Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19
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Le, Trang | Gutiérrez-Sacristán, Alba | Son, Jiyeon | Hong, Chuan | South, Andrew | Beaulieu-Jones, Brett | Loh, Ne Hooi Will | Luo, Yuan | Morris, Michele | Ngiam, Kee Yuan | Patel, Lav | Samayamuthu, Malarkodi | Schriver, Emily | Tan, Amelia | Moore, Jason | Cai, Tianxi | Omenn, Gilbert | Avillach, Paul | Kohane, Isaac | Visweswaran, Shyam | Mowery, Danielle | Xia, Zongqi | Aaron, James | Agapito, Giuseppe | Albayrak, Adem | Alessiani, Mario | Amendola, Danilo | Angoulvant, François | Anthony, Li | Aronow, Bruce | Atz, Andrew | Balshi, James | Bell, Douglas | Bellasi, Antonio | Bellazzi, Riccardo | Benoit, Vincent | Beraghi, Michele | Bernal Sobrino, José Luis | Bernaux, Mélodie | Bey, Romain | Blanco Martínez, Alvar | Boeker, Martin | Bonzel, Clara-Lea | Booth, John | Bosari, Silvano | Bourgeois, Florence | Bradford, Robert | Brat, Gabriel | Bréant, Stéphane | Brown, Nicholas | Bryant, William | Bucalo, Mauro | Burgun, Anita | Cannataro, Mario | Carmona, Aldo | Caucheteux, Charlotte | Champ, Julien | Chen, Krista | Chen, Jin | Chiovato, Luca | Chiudinelli, Lorenzo | Cimino, James | Colicchio, Tiago | Cormont, Sylvie | Cossin, Sébastien | Craig, Jean | Cruz Bermúdez, Juan Luis | Cruz Rojo, Jaime | Dagliati, Arianna | Daniar, Mohamad | Daniel, Christel | Davoudi, Anahita | Devkota, Batsal | Dubiel, Julien | Esteve, Loic | Fan, Shirley | Follett, Robert | Gaiolla, Paula | Ganslandt, Thomas | García Barrio, Noelia | Garmire, Lana | Gehlenborg, Nils | Geva, Alon | Gradinger, Tobias | Gramfort, Alexandre | Griffier, Romain | Griffon, Nicolas | Grisel, Olivier | Hanauer, David | Haverkamp, Christian | He, Bing | Henderson, Darren | Hilka, Martin | Holmes, John | Horki, Petar | Huling, Kenneth | Hutch, Meghan | Issitt, Richard | Jannot, Anne Sophie | Jouhet, Vianney | Kavuluru, Ramakanth | Keller, Mark | Kirchoff, Katie | Klann, Jeffrey | Krantz, Ian | Kraska, Detlef | Krishnamurthy, Ashok | L’yi, Sehi | Leblanc, Judith | Leite, Andressa | Lemaitre, Guillaume | Lenert, Leslie | Leprovost, Damien | Liu, Molei | Lozano-Zahonero, Sarah | Lynch, Kristine | Mahmood, Sadiqa | Maidlow, Sarah | Makoudjou Tchendjou, Adeline | Malovini, Alberto | Mandl, Kenneth | Mao, Chengsheng | Maram, Anupama | Martel, Patricia | Masino, Aaron | Matheny, Michael | Maulhardt, Thomas | Mazzitelli, Maria | Mcduffie, Michael | Mensch, Arthur | Ashraf, Fatima | Milano, Marianna | Minicucci, Marcos | Moal, Bertrand | Moraleda, Cinta | Morris, Jeffrey | Moshal, Karyn | Mousavi, Sajad | Murad, Douglas | Murphy, Shawn | Naughton, Thomas | Neuraz, Antoine | Norman, James | Obeid, Jihad | Okoshi, Marina | Olson, Karen | Orlova, Nina | Ostasiewski, Brian | Palmer, Nathan | Paris, Nicolas | Pedrera Jimenez, Miguel | Pfaff, Emily | Pillion, Danielle | Prokosch, Hans | Prudente, Robson | Quirós González, Víctor | Ramoni, Rachel | Raskin, Maryna | Rieg, Siegbert | Roig Domínguez, Gustavo | Rojo, Pablo | Sáez, Carlos | Salamanca, Elisa | Sandrin, Arnaud | Santos, Janaina | Savino, Maria | Schuettler, Juergen | Scudeller, Luigia | Sebire, Neil | Balazote, Pablo Serrano | Serre, Patricia | Serret-Larmande, Arnaud | Shakeri, Zahra | Silvio, Domenick | Sliz, Piotr | Sonday, Charles | Spiridou, Anastasia | Tan, Bryce | Tan, Byorn | Tanni, Suzana | Taylor, Deanne | Terriza-Torres, Ana | Tibollo, Valentina | Tippmann, Patric | Torti, Carlo | Trecarichi, Enrico | Tseng, Yi-Ju | Vallejos, Andrew | Varoquaux, Gael | Vella, Margaret | Vie, Jill-Jênn | Vitacca, Michele | Wagholikar, Kavishwar | Waitman, Lemuel | Wassermann, Demian | Weber, Griffin | William, Yuan | Yehya, Nadir | Zambelli, Alberto | Zhang, Harrison | Zoeller, Daniela | Zucco, Chiara
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CCSD ; Nature Publishing Group -
International audience.
Abstract Neurological complications worsen outcomes in COVID-19. To define the prevalence of neurological conditions among hospitalized patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test in geographically diverse multinational populations during early pandemic, we used electronic health records (EHR) from 338 participating hospitals across 6 countries and 3 continents (January–September 2020) for a cross-sectional analysis. We assessed the frequency of International Classification of Disease code of neurological conditions by countries, healthcare systems, time before and after admission for COVID-19 and COVID-19 severity. Among 35,177 hospitalized patients with SARS-CoV-2 infection, there was an increase in the proportion with disorders of consciousness (5.8%, 95% confidence interval [CI] 3.7–7.8%, p FDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, p FDR < 0.001) when compared to the pre-admission proportion. During hospitalization, the relative risk of disorders of consciousness (22%, 19–25%), cerebrovascular diseases (24%, 13–35%), nontraumatic intracranial hemorrhage (34%, 20–50%), encephalitis and/or myelitis (37%, 17–60%) and myopathy (72%, 67–77%) were higher for patients with severe COVID-19 when compared to those who never experienced severe COVID-19. Leveraging a multinational network to capture standardized EHR data, we highlighted the increased prevalence of central and peripheral neurological phenotypes in patients hospitalized with COVID-19, particularly among those with severe disease.
