Abstract
Our study aimed to determine the effects of new-onset neurological symptoms (NNS) on clinically relevant outcomes in hospitalized patients with COVID-19 infection. We conducted a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from various regions in the Philippines. We included a total of 10,881 patients with confirmed COVID-19 infection (2008 had NNS while 8873 did not have NNS). The adjusted hazard ratios (aHRs) for mortality among the mild and severe cases were significantly higher by 1.660 (95% CI 1.132–2.435) and by 1.352 (95% CI 1.042–1.752), respectively, in the NNS group compared to those in the non-NNS group. The aHRs for respiratory failure in the NNS group were significantly increased by 1.914 (95% CI 1.346–2.722), by 1.614 (95% CI 1.260–2.068), and by 1.234 (95% CI 1.089–1.398) among the mild, severe, and critical cases, respectively. The aHRs for ICU admission in the NNS group were still significantly higher by 1.973 (95% CI 1.457–2.673) and by 1.831 (95% CI 1.506–2.226) among the mild and severe cases, respectively. Patients who had NNS were not significantly associated with a longer duration of ventilator dependence (adjusted odds ratio (aOR) 0.954, 95% CI 0.772–1.179), longer ICU stay (aOR 0.983, 95% CI 0.772–1.252) and longer hospital admission (aOR 1.045, 95% CI 0.947–1.153). The presence of NNS significantly increases the risk of mortality, respiratory failure and ICU admission among COVID-19 patients. Registration and associated protocol publication: ClinicalTrials.gov website (NCT04386083); Espiritu AI, Sy MCC, Anlacan VMM, Jamora RDG. The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA study): a protocol study. BMJ Open. 2020;10:e040944.
Highlights
We aimed to determine the clinical/neurological features of hospitalized patients with COVID-19 infection and to investigate the effects of new-onset neurological symptoms (NNS) on mortality, respiratory failure, duration of ventilator dependence, intensive care unit (ICU) admission, length of ICU and hospital stay among these patients.The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) and has affected over 192 million individuals worldwide as of July 23, 2021 (Coronavirus disease (COVID19) n.d.)
We identified 10,999 hospitalized patients diagnosed with COVID-19 from the 37 participating study sites
Data on the time to onset of mortality, respiratory failure, ICU admission were used to build Kaplan–Meier curves; the log-rank test was employed to compare the curves
Summary
The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) and has affected over 192 million individuals worldwide as of July 23, 2021 (Coronavirus disease (COVID19) n.d.). During this period in the Philippines, our data breached the 1.5 million mark of confirmed total cases; nearly 54 thousand are active cases and approximately 28 thousand patients died from this infection (Department of Health (Philippines) 2021). Nationwide, about 50% of the intensive care unit (ICU), isolation, and ward beds were occupied and nearly 40% of the total mechanical ventilators were used (Department of Health (Philippines) 2021).
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