Abstract WP30: Positive Covid-19 Cases Requiring Neurology Consultation: Review Of Death Status

Abstract

Background and Purpose: Identify characteristics contributing to death in patients with Covid-19 and neurology consultation Hypothesis: We suspected many characteristics contributed to death in those with Covid-19 requiring neurologic consultation based on our clinical experience and prior descriptive study. Methods: A retrospective review of the characteristics of 200 patients with Covid-19 requiring neurology consultation from April 2020 to February 2021 were analyzed. Continuous variables were summarized by mean ± standard deviation and compared using the Student’s T-test of Wilcoxon rank-sum test. Categorical variables were summarized by frequency and percent and compared using Chi-squared or Fisher’s exact tests. Analyses were preformed with the use of SAS software (version 9.4). P-value < 0.01 was considered statistically significant. Results: The patients who were deceased tended to be older compared to the patients who were alive (73.1 ± 12.4 vs. 64.7 ± 17.6, P-value = 0.001). Patients who were deceased had lower RBC (3.9 ± 1.0 vs 4.5 ± 1.7, P-value=0.006) and higher creatinine (2.3 ± 2.5 vs 1.4 ± 1.3, P-value = 0.003). Patients who were deceased were more likely to have impaired consciousness, coma, acute stroke, and encephalopathy compared to patients who were alive (83.1% vs 41.3%, 56.9% vs 16.9%, 48.3% vs 22.7%, and 86.2% vs. 62.3%). Among 58 with acute stroke, there was no statistically significant difference in type of stroke (38.5% vs 53.6%, P-value = 0.265) or intervention on stroke (15.4% vs 20.7%, P-value = 0.732) by death status. The patients with stroke who were deceased had lower platelets (180.4 ± 98.5 vs 276.6 ± 145.5, P-value = 0.004). Stroke patients who were deceased were more likely to have impaired consciousness and coma (78.6% vs 43.4%, and 53.6% vs 17.2%, respectively). Conclusion: Patients requiring neurologic consultation with Covid-19 have a higher likelihood of death in the setting of acute stroke, coma, encephalopathy, low RBC count, and elevated creatinine; and those with stroke had higher mortality with low platelet count. Further studies with early intervention to improve these factors may play a role in reducing morality.