Annals of Indian Academy of Neurology (Jan 2022)

Comparison of disease profiles and three-month outcomes of patients with neurological disorders with and without COVID-19: An ambispective cohort study

  • Kanchana S Pillai,
  • Deepti Vibha,
  • Pranjal Gupta,
  • Pachipala Sudheer,
  • Biswamohan Mishra,
  • Rahul S Oinam,
  • Ayush Mohan,
  • Kamalesh Tayade,
  • Padma Srivastava,
  • Manjari Tripathi,
  • Achal K Srivastava,
  • Rohit Bhatia,
  • Roopa Rajan,
  • Awadh K Pandit,
  • Rajesh K Singh,
  • Arunmozhimaran Elavarasi,
  • Ayush Agarwal,
  • Anu Gupta,
  • Animesh Das,
  • Divya M Radhakrishnan,
  • Bhargavi Ramanujam,
  • Kapil D Soni,
  • Richa Aggarwal,
  • Naveet Wig,
  • Anjan Trikha

DOI
https://doi.org/10.4103/aian.aian_602_21
Journal volume & issue
Vol. 25, no. 2
pp. 218 – 223

Abstract

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Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-CoV-2 infection. Methods: In an ambispective cohort study design, we enrolled patients with and without SARS CoV-2 infection coming to a medical emergency with neurological disorders between April 2020 and September 2020. Demographic, clinical, biochemical, and treatment details of these patients were collected and compared. Their outcomes, both in-hospital and at 3 months were assessed by the modified Rankin Scale (mRS). Results: Two thirty-five patients (235) were enrolled from emergency services with neurological disorders. Of them, 81 (34.5%) were COVID-19 positive. The mean (SD) age was 49.5 (17.3) years, and the majority of the patients were male (63.0%). The commonest neurological diagnosis was acute ischemic stroke (AIS) (43.0%). The in-hospital mortality was higher in the patients who were COVID-19 positive (COVID-19 positive: 29 (35.8%) versus COVID-19 negative: 12 (7.8%), P value: <0.001). The 3 months telephonic follow-up could be completed in 73.2% of the patients (142/194). Four (12.1%) deaths occurred on follow-up in the COVID-19 positive versus fifteen (13.8%) in the COVID-19 negative patients (P value: 1.00). The 3-month mRS was worse in the COVID-19 positive group (P value <0.001). However, this was driven by higher in-hospital morbidity and mortality in COVID-19 positive patients. Conclusion: Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital and 3 months disability.

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