Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS—A multicentre case–control study
Abstract
Abstract It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case–control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases). Among the 651 patients, [362 (55%) cases and 289 (45%) controls], a higher proportion of cases had impairment in ADLs (199 [68.9%] vs 101 [51.8%], OR 2.06, p < 0.0002) and reported symptoms impacting employment (159 [58.2%] vs 69 [35.6%] OR 2.53, p < 0.0001). There was no significant difference in the proportion with depression or anxiety between case and control groups overall. For cases, impairment of ADLs was associated with increased risk in female sex, age > 50 years and hypertension (OR 5.43, p < 0.003, 3.11, p = 0.02, 3.66, p = 0.04). Those receiving either statins or angiotensin converting enzyme (ACE) inhibitors had a lower risk of impairment in ADLs (OR 0.09, p = 0.0006, 0.17, p = 0.03). Patients with neurological or psychiatric complications of COVID-19 had worse functional outcomes than those with respiratory COVID-19 alone in terms of ADLs and employment. Female sex, age > 50 years, and hypertension were associated with worse outcomes, and statins or ACE inhibitors with better outcomes.
Article Details
Authors (174)
Adam Seed
Nkongho Egbe Franklyn
Thomas M. Jenkins
Nicholas W. S. Davies
David A. Cousins
Laura A. Benjamin
John R. Bradley
Patrick F. Chinnery
Mark Alexander Ellul
Nicholas W. Wood
Benedict Daniel Michael
John P. Aggleton
Ali M. Aggleton
Ammar Al-Chalabi
Christopher M. Allen
Jay Amin
Cherie Armour
Mark R. Baker
Suzanne Barret
Neil Basu
Rahul Batra
Alex Berry
Laura Benjamin
Richard A. I. Bethlehem
Bethan Blackledge
Sarah A. Boardman
John Bradley
David P. Breen
Gerome Breen
Judith Breuer
Matthew Broome
Ed Bullmore
Matthew Butler
Alan Carson
Hannah Castell
Jonathan Cavanagh
Patrick Chinnery
David Christmas
David M. Christmas
Jonathan R. I. Coleman
Alaistair Coles
Ceryce Collie
Nadine Cossette
David Cousins
Colm Cunningham
Alastair Darby
Anthony S. David
Nicholas Davies
Sylviane Defres
Katherine C. Dodd
Alex Dregan
Eugene Duff
Cordelia Dunai
Ava Easton
Franklyn N. Egbe
Mark A. Ellul
Nikos Evangelou
Bethany Facer
Peter M. Fernandes
Richard Francis
Ian Galea
Afagh Garjani
Lily George
Valentina Giunchiglia
Kiran Glen
Rebecca Gregory
Michael Griffiths
Victoria Grimbly
Alexander Grundmann
Savini Gunatilake
Shahd H. M. Hamid
Adam Hampshire
Marc Hardwick
Jade D. Harris
Ewan Harrison
NeiL A. Harrison
Paul J. Harrison
Monika Hartmann
Peter J. Hellyer
Claire Hetherington
Orla Hilton
Julian Hiscox
Eva Maria Hodel
Angela E. Holland
Matthew Hotopf
Yun Huang
Stella Hughes
Masud Husain
Nuffield Department of Clinical Neurosciences, University of Oxford
Sarosh Irani
Thomas A. Jackson
Thomas M. Jackson
Peter Jezzard
Johan Kallberg Zvrskovec
Gursharan Kalsi
Simon Keller
Nathalie Kingston
Sandar Kyaw
E. Charles Leek
Gabriella Lewis
James B. Lilleker
Michael P. P. Lunn
Claire L. MacIver
Daniel Madarshahian
Parisa Mansoori
Naomi Martin
Gavin McDonnell
Emily McGlinchey
Stephen McKeever
Ryan McIlwaine
Andrew M. McIntosh
David K. Menon
Benedict D. Michael
Karla L. Miller
Dina Monssen
Christopher M. Morris
Ciaran Mulholland
Akshay Nair
Edward Needham
Virginia Newcombe
Nathalie Nicholas
Timothy R. Nicholson
Ronan O’Malley
Obioma Orazulume
Marlies Ostermann
Stella-Maria Paddick
Alish Palmos
Arvind Patel
Sharon Peacock
Sophie L. Pendered
Sarah L. Pett
Thomas A. Pollak
Angela Roberts
Henry C. Rogers
Silvia Rota
Rustam Al-Shahi Salman
Merna Samuel
Brendan F. Sargent
Stephen J. Sawcer
Adam W. Seed
Scott Semple
Pamela J. Shaw
Rajish S. K. Shil
Adam Sieradzki
Bhagteshwar Singh
Craig J. Smith
Jacqueline Smith
Stephen M. Smith
Tom Solomon
Leonie Taams
Arina Tamborska
John-Paul Taylor
Kukatharmini Tharmaratnam
Rhys H. Thomas
Emma Thomson
William Trender
Zain-Ul-Abideen Ahmad
Jonathan Underwood
Rachel Upthegrove
Tonny Veenith
Annalena Venneri
Angela Vincent
Daniel j. van Wamelen
Guy Williams
Steven Williams
Sui Hsien Wong
Greta K. Wood
Nicholas Wood
Michael S. Zandi
Fernando Zelaya
Kathleen E. Stirrups
Laura Cocking
Rose Eichenberger
Debbie Clapham
Hannah Stark