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COVID-19 impact on consecutive neurological patients admitted to the emergency department
medRxiv - Neurology Pub Date : 2020-05-26 , DOI: 10.1101/2020.05.23.20110650 Andrea Pilotto , Alberto Benussi , Ilenia Libri , Stefano Masciocchi , Loris Poli , Enrico Premi , Antonella Alberici , Enrico Baldelli , Sonia Bonacina , Laura Brambilla , Matteo Benini , Salvatore Caratozzolo , Matteo Cortinovis , Angelo Costa , Stefano Cotti Piccinelli , Elisabetta Cottini , Viviana Cristillo , Ilenia Delrio , Massimiliano Filosto , Massimo Gamba , Stefano Gazzina , Nicola Gilberti , Stefano Gipponi , Marcello Giunta , Alberto Imarisio , Paolo Liberini , Martina Locatelli , Francesca Schiano di Cola , Renata Rao , Barbara Risi , Luca Rozzini , Andrea Scalvini , Veronica Vergani , Irene Volonghi , Nicola Zoppi , Barbara Borroni , Mauro Magoni , Matilde Leonardi , Gianluigi Zanusso , Sergio Ferrari , Sara Mariotto , Alessandro Pezzini , Roberto Gasparotti , Ciro Paolillo , Alessandro Padovani
medRxiv - Neurology Pub Date : 2020-05-26 , DOI: 10.1101/2020.05.23.20110650 Andrea Pilotto , Alberto Benussi , Ilenia Libri , Stefano Masciocchi , Loris Poli , Enrico Premi , Antonella Alberici , Enrico Baldelli , Sonia Bonacina , Laura Brambilla , Matteo Benini , Salvatore Caratozzolo , Matteo Cortinovis , Angelo Costa , Stefano Cotti Piccinelli , Elisabetta Cottini , Viviana Cristillo , Ilenia Delrio , Massimiliano Filosto , Massimo Gamba , Stefano Gazzina , Nicola Gilberti , Stefano Gipponi , Marcello Giunta , Alberto Imarisio , Paolo Liberini , Martina Locatelli , Francesca Schiano di Cola , Renata Rao , Barbara Risi , Luca Rozzini , Andrea Scalvini , Veronica Vergani , Irene Volonghi , Nicola Zoppi , Barbara Borroni , Mauro Magoni , Matilde Leonardi , Gianluigi Zanusso , Sergio Ferrari , Sara Mariotto , Alessandro Pezzini , Roberto Gasparotti , Ciro Paolillo , Alessandro Padovani
Abstract
Objective: Aim of this study was to analyse the impact of COVID-19 on clinical and laboratory
findings and outcome of neurological patients consecutively admitted to the emergency department
(ED) of a tertiary hub center.
Methods: All adult patients consecutively admitted to the ED for neurological manifestations from
February 20 th through April 30 th 2020 at Spedali Civili of Brescia entered the study. Demographic,
clinical, and laboratory data were extracted from medical records and compared between patients
with and without COVID-19.
Results: Out of 505 consecutively patients evaluated at ED with neurological symptoms, 147
(29.1%) tested positive for SARS-CoV-2. These patients displayed at triage higher values of CRP,
AST, ALT, and fibrinogen but not lymphopenia (p<0.05). They were older (73.1 + 12.4 vs 65.1 +
18.9 years, p=0.001) had higher frequency of stroke (34.7% vs 29.3%), encephalitis/meningitis
(9.5% vs 1.9%) and delirium (16.3% vs 5.0%). Compared to patients without COVID, they were
more frequently hospitalized (91.2% vs 69.3%, p<0.0001) and showed higher mortality rates
(29.7% vs 1.8%, p<0.0.001) and discharge disability, independently from age.
Conclusions: COVID-19 impacts on clinical presentation of neurological disorders, with higher
frequency of stroke, encephalitis and delirium, and was strongly associated with increased
hospitalisation, mortality and disability.
中文翻译：
COVID-19对连续入院急诊科的神经科患者的影响
摘要目的：本研究旨在分析COVID-19对连续入院三级急诊中心（ED）的神经科患者的临床和实验室检查结果以及结局的影响。方法：从2020年2月20日至4月30日在布雷西亚Spedali Civili连续接受急诊的神经系统表现的所有成年患者进入研究。从医疗记录中提取人口统计学，临床和实验室数据，并在有和没有COVID-19的患者之间进行比较。结果：在505名接受ED评估并具有神经系统症状的连续患者中，有147名（29.1％）检测出SARS-CoV-2阳性。这些患者的CRP，AST，ALT和纤维蛋白原值较高，但没有淋巴细胞减少（p <0.05）。他们年龄较大（73.1 + 12.4 vs 65.1 + 18.9岁，p = 0。001）的中风发生率更高（34.7％vs 29.3％），脑炎/脑膜炎（9.5％vs 1.9％）和del妄（16.3％vs 5.0％）。与没有COVID的患者相比，他们住院的频率更高（91.2％vs 69.3％，p <0.0001），并且死亡率更高（29.7％vs 1.8％，p <0.0.001），并且出院残疾与年龄无关。结论：COVID-19对神经系统疾病的临床表现有影响，中风，脑炎和ir妄的发生频率更高，并且与住院，死亡率和残疾增加密切相关。001）和放电残疾，与年龄无关。结论：COVID-19对神经系统疾病的临床表现有影响，中风，脑炎和ir妄的发生频率更高，并且与住院，死亡率和残疾增加密切相关。001）和放电残疾，与年龄无关。结论：COVID-19对神经系统疾病的临床表现有影响，中风，脑炎和ir妄的发生频率更高，并且与住院，死亡率和残疾增加密切相关。
更新日期：2020-05-26
中文翻译：
COVID-19对连续入院急诊科的神经科患者的影响
摘要目的：本研究旨在分析COVID-19对连续入院三级急诊中心（ED）的神经科患者的临床和实验室检查结果以及结局的影响。方法：从2020年2月20日至4月30日在布雷西亚Spedali Civili连续接受急诊的神经系统表现的所有成年患者进入研究。从医疗记录中提取人口统计学，临床和实验室数据，并在有和没有COVID-19的患者之间进行比较。结果：在505名接受ED评估并具有神经系统症状的连续患者中，有147名（29.1％）检测出SARS-CoV-2阳性。这些患者的CRP，AST，ALT和纤维蛋白原值较高，但没有淋巴细胞减少（p <0.05）。他们年龄较大（73.1 + 12.4 vs 65.1 + 18.9岁，p = 0。001）的中风发生率更高（34.7％vs 29.3％），脑炎/脑膜炎（9.5％vs 1.9％）和del妄（16.3％vs 5.0％）。与没有COVID的患者相比，他们住院的频率更高（91.2％vs 69.3％，p <0.0001），并且死亡率更高（29.7％vs 1.8％，p <0.0.001），并且出院残疾与年龄无关。结论：COVID-19对神经系统疾病的临床表现有影响，中风，脑炎和ir妄的发生频率更高，并且与住院，死亡率和残疾增加密切相关。001）和放电残疾，与年龄无关。结论：COVID-19对神经系统疾病的临床表现有影响，中风，脑炎和ir妄的发生频率更高，并且与住院，死亡率和残疾增加密切相关。001）和放电残疾，与年龄无关。结论：COVID-19对神经系统疾病的临床表现有影响，中风，脑炎和ir妄的发生频率更高，并且与住院，死亡率和残疾增加密切相关。
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