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:10.4103/aian.aian_602_21

Comparison of Disease Profiles and Three-Month Outcomes of Patients with Neurological Disorders with and without COVID-19: An Ambispective Cohort Study

Ann Indian Acad Neurol. 2022 Mar-Apr;25(2):218-223. doi: 10.4103/aian.aian_602_21. Epub 2022 Mar 1.

Authors

Kanchana S Pillai¹, Deepti Vibha¹, Pranjal Gupta¹, Pachipala Sudheer¹, Biswamohan Mishra¹, Rahul S Oinam¹, Ayush Mohan¹, Kamalesh Tayade¹, Padma Srivastava¹, Manjari Tripathi¹, Achal K Srivastava¹, Rohit Bhatia¹, Roopa Rajan¹, Awadh K Pandit¹, Rajesh K Singh¹, Arunmozhimaran Elavarasi¹, Ayush Agarwal¹, Anu Gupta¹, Animesh Das¹, Divya M Radhakrishnan¹, Bhargavi Ramanujam¹, Kapil D Soni², Richa Aggarwal², Naveet Wig³, Anjan Trikha²

Affiliations

¹ Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
² Department of Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

Abstract

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.

Keywords: 3- months follow-up; Ambispective cohort study; COVID-19 neurology; in-hospital mortality; modified Rankin Scale.