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- Sung-Min Cho
- Neuroscience Critical Care Division, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine , Baltimore, MD , USA
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- Nicole White
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology , Brisbane, Queensland , Australia
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- Lavienraj Premraj
- Griffith University School of Medicine , Gold Coast, Queensland , Australia
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- Denise Battaglini
- San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Department of Surgical Science and Integrated Diagnostic, University of Genoa , Genoa , Italy
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- Jonathon Fanning
- Critical Care Research Group, The Prince Charles Hospital , Brisbane, Queensland , Australia
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- Jacky Suen
- Critical Care Research Group, The Prince Charles Hospital , Brisbane, Queensland , Australia
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- Gianluigi Li Bassi
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology , Brisbane, Queensland , Australia
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- John Fraser
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology , Brisbane, Queensland , Australia
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- Chiara Robba
- San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Department of Surgical Science and Integrated Diagnostic, University of Genoa , Genoa , Italy
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- Matthew Griffee
- Department of Anesthesiology, University of Utah , Salt Lake City, UT , USA
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- Bhagteshwar Singh
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool , UK
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- ;?>Barbara Wanjiru Citarella
- International Severe Acute Respiratory and emerging Infections Consortium (ISARIC), Pandemic Sciences Institute, University of Oxford , Oxford , UK
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- Laura Merson
- International Severe Acute Respiratory and emerging Infections Consortium (ISARIC), Pandemic Sciences Institute, University of Oxford , Oxford , UK
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- Tom Solomon
- Brain Infections Group, Institute of Infection and Global Health, University of Liverpool , Liverpool , UK
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- David Thomson
- Department of Medicine, University of Cape Town , Cape Town , South Africa
抄録
<jats:title>Abstract</jats:title><jats:p>Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models.</jats:p><jats:p>Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P < 0.001).</jats:p><jats:p>Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age.</jats:p><jats:p>In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age.</jats:p>
収録刊行物
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- Brain
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Brain 146 (4), 1648-1661, 2022-09-10
Oxford University Press (OUP)