Neurological manifestations of COVID-19 in adults and children

Sung-Min Cho; Nicole White; Lavienraj Premraj; Denise Battaglini; Jonathon Fanning; Jacky Suen; Gianluigi Li Bassi; John Fraser; Chiara Robba; Matthew Griffee; Bhagteshwar Singh; Barbara Wanjiru Citarella; Laura Merson; Tom Solomon; David Thomson; Ali Abbas; Nurul Najmee Abdulkadir; Ryuzo Abe; Laurent Abel; Lara Absil; Subhash Acharya; Andrew Acker; Diana Adrião; Saleh Al Ageel; Shakeel Ahmed; Kate Ainscough; Tharwat Aisa; Ali Ait Hssain; Younes Ait Tamlihat; Takako Akimoto; Ernita Akmal; Razi Alalqam; Tala Al-Dabbous; Senthilkumar Alegesan; Cynthia Alegre; Beatrice Alex; Kevin Alexandre; Abdulrahman Al-Fares; Huda Alfoudri; Imran Ali; Naseem Ali Shah; Kazali Enagnon Alidjnou; Jeffrey Aliudin; Qabas Alkhafajee; Clotilde Allavena; Nathalie Allou; Aneela Altaf; João Alves; Rita Alves; Maria Amaral; Nur Amira; Phoebe Ampaw; Roberto Andini; Claire Andrejak; Andrea Angheben; François Angoulvant; Severine Ansart; Sivanesen Anthonidass; Massimo Antonelli; Carlos Alexandre Antunes de Brito; Ardiyan Apriyana; Irene Aragao; Francisco Arancibia; Carolline Araujo; Antonio Arcadipane; Patrick Archambault; Lukas Arenz; Jean-Benoît Arlet; Christel Arnold-Day; Lovkesh Arora; Rakesh Arora; Elise Artaud-Macari; Diptesh Aryal; Angel Asensio; Muhammad Ashraf; Namra Asif; Mohammad Asim; Jean Baptiste Assie; Amirul Asyraf; Anika Atique; AM. Udara Lakshan Attanyake; Johann Auchabie; Hugues Aumaitre; Adrien Auvet; Laurène Azemar; Cecile Azoulay; Benjamin Bach; Delphine Bachelet; Claudine Badr; Nadia Baig; J. Kenneth Baillie; Erica Bak; Agamemnon Bakakos; Nazreen Abu Bakar; Andriy Bal; Mohanaprasanth Balakrishnan; Valeria Balan; Firouze Bani-Sadr; Renata Barbalho; Wendy S Barclay; Saef Umar Barnett; Michaela Barnikel; Audrey Barrelet; Cleide Barrigoto; Marie Bartoli; Joaquín Baruch; Romain Basmaci; Muhammad Fadhli Hassin Basri; Jules Bauer; Diego Fernando Bautista Rincon; Abigail Beane; Alexandra Bedossa; Ker Hong Bee; Husna Begum; Sylvie Behilill; Albertus Beishuizen; Aleksandr Beljantsev; David Bellemare; Anna Beltrame; Marine Beluze; Nicolas Benech; Lionel Eric Benjiman; Dehbia Benkerrou; Suzanne Bennett; Luís Bento; Jan-Erik Berdal; Delphine Bergeaud; Hazel Bergin; Jose Luis Bernal Sobrino; Giulia Bertoli; Lorenzo Bertolino; Simon Bessis; Sybille Bevilcaqua; Karine Bezulier; Amar Bhatt; Krishna Bhavsar; Claudia Bianco; Farah Nadiah Bidin; Moirangthem Bikram Singh; Mohd Nazlin Bin Kamarudin; François Bissuel; Laurent Bitker; Jonathan Bitton; Pablo Blanco-Schweizer; Catherine Blier; Frank Bloos; Mathieu Blot; Filomena Boccia; Laetitia Bodenes; Alice Bogaarts; Debby Bogaert; Anne-Helène Boivin; Pierre-Adrien Bolze; François Bompart; Diogo Borges; Raphaël Borie; Hans Martin Bosse; Elisabeth Botelho-Nevers; Lila Bouadma; Olivier Bouchaud; Sabelline Bouchez; Dounia Bouhmani; Damien Bouhour; Kevin Bouiller; Laurence Bouillet; Camile Bouisse; Anne-Sophie Boureau; John Bourke; Maude Bouscambert; Aurore Bousquet; Jason Bouziotis; Bianca Boxma; Marielle Boyer-Besseyre; Maria Boylan; Fernando Augusto Bozza; Axelle Braconnier; Cynthia Braga; Timo Brandenburger; Filipa Brás Monteiro; Luca Brazzi; Patrick Breen; Dorothy Breen; Kathy Brickell; Shaunagh Browne; Nicolas Brozzi; Marjolein Brusse-Keizer; Nina Buchtele; Christian Buesaquillo; Marielle Buisson; Erlina Burhan; Aidan Burrell; Andre Cabie; Susana Cabral; Eder Caceres; Cyril Cadoz; Jose Andres Calvache; João Camões; Valentine Campana; Paul Campbell; Cecilia Canepa; Mireia Cantero; Pauline Caraux-Paz; Sheila Cárcel; Chiara Simona Cardellino; Sofia Cardoso; Filipe Cardoso; Filipa Cardoso; Nelson Cardoso; Simone Carelli; Nicolas Carlier; Thierry Carmoi; Gayle Carney; Inês Carqueja; Marie-Christine Carret; François Martin Carrier; Ida Carroll; Gail Carson; Maire-Laure Casanova; Mariana Cascão; Siobhan Casey; Jose Casimiro; Bailey Cassandra; Silvia Castañeda; Nidyanara Castanheira; Guylaine Castor-Alexandre; Henry Castrillón; Ivo Castro; Ana Catarino; François-Xavier Catherine; Paolo Cattaneo; Roberta Cavalin; Giulio Giovanni Cavalli; Alexandros Cavayas; Minerva Cervantes-Gonzalez; Anissa Chair; Catherine Chakveatze; Adrienne Chan; Meera Chand; Christelle Chantalat Auger; Jean-Marc Chapplain; Julie Chas; Mobin Chaudry; Jonathan Samuel Chávez Iñiguez; Anjellica Chen; Yih-Sharng Chen; Matthew Pellan Cheng; Antoine Cheret; Thibault Chiarabini; Julian Chica; Suresh Kumar Chidambaram; Leong Chin Tho; Catherine Chirouze; Davide Chiumello; Bernard Cholley; Marie-Charlotte Chopin; Ting Soo Chow; Hiu Jian Chua; Jonathan Chua; Jose Pedro Cidade; Jose Miguel Cisneros Herreros; Anna Ciullo; Jennifer Clarke; Emma Clarke; Sara Clohisey; Perren J Cobb; Cassidy Codan; Caitriona Cody; Alexandra Coelho; Megan Coles; Gwenhaël Colin; Michael Collins; Sebastiano Maria Colombo; Pamela Combs; Marie Connor; Anne Conrad; Sofía Contreras; Elaine Conway; Graham S Cooke; Mary Copland; Hugues Cordel; Amanda Corley; Sabine Cornelis; Alexander Daniel Cornet; Arianne Joy Corpuz; Gregory Corvaisier; Emma Costigan; Camille Couffignal; Sandrine Couffin-Cadiergues; Roxane Courtois; Stephanie Cousse; Rachel Cregan; Sabine Croonen; Gloria Crowl; Jonathan Crump; Claudina Cruz; Juan Luis Cruz Berm; Jaime Cruz Rojo; Marc Csete; Ailbhe Cullen; Matthew Cummings; Gerard Curley; Elodie Curlier; Colleen Curran; Paula Custodio; Ana da Silva Filipe; Charlene Da Silveira; Al-Awwab Dabaliz; Andrew Dagens; Darren Dahly; Heidi Dalton; Jo Dalton; Seamus Daly; Nick Daneman; Corinne Daniel; Emmanuelle A Dankwa; Jorge Dantas; D

doi:10.1093/brain/awac332

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Neurological manifestations of COVID-19 in adults and children

Journal article

Open access

Neurological manifestations of COVID-19 in adults and children

Sung-Min Cho, Nicole White, Lavienraj Premraj, Denise Battaglini, Jonathon Fanning, Jacky Suen, Gianluigi Li Bassi, John Fraser, Chiara Robba, Matthew Griffee, …

Brain, Vol.146(4)

2023

DOI: https://doi.org/10.1093/brain/awac332

Abstract

adolescent

adult

aged

altered state of consciousness

anosmia

Article

central nervous system infection

cerebrovascular accident

child

cohort analysis

controlled study

coronavirus disease 2019

dysgeusia

extracorporeal oxygenation

fatigue

female

hospital admission

hospitalization

human

hypertension

intensive care unit

invasive ventilation

major clinical study

male

middle aged

mortality

myalgia

neurologic disease

neurological complication

observational study

pandemic

prevalence

retrospective study

risk factor

secondary analysis

seizure

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. 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). 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. 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. © 2022 The Author(s). Published by Oxford University Press on behalf of the Guarantors of Brain.

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Title: Neurological manifestations of COVID-19 in adults and children
Creators: Sung-Min Cho
Nicole White - Queensland University of Technology
Lavienraj Premraj - Prince Charles Hospital
Denise Battaglini - Universitat de Barcelona
Jonathon Fanning - University of Queensland
Jacky Suen - University of Queensland
Gianluigi Li Bassi - University of Queensland
John Fraser - Prince Charles Hospital
Chiara Robba - University of Genoa
Matthew Griffee - University of Utah
Bhagteshwar Singh - Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool
Barbara Wanjiru Citarella - University of Oxford
Laura Merson - University of Oxford
Tom Solomon - University of Liverpool
David Thomson - University of Cape Town
Ali Abbas
Nurul Najmee Abdulkadir
Ryuzo Abe
Laurent Abel
Lara Absil
Subhash Acharya
Andrew Acker
Diana Adrião
Saleh Al Ageel
Shakeel Ahmed
Kate Ainscough
Tharwat Aisa
Ali Ait Hssain
Younes Ait Tamlihat
Takako Akimoto
Ernita Akmal
Razi Alalqam
Tala Al-Dabbous
Senthilkumar Alegesan
Cynthia Alegre
Beatrice Alex
Kevin Alexandre
Abdulrahman Al-Fares
Huda Alfoudri
Imran Ali
Naseem Ali Shah
Kazali Enagnon Alidjnou
Jeffrey Aliudin
Qabas Alkhafajee
Clotilde Allavena
Nathalie Allou
Aneela Altaf
João Alves
Rita Alves
Maria Amaral
Nur Amira
Phoebe Ampaw
Roberto Andini
Claire Andrejak
Andrea Angheben
François Angoulvant
Severine Ansart
Sivanesen Anthonidass
Massimo Antonelli
Carlos Alexandre Antunes de Brito
Ardiyan Apriyana
Irene Aragao
Francisco Arancibia
Carolline Araujo
Antonio Arcadipane
Patrick Archambault
Lukas Arenz
Jean-Benoît Arlet
Christel Arnold-Day
Lovkesh Arora
Rakesh Arora
Elise Artaud-Macari
Diptesh Aryal
Angel Asensio
Muhammad Ashraf
Namra Asif
Mohammad Asim
Jean Baptiste Assie
Amirul Asyraf
Anika Atique
AM. Udara Lakshan Attanyake
Johann Auchabie
Hugues Aumaitre
Adrien Auvet
Laurène Azemar
Cecile Azoulay
Benjamin Bach
Delphine Bachelet
Claudine Badr
Nadia Baig
J. Kenneth Baillie
Erica Bak
Agamemnon Bakakos
Nazreen Abu Bakar
Andriy Bal
Mohanaprasanth Balakrishnan
Valeria Balan
Firouze Bani-Sadr
Renata Barbalho
Wendy S Barclay
Saef Umar Barnett
Michaela Barnikel
Audrey Barrelet
Cleide Barrigoto
Marie Bartoli
Joaquín Baruch
Romain Basmaci
Muhammad Fadhli Hassin Basri
Jules Bauer
Diego Fernando Bautista Rincon
Abigail Beane
Alexandra Bedossa
Ker Hong Bee
Husna Begum
Sylvie Behilill
Albertus Beishuizen
Aleksandr Beljantsev
David Bellemare - Groote Schuur Hospital
Anna Beltrame
Marine Beluze
Nicolas Benech
Lionel Eric Benjiman
Dehbia Benkerrou
Suzanne Bennett
Luís Bento
Jan-Erik Berdal
Delphine Bergeaud
Hazel Bergin
Jose Luis Bernal Sobrino
Giulia Bertoli
Lorenzo Bertolino
Simon Bessis
Sybille Bevilcaqua
Karine Bezulier
Amar Bhatt
Krishna Bhavsar
Claudia Bianco
Farah Nadiah Bidin
Moirangthem Bikram Singh - Christian Medical College & Hospital
Mohd Nazlin Bin Kamarudin
François Bissuel
Laurent Bitker
Jonathan Bitton
Pablo Blanco-Schweizer
Catherine Blier
Frank Bloos
Mathieu Blot
Filomena Boccia
Laetitia Bodenes
Alice Bogaarts
Debby Bogaert
Anne-Helène Boivin
Pierre-Adrien Bolze
François Bompart
Diogo Borges
Raphaël Borie
Hans Martin Bosse
Elisabeth Botelho-Nevers
Lila Bouadma
Olivier Bouchaud
Sabelline Bouchez
Dounia Bouhmani
Damien Bouhour
Kevin Bouiller
Laurence Bouillet
Camile Bouisse
Anne-Sophie Boureau
John Bourke - Prince Charles Hospital
Maude Bouscambert
Aurore Bousquet
Jason Bouziotis
Bianca Boxma
Marielle Boyer-Besseyre
Maria Boylan
Fernando Augusto Bozza
Axelle Braconnier
Cynthia Braga
Timo Brandenburger
Filipa Brás Monteiro
Luca Brazzi
Patrick Breen
Dorothy Breen
Kathy Brickell
Shaunagh Browne
Nicolas Brozzi
Marjolein Brusse-Keizer
Nina Buchtele
Christian Buesaquillo
Marielle Buisson
Erlina Burhan
Aidan Burrell
Andre Cabie
Susana Cabral
Eder Caceres
Cyril Cadoz
Jose Andres Calvache
João Camões
Valentine Campana
Paul Campbell
Cecilia Canepa
Mireia Cantero
Pauline Caraux-Paz
Sheila Cárcel
Chiara Simona Cardellino
Sofia Cardoso
Filipe Cardoso
Filipa Cardoso
Nelson Cardoso
Simone Carelli
Nicolas Carlier
Thierry Carmoi
Gayle Carney
Inês Carqueja
Marie-Christine Carret
François Martin Carrier
Ida Carroll
Gail Carson
Maire-Laure Casanova
Mariana Cascão
Siobhan Casey
Jose Casimiro
Bailey Cassandra
Silvia Castañeda
Nidyanara Castanheira
Guylaine Castor-Alexandre
Henry Castrillón
Ivo Castro
Ana Catarino
François-Xavier Catherine
Paolo Cattaneo
Roberta Cavalin
Giulio Giovanni Cavalli
Alexandros Cavayas
Minerva Cervantes-Gonzalez
Anissa Chair
Catherine Chakveatze
Adrienne Chan
Meera Chand
Christelle Chantalat Auger
Jean-Marc Chapplain
Julie Chas
Mobin Chaudry
Jonathan Samuel Chávez Iñiguez
Anjellica Chen
Yih-Sharng Chen
Matthew Pellan Cheng
Antoine Cheret
Thibault Chiarabini
Julian Chica
Suresh Kumar Chidambaram
Leong Chin Tho - University of Cape Town
Catherine Chirouze
Davide Chiumello
Bernard Cholley
Marie-Charlotte Chopin
Ting Soo Chow
Hiu Jian Chua
Jonathan Chua
Jose Pedro Cidade
Jose Miguel Cisneros Herreros
Anna Ciullo
Jennifer Clarke
Emma Clarke
Sara Clohisey
Perren J Cobb
Cassidy Codan
Caitriona Cody
Alexandra Coelho
Megan Coles
Gwenhaël Colin
Michael Collins
Sebastiano Maria Colombo
Pamela Combs
Marie Connor
Anne Conrad
Sofía Contreras
Elaine Conway
Graham S Cooke
Mary Copland
Hugues Cordel
Amanda Corley
Sabine Cornelis
Alexander Daniel Cornet
Arianne Joy Corpuz
Gregory Corvaisier
Emma Costigan
Camille Couffignal
Sandrine Couffin-Cadiergues
Roxane Courtois
Stephanie Cousse
Rachel Cregan
Sabine Croonen
Gloria Crowl
Jonathan Crump
Claudina Cruz
Juan Luis Cruz Berm
Jaime Cruz Rojo
Marc Csete
Ailbhe Cullen
Matthew Cummings - University of Utah
Gerard Curley
Elodie Curlier
Colleen Curran
Paula Custodio
Ana da Silva Filipe
Charlene Da Silveira
Al-Awwab Dabaliz
Andrew Dagens
Darren Dahly
Heidi Dalton
Jo Dalton - Prince Charles Hospital
Seamus Daly
Nick Daneman
Corinne Daniel
Emmanuelle A Dankwa
Jorge Dantas
D
Publication Details: Brain, Vol.146(4)
Publisher: Oxford University Press
Identifiers: 991006163019102656
Language: English
Resource Type: Journal article