Clinical Variables Associated With Impaired Consciousness in Hospitalized COVID-19 Patients

Impaired consciousness is associated with complications and mortality in COVID-19 patients. We study factors associated with impaired consciousness as measured by the Glasgow Coma Scale (GCS) in COVID-19 patients.

This is a retrospective study of 604 patients with COVID-19 in the metropolitan New York City area. We study the association of demographics, comorbidity, disease severity, treatment management, and laboratory measurements with both GCS nadir during hospitalization and GCS at discharge.

Age was significantly associated with severe GCS nadir during hospitalization and at hospital discharge. Body mass index comorbidity was significantly associated with severe GCS at hospital discharge. Sedation treatment was significantly associated with both moderate and severe GCS nadir during hospitalization. Glucose nadir was significantly associated with severe GCS nadir during hospitalization. Sodium level at admission was associated with decreased relative risk while BUN peak level during hospitalization was associated with increased relative risk for severe GCS on discharge.

We found that factors from demographics, comorbidity, treatment management, and laboratory measurements were associated with GCS while disease severity was not significantly associated with GCS. These findings can guide clinicians for treatment approaches for the early identification of impaired consciousness and its degrees of severity in COVID-19 patients.