Journal article
Neurological manifestations of COVID-19 in adults and children
Brain (London, England : 1878), Vol.146(4), pp.1648-1661
04/03/2023
DOI: 10.1093/brain/awac332
PMCID: PMC9494397
PMID: 36087305
Abstract
Abstract Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P < 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age.
Details
- Title: Subtitle
- Neurological manifestations of COVID-19 in adults and children
- Creators
- Sung-Min Cho - Johns Hopkins MedicineLovkesh AroraNicole White - Queensland University of TechnologyLavienraj Premraj - Griffith UniversityDenise Battaglini - University of GenoaJonathon Fanning - University of QueenslandJacky Suen - University of QueenslandGianluigi Li Bassi - Queensland University of TechnologyJohn Fraser - Prince Charles HospitalChiara Robba - University of GenoaMatthew Griffee - University of UtahBhagteshwar Singh - Health Protection Research Unit in Emerging and Zoonotic Infections at University of LiverpoolLaura Merson - University of OxfordTom Solomon - University of LiverpoolDavid Thomson - University of Cape TownAli AbbasNurul Najmee AbdulkadirRyuzo AbeLaurent AbelLara AbsilSubhash AcharyaAndrew AckerDiana AdriãoSaleh Al AgeelShakeel AhmedKate AinscoughTharwat AisaAli Ait HssainYounes Ait TamlihatTakako AkimotoErnita AkmalRazi AlalqamTala Al-DabbousSenthilkumar AlegesanCynthia AlegreBeatrice AlexKévin AlexandreAbdulrahman Al-FaresHuda AlfoudriImran AliNaseem Ali ShahKazali Enagnon AlidjnouJeffrey AliudinQabas AlkhafajeeClotilde AllavenaNathalie AllouAneela AltafJoão AlvesRita AlvesMaria AmaralNur AmiraPhoebe AmpawRoberto AndiniClaire AndrejakAndrea AnghebenFrançois AngoulvantSéverine AnsartSivanesen AnthonidassMassimo AntonelliCarlos Alexandre Antunes de BritoArdiyan ApriyanaIrene AragaoFrancisco ArancibiaCarolline AraujoAntonio ArcadipanePatrick ArchambaultLukas ArenzJean-Benoît ArletChristel Arnold-DayRakesh AroraElise Artaud-MacariDiptesh AryalAngel AsensioMuhammad AshrafNamra AsifMohammad AsimJean Baptiste AssieAmirul AsyrafAnika AtiqueAm Udara Lakshan AttanyakeJohann AuchabieHugues AumaitreAdrien AuvetLaurène AzemarCecile AzoulayBenjamin BachDelphine BacheletClaudine BadrNadia BaigJ Kenneth BaillieErica BakAgamemnon BakakosNazreen Abu BakarAndriy BalMohanaprasanth BalakrishnanValeria BalanFirouzé Bani-SadrRenata BarbalhoISARIC Clinical Characterisation GroupWendy Barclay
- Resource Type
- Journal article
- Publication Details
- Brain (London, England : 1878), Vol.146(4), pp.1648-1661
- Publisher
- Oxford University Press (OUP)
- DOI
- 10.1093/brain/awac332
- PMID
- 36087305
- PMCID
- PMC9494397
- ISSN
- 0006-8950
- eISSN
- 1460-2156
- Grant note
- DOI: 10.13039/501100000272, name: National Institute for Health Research, award: CO-CIN-01; name: Medical Research Council, award: MC_PC_19059; DOI: 10.13039/100018336, name: Health Protection Research Unit; DOI: 10.13039/501100002141, name: Public Health England, award: 200907; name: Respiratory Infections, award: 200927; DOI: 10.13039/501100023566, name: Liverpool Experimental Cancer Medicine Centre, award: C18616/A25153; name: Biomedical Research Centre, award: IS-BRC-1215-20013; name: UK Foreign; name: Commonwealth and Development Office and Wellcome, award: 215091/Z/18/Z, 225288/Z/22/Z; DOI: 10.13039/100000865, name: Bill & Melinda Gates Foundation, award: OPP1209135; DOI: 10.13039/100000050, name: NHLBI, award: 1K23HL157610; name: Advance Queensland Industry Research Fellowship, award: AQIRF076-2020-CV
- Language
- English
- Date published
- 04/03/2023
- Academic Unit
- Anesthesia
- Record Identifier
- 9984539756102771
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