COVID-19 in Patients With Pre-existing Neurologic Disorders: Clinical Course and Outcomes (2608)

Document Type

Article

Publication Date

4-13-2021

Publication Title

Neurology

Keywords

california; sjci; covid-19

Abstract

Objective: To assess the clinical course and outcomes of COVID-19 in patients with pre-existing neurologic disorders and the impact of COVID-19 on neurologic disorder during and after COVID-19.

Background: In March of 2020, as COVID-19 increased in the United States, several risk factors for severe COVID-19 emerged, including age, hypertension, diabetes, and immunocompromised state. Neurologic disorders were not among these risk factors, and no information existed on the course and outcomes of COVID-19 in patients with various neurologic disorders.

Design/Methods: After receiving IRB approval, a structured questionnaire was distributed via various media platforms between April–October 2020 to the US neurologists and neurology trainees with questions pertaining to their patients with pre-existing neurologic disorders who had COVID-19 infection confirmed either by SARS-Co-V2 PCR or IgG test.

Results: Over a 6-month period, 66 patients, (age range 1–94, mean 49.2 years, 39 females, 27 males) were submitted, with most frequent neurologic disorders being chronic migraine (23%), epilepsy (12%) and multiple sclerosis (MS) (11%). Of these, 58% had a mild-to-moderate course of COVID-19 requiring no hospitalization, 41% required hospitalization or intensive care unit admission, and 5 patients died (2 were in their 90s with a history of stroke, 2 in their 60s with malignancy, and one 31-year-old male with MS.) COVID-19 resulted in exacerbation of the underlying neurologic disorder during or after COVID-19 in 57% of patients. Common persistent symptoms after COVID-19 included fatigue, exercise intolerance and headache.

Conclusions: In this cohort, majority of patients with pre-existing neurologic disorders had a mild-to-moderate course of COVID-19 requiring no hospitalization, but many experienced exacerbation of their pre-existing neurologic disorder during or after COVID-19 and had persistent symptoms of fatigue, exercise intolerance and headache. Large prospective studies are needed to determine which neurologic disorders present a significant risk in order to protect the most vulnerable patient population.

Clinical Institute

Neurosciences (Brain & Spine)

Department

Infectious Diseases

Department

Neurosciences

Comments

Svetlana Blitshteyn, Jill Brook, Mia Minen, Akanksha Sharma, Maria Diaz Ordonez, Samantha Holden, Katherine Zarroli, Deepti Chrusciel, Tanya Reyna, Carrie Landess, Megan Donnelly, Karima Benameur

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