The Impact of SARS-CoV-2 Infection on the Length of Stay in the Neuro-ICU:A Prospective Multicenter Cohort Study in Eight Neuro-ICU, China Between February and April 2023

Liang Tan; Feilong Wang; Yi Huang; Chuhua Fu; Haijun Zhang; Jianfei Feng; Yincai Xu; Xinzhen Ye; Rongrui Tang; Yinglian Chen; Liansheng Mou; Ronghao Li; Jingyu Chen; Jishu Xian

doi:10.2147/NDT.S447887

The Impact of SARS-CoV-2 Infection on the Length of Stay in the Neuro-ICU:A Prospective Multicenter Cohort Study in Eight Neuro-ICU, China Between February and April 2023

Neuropsychiatr Dis Treat. 2024 Mar 30:20:765-775. doi: 10.2147/NDT.S447887. eCollection 2024.

Authors

Liang Tan^#¹, Feilong Wang^#¹, Yi Huang², Chuhua Fu³, Haijun Zhang⁴, Jianfei Feng⁵, Yincai Xu⁶, Xinzhen Ye⁷, Rongrui Tang⁸, Yinglian Chen⁹, Liansheng Mou¹⁰, Ronghao Li¹¹, Jingyu Chen¹, Jishu Xian¹

Affiliations

¹ Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, People's Republic of China.
² Department of Neurosurgery, The Ninth People's Hospital of Chongqing, Chongqing, People's Republic of China.
³ Department of Neurosurgery, Xiangyang No.1 People's Hospital, University of Medicine, Xiangyang, Hubei, People's Republic of China.
⁴ Department of Neurosurgery, Kaifeng Central Hospital, Kaifeng, Henan, People's Republic of China.
⁵ Department of Encephalopathy, Beibei Traditional Chinese Medical Hospital, Chongqing, People's Republic of China.
⁶ Department of Neurosurgery, Zheng Coal General Hospital, Zhengzhou, Henan Province, People's Republic of China.
⁷ Department of Neurosurgery, Songshan General Hospital, Chongqing, People's Republic of China.
⁸ Department of Neurosurgery, University-Town Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
⁹ Zhuhai Brainlightning Research Institute, Zhuhai City, Guangdong, People's Republic of China.
¹⁰ Department of Neurosurgery, Liangping District People's Hospital, Chongqing, People's Republic of China.
¹¹ Department of Basic Medicine, Army Medical University, Chongqing, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: The SARS-CoV-2 infection cases are increasing rapidly in neuro-intensive care units (neuro-ICUs) at the beginning of 2023 in China. We aimed to characterize the prevalence, risk factors, and prognosis of critically ill patients treated in neuro-ICUs.

Materials and methods: In the prospective, multicenter, observational registry study, critically ill patients with intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI) admitted to eight Chinese neuro-ICUs between Feb 16, 2023, to Apr 30, 2023 were enrolled for the study. Mortality and ICU stay day were used as the primary outcomes.

Results: 131 patients were finally included and analyzed (mean age 60.36 years [SD 13.81], 64.12% male, 39.69% SARS-CoV-2 infected). The mortality is higher in the SARS-CoV-2 infection group without statistical signification (7.69% vs 5.06%, p>0.05). The length of stay (LOS) in neuro-ICUs was significantly longer among the SARS-CoV-2 infection patients (7(1-12) vs 4(1-8), p<0.01), with increased viral pneumonia occurrence (58.54% vs 7.32%, p<0.01). SARS-CoV-2 infection, surgery, and low GCS scores were independent risk factors for prolonged LOS, and respiratory/renal failure were independent risk factors for death.

Conclusion: Based on the present neuro-ICU cohort, SARS-CoV-2 infection was a significant risk for the prolonged LOS of neuro-critically ill patients.

Trial registration: Registered with Chictr.org.cn (ChiCTR2300068355) at 16 February 2023, Prospective registration. https://www.chictr.org.cn/showproj.html?proj=188252.

Keywords: SARS-CoV-2; intensive care unit; intracerebral hemorrhage; subarachnoid hemorrhage; traumatic brain injury.

Grants and funding

This study was supported by the Chongqing Middle and Young Medical High-end Talent Project, the Scientific Research Program of the Education Department of Hubei Province (Grant number D20222103), and the Chongqing Science-health joint medical research project (2022QNXM27). The funders were not involved in the study design, data collection/interpretation, and the decision to submit the publication results.