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Neurological comorbidities and COVID-19-related case fatality: A cohort study

Alberto Romagnolo1, Gabriele Imbalzano1, Carlo Alberto Artusi1

  • 1Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy; SC Neurologia 2U, AOU Città della Salute e della Scienza, Turin, Italy.

Journal of the Neurological Sciences
|August 13, 2021
PubMed

Insights

Pre-existing neurological conditions, especially neurodegenerative diseases, significantly increase the risk of death from Coronavirus disease-2019 (COVID-19). These findings highlight the need for prioritized screening, care, and vaccination for neurological patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Neurological involvement is a known complication of Coronavirus disease-2019 (COVID-19).
  • The impact of pre-existing neurological conditions on COVID-19 mortality remains under investigation.
  • This study examines the case fatality rate (CFR) in COVID-19 patients with prior neurological diagnoses.

Purpose of the Study:

  • To assess the association between pre-existing neurological diseases and COVID-19 related mortality.
  • To compare the CFR and survival outcomes in COVID-19 patients with and without neurological comorbidities.

Main Methods:

  • Retrospective cohort study of 332 COVID-19 patients admitted between March-April 2020.
  • Multivariate regression analysis to determine the association between neurological diseases and mortality.
  • Propensity score matching (1:1) to compare CFR and survival curves between neurological and non-neurological patient groups.

Main Results:

  • Patients with pre-existing neurological disease (22.6%) had a significantly increased risk of COVID-19 mortality (OR: 2.559, p < 0.017).
  • The overall CFR was double in patients with neurological conditions (48.0% vs. 24.0%, p = 0.002).
  • Neurodegenerative diseases showed a significantly higher CFR (73.9% vs. 39.1%, p = 0.017), while cerebrovascular diseases did not reach statistical significance.

Conclusions:

  • Pre-existing neurological comorbidities, particularly neurodegenerative diseases, substantially increase COVID-19 case fatality.
  • These findings underscore the critical need for prioritized screening, healthcare access, and vaccination for individuals with neurological conditions.
Abstract

Keywords:
COVID-19DementiaMortalityNeurologyStroke

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