Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves.

Abstract

OBJECTIVE:

The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves.

METHODS:

In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic.

RESULTS:

Two hundred twenty-three patients were included, of whom 112 and 111 were hospitalized during the first and second pandemic waves, respectively. Patients admitted during the second wave were younger and exhibited pulmonary COVID-19 severity, resulting in less oxygen support (n = 41, 36.9% vs n = 79, 70.5%, p < 0.001) and lower mortality rates (14.4% vs 31.3%, p = 0.004). The different healthcare strategies and early steroid treatment emerged as significant predictors of mortality independently from age, pre-morbid conditions and COVID-19 severity in Cox regression analyses.

CONCLUSIONS:

Differences in healthcare strategies during the second phase of the COVID-19 pandemic probably explain the differences in clinical outcomes independently of disease severity, underlying the importance of standardized early management of neurological patients with SARS-CoV-2 infection.

• Authors: Viviana Cristillo, Andrea Pilotto, Alberto Benussi, Ilenia Libri, Marcello Giunta, Andrea Morotti, Stefano Gipponi, Martina Locatelli, Stefano Cotti Piccinelli, Valentina Mazzoleni, Francesca Schiano di Cola, Stefano Masciocchi, Debora Pezzini, Andrea Scalvini, Enrico Premi, Elisabetta Cottini, Massimo Gamba, Mauro Magoni, Marco Maria Fontanella, Alessandro Padovani
• Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Neurol Sci) Vol. 43 Issue 5 Pg. 2923-2927 (May 2022) ISSN: 1590-3478 [Electronic] Italy
• PMID: 35175442 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Topics

• COVID-19
• Cohort Studies
• Delivery of Health Care
• Humans
• Pandemics
• SARS-CoV-2