TY - JOUR
T1 - Multinational characterization of neurological phenotypes in patients hospitalized with COVID-19
AU - The Consortium for Clinical Characterization of COVID-19 by EHR (4CE)
AU - Le, Trang T.
AU - Gutiérrez-Sacristán, Alba
AU - Son, Jiyeon
AU - Hong, Chuan
AU - South, Andrew M.
AU - Beaulieu-Jones, Brett K.
AU - Loh, Ne Hooi Will
AU - Luo, Yuan
AU - Morris, Michele
AU - Ngiam, Kee Yuan
AU - Patel, Lav P.
AU - Samayamuthu, Malarkodi J.
AU - Schriver, Emily
AU - Tan, Amelia L.M.
AU - Moore, Jason
AU - Cai, Tianxi
AU - Omenn, Gilbert S.
AU - Avillach, Paul
AU - Kohane, Isaac S.
AU - Aaron, James R.
AU - Agapito, Giuseppe
AU - Albayrak, Adem
AU - Alessiani, Mario
AU - Amendola, Danilo F.
AU - Angoulvant, François
AU - Anthony, Li L.L.J.
AU - Aronow, Bruce J.
AU - Atz, Andrew
AU - Balshi, James
AU - Bell, Douglas S.
AU - Bellasi, Antonio
AU - Bellazzi, Riccardo
AU - Benoit, Vincent
AU - Beraghi, Michele
AU - Bernal Sobrino, José Luis
AU - Bernaux, Mélodie
AU - Bey, Romain
AU - Blanco Martínez, Alvar
AU - Boeker, Martin
AU - Bonzel, Clara Lea
AU - Booth, John
AU - Bosari, Silvano
AU - Bourgeois, Florence T.
AU - Bradford, Robert L.
AU - Brat, Gabriel A.
AU - Bréant, Stéphane
AU - Brown, Nicholas W.
AU - Bryant, William A.
AU - Bucalo, Mauro
AU - Burgun, Anita
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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%, pFDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, pFDR < 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.
AB - 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%, pFDR < 0.001) and unspecified disorders of the brain (8.1%, 5.7–10.5%, pFDR < 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.
UR - https://www.scopus.com/pages/publications/85118178744
U2 - 10.1038/s41598-021-99481-9
DO - 10.1038/s41598-021-99481-9
M3 - Article
C2 - 34642371
AN - SCOPUS:85118178744
SN - 2045-2322
VL - 11
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 20238
ER -