Mireles-Ramírez  1 , Aldo Guadalupe Cisneros-Aréchiga  1 , Ofelia Padilla-De la Torre  1 , Héctor Raúl Pérez-Gómez  3 , Eduardo Rodríguez-Noriega  3
Affiliations

Neurological Manifestations and Complications of the Central Nervous System as Risk Factors and Predictors of Mortality in Patients Hospitalized with COVID-19: A Cohort Study

Ana Luisa Corona-Nakamura et al. J Clin Med. .

Abstract

The aim of this study was to analyze the risk factors and predictors of mortality in a retrospective cohort of patients with coronavirus disease (COVID-19) who presented central nervous system (CNS) manifestations and complications when admitted to hospital. Patients hospitalized from 2020 to 2022 were selected. Demographic variables; history of neurological, cardiological and pulmonary manifestations; comorbidities; prognostic severity scales; and laboratory tests were included. Univariate and adjusted analyses were performed to determine risk factors and predictors of mortality. A forest plot diagram was used to show the strength of the associated risk factors. The cohort included 991 patients; at admission, 463 patients presented CNS damage and of these, 96 hospitalized patients presented de novo CNS manifestations and complications. We estimate a general mortality of 43.7% (433/991) and 77.1% (74/96), for hospitalized patients with de novo CNS manifestations and complications, respectively. The following were identified as risks for the development of hospital CNS manifestations and complications when in hospital: an age of ≥64 years, a history of neurological disease, de novo deep vein thrombosis, D-dimer ≥ 1000 ng/dL, a SOFA ≥ 5, and a CORADS 6. In a multivariable analysis, the mortality predictors were an age of ≥64 years, a SOFA ≥ 5, D-dimer ≥ 1000 ng/mL and hospital CNS manifestations and complications when admitted to hospital. Old age, being hospitalized in critical condition, and having CNS manifestations and complications in hospital are predictors of mortality in hospitalized patients with COVID-19.

Keywords: COVID-19; central nervous system; predictors of mortality; risk factors.

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Conflict of interest statement

The authors of this research study declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram. CNS, central nervous system.
Figure 2
Figure 2
Forest plot of risk factors associated with CNS manifestations and complications in patients hospitalized with COVID-19.
See this image and copyright information in PMC

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