Frontiers in Neurology (Jul 2020)

Neurological Comorbidity Is a Predictor of Death in Covid-19 Disease: A Cohort Study on 576 Patients

  • David García-Azorín,
  • Enrique Martínez-Pías,
  • Javier Trigo,
  • Isabel Hernández-Pérez,
  • Gonzalo Valle-Peñacoba,
  • Blanca Talavera,
  • Paula Simón-Campo,
  • Mercedes de Lera,
  • Alba Chavarría-Miranda,
  • Cristina López-Sanz,
  • María Gutiérrez-Sánchez,
  • Elena Martínez-Velasco,
  • María Pedraza,
  • Álvaro Sierra,
  • Beatriz Gómez-Vicente,
  • Ángel Guerrero,
  • Ángel Guerrero,
  • David Ezpeleta,
  • María Jesús Peñarrubia,
  • Jose Ignacio Gómez-Herreras,
  • Elena Bustamante-Munguira,
  • Cristina Abad-Molina,
  • Antonio Orduña-Domingo,
  • Guadalupe Ruiz-Martin,
  • María Isabel Jiménez-Cuenca,
  • Santiago Juarros,
  • Carlos del Pozo-Vegas,
  • Carlos Dueñas-Gutierrez,
  • Jose María Prieto de Paula,
  • Belén Cantón-Álvarez,
  • Jose Manuel Vicente,
  • Juan Francisco Arenillas,
  • Juan Francisco Arenillas,
  • Juan Francisco Arenillas

DOI
https://doi.org/10.3389/fneur.2020.00781
Journal volume & issue
Vol. 11

Abstract

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Introduction: Prognosis of Coronavirus disease 2019 (Covid-19) patients with vascular risk factors, and certain comorbidities is worse. The impact of chronic neurological disorders (CND) on prognosis is unclear. We evaluated if the presence of CND in Covid-19 patients is a predictor of a higher in-hospital mortality. As secondary endpoints, we analyzed the association between CND, Covid-19 severity, and laboratory abnormalities during admission.Methods: Retrospective cohort study that included all the consecutive hospitalized patients with confirmed Covid-19 disease from March 8th to April 11th, 2020. The study setting was Hospital Clínico, tertiary academic hospital from Valladolid. CND was defined as those neurological conditions causing permanent disability. We assessed demography, clinical variables, Covid-19 severity, laboratory parameters and outcome. The primary endpoint was in-hospital all-cause mortality, evaluated by multivariate cox-regression log rank test. We analyzed the association between CND, covid-19 severity and laboratory abnormalities.Results: We included 576 patients, 43.3% female, aged 67.2 years in mean. CND were present in 105 (18.3%) patients. Patients with CND were older, more disabled, had more vascular risk factors and comorbidities and fewer clinical symptoms of Covid-19. They presented 1.43 days earlier to the emergency department. Need of ventilation support was similar. Presence of CND was an independent predictor of death (HR 2.129, 95% CI: 1.382–3.280) but not a severer Covid-19 disease (OR: 1.75, 95% CI: 0.970–3.158). Frequency of laboratory abnormalities was similar, except for procalcitonin and INR.Conclusions: The presence of CND is an independent predictor of mortality in hospitalized Covid-19 patients. That was not explained neither by a worse immune response to Covid-19 nor by differences in the level of care received by patients with CND.

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