Critical Care Explorations (Apr 2022)

Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Hospitalized Patients During the First Year of the COVID-19 Pandemic

  • Anna M. Cervantes-Arslanian, MD,
  • Chakradhar Venkata, MD,
  • Pria Anand, MD,
  • Joseph D. Burns, MD,
  • Charlene J. Ong, MD,
  • Allison M. LeMahieu, MS,
  • Phillip J. Schulte, PhD,
  • Tarun D. Singh, MD,
  • Alejandro A. Rabinstein, MD,
  • Neha Deo, BS,
  • Vikas Bansal, MBBS, MPH,
  • Karen Boman, BS,
  • Juan Pablo Domecq Garces, MD,
  • Donna Lee Armaignac, PhD, APRN,
  • Amy B. Christie, MD,
  • Roman R. Melamed, MD,
  • Yasir Tarabichi, MD, MSCR,
  • Sreekanth R. Cheruku, MD, MPH,
  • Ashish K. Khanna, MD, FCCP, FCCM, FASA,
  • Joshua L. Denson, MD, MS,
  • Valerie M. Banner-Goodspeed, MPH,
  • Harry L. Anderson, III, MD, FACS, FICS, FCCM, FCCP, FAIM,
  • Ognjen Gajic, MD, MS,
  • Vishakha K. Kumar, MD, MBA,
  • Allan Walkey, MD,
  • Rahul Kashyap, MD, MBA,
  • on behalf of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group,
  • Jean-Baptiste Mesland,
  • Pierre Henin,
  • Hélène Petre,
  • Isabelle Buelens,
  • Anne-Catherine Gerard,
  • Philippe Clevenbergh,
  • Rolando Claure-Del Granado,
  • Jose A. Mercado,
  • Esdenka Vega-Terrazas,
  • Maria F. Iturricha-Caceres,
  • Ruben Garza,
  • Eric Chu,
  • Victoria Chan,
  • Oscar Y Gavidia,
  • Felipe Pachon,
  • Yeimy A Sanchez,
  • Danijel knežević,
  • Mohamed El Kassas,
  • Mohamed Badr,
  • Ahmed Tawheed,
  • Ahmed Tawheed,
  • Hend Yahia,
  • Dimitrios Kantas,
  • Vasileios Koulouras,
  • Estela Pineda,
  • Gabina María Reyes Guillen,
  • Helin Archaga Soto,
  • Ana Karen Vallecillo Lizardo,
  • Csaba Kopitkó,
  • Ágnes Bencze,
  • István Méhész,
  • Zsófia Gerendai,,
  • Girish Vadgaonkar,
  • Rekha Ediga,
  • Shilpa Basety,
  • Shwetha Dammareddy,
  • Phani Sreeharsha Kasumalla,
  • Smitha S. Segu,
  • Tuhin Chakraborty,
  • Epcebha Joyce,
  • Sridhar Papani,
  • Mahesh Kamuram,
  • Mradul Kumar Daga,
  • Munisha Agarwal,
  • Ishan Rohtagi,
  • Anusha Cherian,
  • Sreejith Parameswaran,
  • Magesh Parthiban,
  • Phaneendra Doddaga,
  • Neethi Chandra,
  • Puneet Rijhwani,
  • Ashish Jain,
  • Aviral Gupta,
  • Ram Mohan Jaiswal,
  • Ambika Tyagi,
  • Nimish Mathur,
  • Madhav Prabhu,
  • Vishal Jakati,
  • Mukur Petrolwala,
  • Bharat Ladva,
  • Surapaneni Krishna Mohan,
  • Ekambaram Jyothisree,
  • Umamaheswara Raju,
  • Janaki Manduva,
  • Naresh Kolakani,
  • Shreeja Sripathi,
  • Sheetal Chaitanya,
  • Kamlesh Kumar Agrawal,
  • Vijendra Baghel,
  • Kirti Kumar Patel,
  • Nooshin Dalili,
  • Mohsen Nafa,
  • Wataru Matsuda,
  • Reina Suzuki,
  • Michihito Kyo,
  • Shu Tahara,
  • Mineji Hayakawa,
  • Kunihiko Maekawa,
  • Reina Suzuki,
  • Masamitsu Sanui,
  • Sho Horikita,
  • Yuki Itagaki,
  • Akira Kodate,
  • Reina Suzuki,
  • Akira Kodate,
  • Yuki Takahashi,
  • Koyo Moriki,
  • Takuya Shiga,
  • Yudai Iwasaki,
  • Hidenobu Shigemitsu,
  • Yuka Mishima,
  • Nobuyuki Nosaka,
  • Michio Nagashima,
  • Abdulrahman Al-Fares,
  • Rene Rodriguez-Gutierrez,
  • Jose Gerardo Gonzalez-Gonzalez,
  • Alejandro Salcido-Montenegro,
  • Adrian Camacho-Ortiz,
  • Mariana Janeth Hermosillo Ulloa,
  • Fatimah Hassan-Hanga,
  • Hadiza Galadanci,
  • Abubakar Shehu Gezawa,
  • Halima M. S. Kabara,
  • Taiwo Gboluwaga Amole,
  • Halima Kabir,
  • Dalha Gwarzo Haliru,
  • Abdullahi S Ibrahim,
  • Muhammad Sohaib Asghar,
  • Mashaal Syed,
  • Syed Anosh Ali Naqvi,
  • Igor Borisovich Zabolotskikh,,
  • Konstantin Dmitrievich Zybin,
  • Sergey Vasilevich Sinkov,
  • Tatiana Sergeevna Musaeva,
  • Razan K Alamoudi,
  • Hassan M. AlSharif,
  • Sarah A. Almazwaghi,
  • Mohammed S Elsakran,
  • Mohamed A Aid,
  • Mouaz A Darwich,
  • Omnia M Hagag,
  • Salah A Ali,
  • Alona rocacorba,
  • Kathrine Supeña,
  • Efren Ray Juane,
  • Jenalyn Medina,
  • Jowany Baduria,
  • Marwa Ridha Amer,
  • Mohammed Abdullah,
  • Bawazeer, Talal I. Dahhan,
  • Eiad Kseibi,
  • Abid Shahzad Butt,
  • Syed Moazzum Khurshid,
  • Muath Rabee,
  • Mohammed Abujazar,
  • Razan Alghunaim,
  • Maal Abualkhair,
  • Abeer Turki AlFirm,
  • Eiad Kseibi,
  • Syed Moazzum Khurshid,
  • Muath Rabee,
  • Mohammed Abujazar,
  • Razan Alghunaim,
  • Yaseen M Arabi,
  • Sheryl Ann Abdukahil,
  • Mohammed A Almazyad,
  • Mohammed I Alarifi,
  • Jara M Macarambon,
  • Ahmad Abdullah Bukhari,
  • Hussain A. Albahrani,
  • Kazi N Asfina,
  • Kaltham M Aldossary,
  • Marija Zdravkovic,
  • Zoran Todorovic,
  • Viseslav Popadic,
  • Slobodan Klasnja,
  • Ana Andrijevic,
  • Srdjan Gavrilovic,
  • Vladimir Carapic,
  • Bojan Kovacevic,
  • Jovana Bojicic,
  • Stevanovic Predrag,
  • Dejan S Stojakov,
  • Duska K Ignjatovic,
  • Suzana C Bojic,
  • Marina M Bobos,
  • Irina B Nenadic,
  • Milica S Zaric,
  • Marko D Djuric,
  • Vladimir R Djukic,
  • Santiago Y. Teruel,
  • Belen C. Martin,
  • Santiago Y. Teruel,
  • Uluhan Sili,
  • Huseyin Bilgin,
  • Pinar Ay,
  • Varsha P Gharpure,
  • Usman Raheemi,
  • Kenneth W. Dodd,
  • Nicholas Goodmanson,
  • Kathleen Hesse,
  • Paige Bird,
  • Chauncey Weinert,
  • Nathan Schoenrade,
  • Abdulrahman Altaher,
  • Esmael Mayar,
  • Matthew Aronson,
  • Tyler Cooper,
  • Monica Logan,
  • Brianna Miner,
  • Gisele Papo,
  • Eric M. Siegal,
  • Phyllis Runningen,
  • Suzanne Barry,
  • Christopher Woll,
  • Gregory Wu,
  • Erin Carrole,
  • Kathryn Burke,
  • Mustafa Mohammed,
  • Roman R. Melamed,
  • David M. Tierney,
  • Love A. Patel,
  • Vino S. Raj,
  • Barite U. Dawud,
  • Narayana Mazumder,
  • Abbey Sidebottom,
  • Alena M. Guenther,
  • Benjamin D. Krehbiel,
  • Nova J. Schmitz,
  • Stacy L. Jepsen,
  • Lynn Sipsey,
  • Anna Schulte,
  • Whitney Wunderlich,
  • Cecely Hoyt,
  • Abhijit A Raval,
  • Andrea Franks,
  • Katherine Irby,
  • Ronald C. Sanders, Jr.,
  • Glenda Hefley,
  • Jennifer M. Jarvis,
  • Anmol Kharbanda,
  • Sunil Jhajhria,
  • Zachary Fyffe,
  • Stephen Capizzi,
  • Bethany Alicie,
  • Martha Green,
  • Lori Crockarell,
  • Amelia Drennan,
  • Kathleen Dubuque,
  • Tonya Fambrough,
  • Nikole Gasaway,
  • Briana Krantz,
  • Peiman Nebi,
  • Jan Orga,
  • Margaret Serfass,
  • Alina Simion,
  • Kimberly Warren,
  • Cassie Wheeler,
  • CJ Woolman,
  • Amy B. Christie,
  • Dennis W. Ashley,
  • Rajani Adiga,
  • Andrew S. Moyer,
  • George M. Verghese,
  • Andrea Sikora Newsome,
  • Christy C. Forehand,
  • Rebecca Bruning,
  • Timothy W. Jones,
  • Moldovan Sabov,
  • Fatema Zaidi,
  • Fiona Tissavirasingham,
  • Dhatri Malipeddi,
  • Jarrod M Mosier,
  • Karen Lutrick,
  • Beth Salvagio Campbell,
  • Cathleen Wilson,
  • Patrick Rivers,
  • Jonathan Brinks,
  • Mokenge Ndiva Mongoh,
  • Boris Gilson,
  • Donna Lee Armaignac,
  • Don Parris,
  • Maria Pilar Zuniga,
  • Ilea Vargas,
  • Viviana Boronat,
  • Anneka Hutton,
  • Navneet Kaur,
  • Prashank Neupane,
  • Nohemi Sadule-Rios,
  • Lourdes M. Rojas,
  • Aashish Neupane,
  • Priscilla Rivera,
  • Carlos Valle Carlos,
  • Gregory Vincent,
  • Mahesh Amin,
  • Mary E Schelle,
  • Amanda Steadham,
  • Christopher M Howard,
  • Cameron McBride,
  • Jocelyn Abraham,
  • Orlando Garner,
  • Katherine Richards,
  • Keegan Collins,
  • Preethi Antony,
  • Sindhu Mathew,
  • Valerie C. Danesh,
  • Gueorgui Dubrocq,
  • Amber L. Davis,
  • Marissa J Hammers,
  • ill M. McGahey,
  • Amanda C. Farris,
  • Elisa Priest,
  • Robyn Korsmo,
  • Lorie Fares,
  • Kathy Skiles,
  • Susan M. Shor,
  • Kenya Burns,
  • Corrie A Dowell,
  • Gabriela “Hope” Gonzales,
  • Melody Flores,
  • Lindsay Newman,
  • Debora A Wilk,
  • Jason Ettlinger,
  • Jaccallene Bomar,
  • Himani Darji,
  • Alejandro Arroliga,
  • Alejandro C Arroliga,
  • Corrie A. Dowell,
  • Gabriela Hope Conzales,
  • Melody Flores,
  • Lindsay Newman,
  • Debora A. Wilk,
  • Jason Ettlinger,
  • Himani Darji,
  • Jaccallene Bomar,
  • Paras B. Khandhar,
  • Elizabeth Kring,
  • Valerie M. Banner-Goodspeed,
  • Somnath Bose,
  • Lauren E. Kelly,
  • Melisa Joseph,
  • Marie McGourty,
  • Krystal Capers,
  • Benjamin Hoenig,
  • Maria C. Karamourtopoulos,
  • Anica C. Law,
  • Elias N. Baedorf Kassis,
  • Allan J. Walkey,
  • Sushrut S. Waikar,
  • Michael A. Garcia,
  • Mia Colona,
  • Zoe Kibbelaar,
  • Michael Leong,
  • Daniel Wallman,
  • Kanupriya Soni,
  • Jennifer Maccarone,
  • Joshua Gilman,
  • Ycar Devis,
  • Joseph Chung,
  • Munizay Paracha,
  • David N. Lumelsky,
  • Madeline DiLorenzo,
  • Najla Abdurrahman,
  • Shelsey Johnson,
  • Maj Andrew M. Hersh,
  • CPT Stephanie L Wachs,
  • Brittany S. Swigger,
  • Stephanie L Wachs,
  • Capt Lauren A. Sattler,
  • Capt Michael N. Moulton,
  • Kimberly Zammit,
  • Patrick, J McGrath,
  • William Loeffler,
  • Maya, R. Chilbert,
  • Aaron S. Miller,
  • Edwin L. Anderson,
  • Rosemary Nagy,
  • Ravali R. Inja,
  • Pooja A. Nawathe,
  • Isabel Pedraza,
  • Jennifer Tsing,
  • Karen Carr,
  • Anila Chaudhary,
  • Kathleen Guglielmino,
  • Raghavendra Tirupathi,
  • Alymer Tang,
  • Arshad Safi,
  • Cindy Green,
  • Jackie Newell,
  • Rayan E. Ihle,
  • Shelda A. Martin,
  • Elaine A. Davis,
  • Katja M. Gist,
  • Imran A Sayed,
  • John Brinton,
  • Larisa Strom,
  • Kathleen Chiotos,
  • Allison M. Blatz,
  • Giyoung Lee,
  • Ryan H. Burnett,
  • Guy I. Sydney,
  • Danielle M. Traynor,
  • Karissa Nauert,
  • Annika Gonzalez,
  • Mariel Bagley,
  • Anita Santpurkar,
  • Salim Surani,
  • Joshua White,
  • Aftab Khan,
  • Rahul Dhahwal,
  • Sreekanth Cheruku,
  • Farzin Ahmed,
  • Christopher Deonarine,
  • Ashley Jones,
  • Mohammad-Ali Shaikh,
  • David Preston,
  • Jeanette Chin,
  • Vidula Vachharajani,
  • Abhijit Duggal,
  • Prabalini Rajendram,
  • Omar Mehkri,
  • Siddharth Dugar,
  • Michelle Biehl,
  • Gretchen Sacha,
  • Stuart Houltham,
  • Alexander King,
  • Kiran Ashok,
  • Bryan Poynter,
  • Mary Beukemann,
  • Richard Rice,
  • Susan Gole,
  • Valerie Shaner,
  • Adarsh Conjeevaram,
  • Michelle Ferrari,
  • Narendrakumar Alappan,
  • Steven Minear,
  • Jaime Hernandez-Montfort,
  • Syed Sohaib Nasim,
  • Ravi Sunderkrishnan,
  • Debasis Sahoo,
  • Patrick S. Milligan,
  • Sandeep K. Gupta,
  • Joy M. Koglin,
  • Regina Gibson,
  • Lana Johnson,
  • Felicia Preston,
  • Crimson Scott,
  • Bethany Nungester,
  • Dana D Byrne,
  • Christa A Schorr,
  • Katie Grant,
  • Katherine L Doktor,
  • Maura C Porto,
  • Olga Kaplan,
  • James E. Siegler, III,
  • Brian Schonewald,
  • Ashley Woodford,
  • Alan Tsai,
  • Savina Reid,
  • Kuntal Bhowmick,
  • Saba Daneshpooy,
  • Cyrus Mowdawalla,
  • Trishna Akshay Dave,
  • Wilhemina Kennedy,
  • Connor Crudeli,
  • Christopher Ferry,
  • Long Nguyen,
  • Sneha Modi,
  • Niharika Padala,
  • Pavan Jitendra Patel,
  • Belle Lin,
  • Lena Chatterjee,
  • Jamie Qiuyun,
  • Fan Mandi Liu,
  • Rasagna Kota,
  • Annesha Banerjee,
  • Steven K. Daugherty,
  • Sam Atkinson,
  • Kelly Shrimpton,
  • Sidney Ontai,
  • Brian Contreras,
  • Uzoma Obinwanko,
  • Nneka Amamasi,
  • Amir Sharafi,
  • Sarah Lee,
  • Zahia Esber,
  • Chetna Jinjvadia,
  • Raquel R Bartz,
  • Vijay Krishnamoorthy,
  • Bryan Kraft,
  • Aaron Pulsipher,
  • Eugene Friedman,
  • Sachin Mehta,
  • Margit Kaufman,
  • Gregg Lobel,
  • Nisha Gandhi,
  • Amr Abdelaty,
  • Elizabeth Shaji,
  • Kiana Lim,
  • Juan Marte,
  • Dani Ashley Sosa,
  • David P. Yamane,
  • Ivy Benjenk,
  • Nivedita Prasanna,
  • Nicholas Perkins,
  • Prera J. Roth,
  • Banu Sivaraj,
  • Haley Fulton,
  • Madison G Herin,
  • Marissa Crum,
  • Morgan E. Fretwell,
  • Emily-Rose Zhou,
  • Christine Waller,
  • Kara Kallies,
  • Christine Waller,
  • Jonean Thorsen,
  • Alec Fitzsimmons,
  • Haley Olsen,
  • Heda R. Dapul,
  • Sourabh Verma,
  • Alan Salas,
  • Ariel Daube,
  • Michelle Korn,
  • Michelle Ramirez,
  • Logi Rajagopalan,
  • Laura Santos,
  • Héctor Collazo Santiago,
  • Ricardo Alan Hernandez,
  • Norma Smalls,
  • Asher G Bercow,
  • Mark Shlomovich,
  • Christine Crandall,
  • Sasko Stojanovski,
  • Kristin Johnson,
  • Kelly Michienzi,
  • Steven Q. Davis,
  • Valentina Jovic,
  • Valentina Jovic,
  • Max Masuda,
  • Amanda Hayes,
  • Katharine Nault,
  • Michael Smith,
  • William Snow,
  • Riley Liptak,
  • Hannah Durant,
  • Valerie Pendleton,
  • Alay Nanavati,
  • Risa Mrozowsk,
  • Namrata Nag,
  • Jeff Brauer,
  • Ashwin Dharmadhikari,
  • Sahib Singh,
  • Franco Laghi,
  • Ghania Naeem,
  • Andrew Wang,
  • Kevin Bliden,
  • Amit Rout,
  • Jaime Barnes,
  • Martin Gesheff,
  • Asha Thomas,
  • Melbin Thomas,
  • Alicia R. Liendo,
  • Jovan Milosavljevic,
  • Kenan Abbasi,
  • Nicholas B. Burley,
  • Nicole Rapista,
  • Samuel Amankwah,
  • Sanjay K Poude,
  • Saroj Timilsina,
  • Sauradeep Sarkar,
  • Oluwasayo Akinyosoye,
  • Shashi K. Yalamanchili,
  • Sheena Moorthy,
  • Sonia Sugumar,
  • Jonathan Ford,
  • Martin C. Taylor,
  • Charlotte Dunderdale,
  • Alyssa Henshaw,
  • Mary K. Brunk,
  • Jessica Hagy,
  • Shehryar Masood,
  • Sushrutha Sridhar,
  • Yuk Ming Liu,
  • Sarah Zavala,
  • Sarah Zavala,
  • Esther Shim,
  • Ronald A. Reilkoff,
  • Julia A. Heneghan,
  • Sarah Eichen,
  • Lexie Goertzen,
  • Scott Rajala,
  • Ghislaine Feussom,
  • Ben Tang,
  • Christine C. Junia,
  • Robert Lichtenberg,
  • Hasrat Sidhu,
  • Diana Espinoza,
  • Shelden Rodrigues,
  • Maria Jose Zabala,
  • Daniela Goyes,
  • Ammu Susheela,
  • Buddhi Hatharaliyadda,
  • Naveen Rameshkumar,
  • Amulya Kasireddy,
  • Genessis Maldonado,
  • Lisseth Beltran,
  • Akshata Chaugule,
  • Hassan Khan,
  • Namrata Patil,
  • Ruhi Patil,
  • Rodrigo Cartin-Ceba,
  • Ayan Sen,
  • Fahimeh Talaei,
  • Rahul Kashyap,
  • Juan Pablo Domecq,
  • Ognjen Gajic,
  • Vikas Bansal,
  • Aysun Tekin,
  • Amos Lal,
  • John C. O’Horo,
  • Neha N. Deo,
  • Mayank Sharma,
  • Shahraz Qamar,
  • Romil Singh,
  • Diana J. Valencia Morales,
  • Abigail T. La Nou,
  • Marija Bogojevic,
  • Simon Zec,
  • Devang Sanghavi,
  • Pramod Guru,
  • Pablo Moreno Franco,
  • Karthik Gnanapandithan,
  • Hollie Saunders,
  • Zachary Fleissner,
  • Juan Garcia,
  • Alejandra Yu Lee Mateus,
  • Siva Naga Yarrarapu,
  • Nirmaljot Kaur,
  • Abhisekh Giri,
  • Mohammed Mustafa Hasan,
  • Ashrita Donepudi,
  • Syed Anjum Khan,
  • Nitesh Kumar Jain,
  • Thoyaja Koritala,
  • Alexander Bastidas,
  • Gabriela Orellana,
  • Adriana Briceno Bierwirth,
  • Eliana Milazzo,
  • Juan Guillermo Sierra,
  • Thao Dang,
  • Rahul S Nanchal,
  • Paul A Bergl,
  • Jennifer L Peterson,
  • Jessica Timmer,
  • Kimberly Welker,
  • Travis Yamanaka,
  • Nicholas A. Barreras,
  • Michael Markos,
  • Anita Fareeduddin,
  • Rohan Mehta,
  • Chakradhar Venkata,
  • Miriam Engemann,
  • Annamarie Mantese,
  • Yasir Tarabichi,
  • Adam Perzynski,
  • Christine Wang,
  • Dhatri Kotekal,
  • Adriana C Briceno Bierwirth,
  • Gabriela M Orellana,
  • Gerardo Catalasan,
  • Shohana Ahmed,
  • Carlos F Matute,
  • Ahmad Hamdan,
  • Ivania Salinas,
  • Genesis Del Nogal,
  • Angel Tejada,
  • Anna Eschler,
  • Mary Hejna,
  • Emily Lewandowski,
  • Kristen Kusmierski,
  • Clare Martin,
  • Jen-Ting Chen,
  • Aluko Hope,
  • Zoe Tsagaris,
  • Elise Ruen,
  • Aram Hambardzumyan,
  • Nasar A Siddiqi,
  • Lesly Jurado,
  • Lindsey Tincher,
  • Carolyn Brown,
  • Prithvi Sendi,
  • Meghana Nadiger,
  • Balagangadhar Totapally,
  • Bhagat S. Aulakh,
  • Sandeep Tripathi,
  • Jennifer A. Bandy,
  • Lisa M. Kreps,
  • Dawn R. Bollinger,
  • Jennifer A. Bandy,
  • Neha Gupta,
  • Brent R Brown,
  • Tracy L Jones,
  • Kassidy Malone,
  • Lauren A Sinko,
  • Amy B Harrell,
  • Shonda C Ayers,
  • Lisa M Settle,
  • Taylor J Sears,
  • Roger Scott Stienecker,
  • Andre G. Melendez,
  • Tressa A. Brunner,
  • Sue M Budzon,
  • Jessica L. Heffernan,
  • Janelle M. Souder,
  • Tracy L. Miller,
  • Andrea G. Maisonneuve,
  • Roberta E. Redfern,
  • Jessica Shoemaker,
  • Jennifer Micham,
  • Lynn Kenney,
  • Gabriel Naimy,
  • Victoria Schauf,
  • Sara Utley,
  • Holly Balcer,
  • Kerry P. J. Pulver,
  • Jennifer Yehle,
  • Alicia Weeks,
  • Terra Inman,
  • Majdi Hamarshi,
  • Jeannette Ploetz,
  • Nick Bennett,
  • Kyle Klindworth,
  • Moustafa Younis,
  • Adham Mohamed,
  • Brian L. Delmonaco,
  • Anthony Franklin,
  • Mitchell Heath,
  • Diane Barkas,
  • Antonia L. Vilella,
  • Sara B. Kutner,
  • Kacie Clark,
  • Danielle Moore,
  • Shina Menon,
  • John K McGuire,
  • Deana Rich,
  • Harry L. Anderson, III,
  • Dixy Rajkumar,
  • Ali Abunayla,
  • Jerrilyn Heiter,
  • Howard A. Zaren,
  • Stephanie J. Smith,
  • Grant C. Lewis,
  • Lauren Seames,
  • Cheryl Farlow,
  • Judy Miller,
  • Gloria Broadstreet,
  • John Lin,
  • Cindy Terrill,
  • Brock Montgomery,
  • Sydney Reyes,
  • Summer Reyes,
  • Alex Plattner,
  • Anthony Martinez,
  • Micheal Allison,
  • Aniket Mittal,
  • Rafael Ruiz,
  • Aleta Skaanland,
  • Robert Ross,
  • Umang Patel,
  • Jordesha Hodge,
  • Krunal Kumar Patel,
  • Shivani Dalal,
  • Himanshu Kavani,
  • Sam Joseph,
  • Michael A. Bernstein,
  • Ian K. Goff,
  • Matthew Naftilan,
  • Amal Mathew,
  • Deborah Williams,
  • Sue Murdock,
  • Maryanne Ducey,
  • Kerianne Nelson,
  • Jason Block,
  • James Mitchel,
  • Connor G O’Brien,
  • Sylvan Cox,
  • William Marx,
  • Ioana Amzuta,
  • Asad J. Choudhry,
  • Mohammad T. Azam,
  • Kristina L Carter,
  • Michael A Olmos,
  • Brittany M Parker,
  • Julio Quintanilla,
  • Tara A Craig,
  • Brendon J Clough,
  • Jeffrey T Jameson,
  • Neha Gupta,
  • Tracy L Jones,
  • Shonda C Ayers,
  • Amy B Harrell,
  • Brent R Brown,
  • Utpal S. Bhalala,
  • Joshua Kuehne,
  • Melinda Garcia,
  • Morgan Beebe,
  • Heather Herrera,
  • Chris Fiack,
  • Stephanie Guo,
  • May Vawer,
  • Beth Blackburn,
  • Caleb Darby,
  • Kristy Page,
  • Amanda Brown,
  • Jessie McAbee,
  • Katherine A. Belden,
  • Michael Baram,
  • Devin M. Weber,
  • Rosalie DePaola,
  • Yuwei Xia,
  • Hudson Carter,
  • Aaron Tolley,
  • Mary Barletta,
  • Mark Steele,
  • Laurie Kemble,
  • Joshua L. Denson,
  • A. Scott Gillet,
  • Margo Brown,
  • Rachael Stevens,
  • Andrew Wetherbie,
  • Kevin Tea,
  • Mathew Moore,
  • Abdurrahman Husain,
  • Atul Malhotra,
  • Qais Zawaydeh,
  • Benjamin J Sines,
  • Thomas J Bice,
  • Emily A. Vail,
  • Susannah Nicholson,
  • Rachelle B. Jonas,
  • AnnaRose E. Dement,
  • William Tang,
  • Mark DeRosa,
  • Robert E. Villarreal,
  • Rajany V. Dy,
  • Alfredo Iardino,
  • Jill Sharma,
  • Richard Czieki,
  • Julia Christopher,
  • Ryan Lacey,
  • Marwan Mashina,
  • Kushal Patel,
  • Erica C. Bjornstad,
  • Nancy M. Tofil,
  • Scott House,
  • Isabella Aldana,
  • Nikhil K. Meena,
  • Jose D. Caceres,
  • Nikhil K Meena,
  • Sarenthia M. Epps,
  • Harmeen Goraya,
  • Kelsey R. Besett,
  • Ryan James,
  • Lana Y. Abusalem,
  • Akash K. Patel,
  • Lana S Hasan,
  • Dina Gomaa,
  • Michael Goodman,
  • Devin Wakefield,
  • Anthony Spuzzillo,
  • John O. Shinn II,
  • Robert MacLaren,
  • Azra Bihorac,
  • Tezcan Ozrazgat Baslanti,
  • George Omalay,
  • Haleh Hashemighouchani,
  • Julie S. Cupka,
  • Matthew M Ruppert,
  • Patrick W. McGonagill,
  • Colette Galet,
  • Janice Hubbard,
  • David Wang,
  • Lauren Allan,
  • Aditya Badheka,
  • Madhuradhar Chegondi,
  • Usman Nazir,
  • Garrett Rampon,
  • Jake Riggle,
  • Nathan Dismang,
  • Vicki Montgomery,
  • Janice Sullivan,
  • Sarah Morris,
  • Jennifer Nason,
  • Ozan Akca,
  • Rainer Lenhardt,
  • Rodrigo S. Cavallazzi,
  • Ann Jerde,
  • Alexa Black,
  • Allison Polidori,
  • Haily Griffey,
  • Justin Winkler,
  • Thomas Brenzel,
  • Roger A. Alvarez,
  • Amarilys Alarcon-Calderon,
  • Marie Anne Sosa,
  • Sunita K. Mahabir,
  • Mausam J. Patel,
  • Pauline Park,
  • Andrew Admon,
  • Sinan Hanna,
  • Rishi Chanderraj,
  • Maria Pliakas,
  • Ann Wolski,
  • Jennifer Cirino,
  • Dima Dandachi,
  • Hariharan Regunath,
  • Maraya N. Camazine,
  • Grant. E. Geiger,
  • Abdoulie O. Njai,
  • Baraa M. Saad,
  • Faraaz Ali Shah,
  • Byron Chuan,
  • Sagar L. Rawal,
  • Manal Piracha,
  • Joseph E. Tonna,
  • Nicholas M. Levin,
  • Kayte Suslavich,
  • Rachel Tsolinas,
  • Zachary T. Fica,
  • Chloe R. Skidmore,
  • Renee D. Stapleton,
  • Anne E. Dixon,
  • Olivia Johnson,
  • Sara S. Ardren,
  • Stephanie Burns,
  • Anna Raymond,
  • Erika Gonyaw,
  • Kevin Hodgdon,
  • Chloe Housenger,
  • Benjamin Lin,
  • Karen McQuesten,
  • Heidi Pecott-Grimm,
  • Julie Sweet,
  • Sebastian Ventrone,
  • Nita Khandelwal,
  • T. Eoin West,
  • Ellen S. Caldwell,
  • Lara Lovelace-Macon,
  • Navya Garimella,
  • Denisse B. Dow,
  • Sreekanth R. Cheruku,
  • Catherine Chen,
  • Farzin Ahmed,
  • Christopher Deonarine,
  • Ashley Jones,
  • David Preston,
  • Mohammad-Ali Shaikh,
  • Jeanette Chin,
  • Murtaza Akhter,
  • Rania Abdul Rahman,
  • Mary Mulrow,
  • Erin M. Wilfong,
  • Kelsi Vela,
  • Ashish K. Khanna,
  • Lynne Harris,
  • Bruce Cusson,
  • Jacob Fowler,
  • David Vaneenenaam,
  • Glen McKinney,
  • Imoh Udoh,
  • Kathleen Johnson,
  • Patrick G. Lyons,
  • Andrew P Michelson,
  • Sara S. Haluf,
  • Lauren M. Lynch,
  • Nguyet M. Nguyen,
  • Aaron Steinberg,
  • Nicholas Braus,
  • Vishwanath Pattan,
  • Jessica Papke,
  • Ismail Jimada,
  • Nida Mhid,
  • Samuel Chakola,
  • Kevin Sheth,
  • Abdalla Ammar,
  • Mahmoud Ammar,
  • Victor Torres Lopez,
  • Charles Dela Cruz,,
  • Akhil Khosla,
  • Samir Gautam

DOI
https://doi.org/10.1097/CCE.0000000000000686
Journal volume & issue
Vol. 4, no. 4
p. e0686

Abstract

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OBJECTIVES:. To describe the prevalence, associated risk factors, and outcomes of serious neurologic manifestations (encephalopathy, stroke, seizure, and meningitis/encephalitis) among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:. Prospective observational study. SETTING:. One hundred seventy-nine hospitals in 24 countries within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. PATIENTS:. Hospitalized adults with laboratory-confirmed SARS-CoV-2 infection. INTERVENTIONS:. None. RESULTS:. Of 16,225 patients enrolled in the registry with hospital discharge status available, 2,092 (12.9%) developed serious neurologic manifestations including 1,656 (10.2%) with encephalopathy at admission, 331 (2.0%) with stroke, 243 (1.5%) with seizure, and 73 (0.5%) with meningitis/encephalitis at admission or during hospitalization. Patients with serious neurologic manifestations of COVID-19 were older with median (interquartile range) age 72 years (61.0–81.0 yr) versus 61 years (48.0–72.0 yr) and had higher prevalence of chronic medical conditions, including vascular risk factors. Adjusting for age, sex, and time since the onset of the pandemic, serious neurologic manifestations were associated with more severe disease (odds ratio [OR], 1.49; p < 0.001) as defined by the World Health Organization ordinal disease severity scale for COVID-19 infection. Patients with neurologic manifestations were more likely to be admitted to the ICU (OR, 1.45; p < 0.001) and require critical care interventions (extracorporeal membrane oxygenation: OR, 1.78; p = 0.009 and renal replacement therapy: OR, 1.99; p < 0.001). Hospital, ICU, and 28-day mortality for patients with neurologic manifestations was higher (OR, 1.51, 1.37, and 1.58; p < 0.001), and patients had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, –0.84, –1.34, and –0.84; p < 0.001). CONCLUSIONS:. Encephalopathy at admission is common in hospitalized patients with SARS-CoV-2 infection and is associated with worse outcomes. While serious neurologic manifestations including stroke, seizure, and meningitis/encephalitis were less common, all were associated with increased ICU support utilization, more severe disease, and worse outcomes.