Comparison of disease profiles and three-month outcomes of patients with neurological disorders with and without COVID-19: An ambispective cohort study
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
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
Room Number 707, Department of Neurology, Neurosciences Center, All India Institute of Medical Sciences, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
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.