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Neuropsychiatric complications of coronavirus disease 2019: Mount Sinai Health System cohort study

Kapil Gururangan1,2, Veronica J Peschansky1,3, Grace Van Hyfte4

  • 1Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Journal of Neurology
|April 24, 2024
PubMed

Insights

Neuropsychiatric complications, particularly altered mental status (AMS), were frequent in hospitalized COVID-19 patients. These complications, along with factors like ventilator use, increased mortality risk.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) has been associated with a wide range of clinical manifestations.
  • Neuropsychiatric complications represent a significant concern in patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Purpose of the Study:

  • To determine the incidence of neuropsychiatric complications in hospitalized COVID-19 patients.
  • To investigate the relationship between these complications, pre-existing conditions, and patient outcomes, including mortality.

Main Methods:

  • A retrospective analysis of 974 patients hospitalized with COVID-19 across a New York City health system.
  • Data on neuropsychiatric complications (altered mental status, seizures, stroke, headache, anxiety, ataxia) and in-hospital mortality were extracted.
  • Multivariate logistic regression was used to assess associations.

Main Results:

  • Neuropsychiatric complications were observed in 58.8% of patients, with altered mental status (AMS) in 39.8%.
  • In-hospital mortality was 22.0% and was linked to AMS, ventilator support, age, and inflammatory markers.
  • Anticoagulant therapy correlated with reduced mortality and AMS incidence.

Conclusions:

  • Neuropsychiatric complications, especially AMS, are common and diverse among hospitalized COVID-19 patients.
  • These complications are associated with increased in-hospital mortality.
  • Findings highlight the significant neurological impact of COVID-19 in a large, diverse patient population.
Abstract

Keywords:
Coronavirus disease 2019Mount Sinai Health SystemNeuroCOVIDNeurological complicationsSARS-CoV-2

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