Cross-sectional case-control studies (Blue)
COVID‐19 related acute neurological phenotypes are being increasingly recognized, with neurological complications reported in over 30% of hospitalized patients. However, multicentric studies providing a population‐based perspective are lacking. The authors of this article conducted a retrospective multicentric study in five hospitals in Northern Portugal, representing 45.1% of all hospitalized patients in this region, between March 1st and June 30th, 2020. Among 1261 hospitalized COVID‐19 patients, 457 (36.2%) presented neurological manifestations, corresponding to a rate of 357 per 1000 in the Northern Region. Patients with neurologic manifestations were younger (68.0 vs. 71.2 years, p=0.002), and the most frequent neurological symptoms were headache (13.4%), delirium (10.1%) and impairment of consciousness (9.7%). Acute well‐defined CNS involvement was found in 19.1% of patients, corresponding to a rate of 217 per 1000 hospitalized patients in the whole region. Admitting that all patients with severe neurological events were hospitalized, the authors extrapolated their results to all COVID‐19 patients in the region, estimating that 116 will have a severe neurological event, corresponding to a rate of 9 per 1000 (7‐11). Overall case‐fatality in patients presenting neurological manifestations was 19.8%, increasing to 32.6% among those with acute well‐defined CNS involvement. The authors concluded that neurological symptoms are common and associated with a high degree of disability at discharge in hospitalized COVID-19 patients. CNS involvement with criteria for in‐hospital admission was observed in a significant proportion of patients. This knowledge provides the tools for adequate health planning and for improving COVID‐19 multidisciplinary patient care.
Vanessa Oliveira et al. Neuro‐COVID frequency and short‐term outcome in the northern Portuguese population. European Journal of Neurology. https://doi.org/10.1111/ene.14874