Neurological manifestations of COVID-19 in adults and children.
Neurological manifestations of COVID-19 in adults and children.
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DOI：
10.1093/brain/awac332
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发表时间：
2023-04-19
期刊：
影响因子：
--
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文献类型：
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成人和儿童冠状病毒病2019 （COVID-19）的不同神经学表现及其影响尚未得到很好的表征。我们的目的是确定住院COVID-19患者的神经系统表现和院内并发症的患病率，并确定成人和儿童之间的差异。从2020年1月30日至2021年5月25日，我们利用国际严重急性呼吸道和新发感染联盟（ISARIC）在全球1507个地点进行了一项前瞻性多中心观察性研究。神经系统表现和神经系统并发症的分析考虑了预定义患者亚组的未调整患病率估计，并使用广义线性模型将调整估计作为患者年龄和住院时间的函数。总共纳入了16239例因COVID-19住院并评估神经系统表现和并发症的患者（成人158267例，儿童2972例）。在成人和儿童中，入院时最常见的神经学表现为疲劳（成人：37.4%；儿童：20.4%）、意识改变（20.9%;6.8%）、肌痛（16.9%;7.6%）、语难（7.4%;1.9%）、嗅觉缺失（6.0%;2.2%）和癫痫发作（1.1%;5.2%）。在成人中，最常见的住院神经系统并发症是中风（1.5%）、癫痫（1%）和中枢神经系统感染（0.2%）。这两种情况在重症监护病房（ICU）患者中发生的频率高于非ICU患者。在儿童中，癫痫发作是唯一在ICU比非ICU更频繁发生的神经系统并发症（7.1%比2.3%,P < 0.001）。脑卒中患病率随着年龄的增长而增加，而中枢神经系统感染和癫痫发作随着年龄的增长而稳步下降。在大流行期间，随着时间的推移，中风的发病率急剧下降。高血压、慢性神经系统疾病和体外膜氧合的使用与卒中风险增加有关。意识改变与中枢神经系统感染、癫痫发作和中风有关。所有住院神经系统并发症均与死亡几率增加有关。死亡的可能性随着年龄的增长而增加，特别是在25岁以后。总之，成人和儿童与COVID-19相关的神经系统表现和院内并发症不同。中风风险随着年龄的增长而增加，而中枢神经系统感染和癫痫发作风险随着年龄的增长而降低。Cho等人的研究表明，与COVID-19相关的最常见的神经系统症状和住院并发症在成人和儿童之间存在差异。中风的风险随着年龄的增长而增加，而中枢神经系统感染和癫痫发作的风险则降低。所有住院神经系统并发症都与死亡风险增加有关。
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. Cho et al. show that the most frequent neurological manifestations and in-hospital complications associated with COVID-19 differ between adults and children. Stroke risk increases with age, while CNS infection and seizure risk decrease. All in-hospital neurological complications are associated with increased mortality risk.
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影响因子：
38.1
作者：
Pezzini, Alessandro;Padovani, Alessandro
通讯作者：
Padovani, Alessandro
DOI：
10.1016/j.jtcvs.2021.09.063
发表时间：
2023-05-10
影响因子：
6
作者：
Ong, Chin Siang;Etchill, Eric;Cho, Sung-Min
通讯作者：
Cho, Sung-Min
影响因子：
--
作者：
Ermis U;Rust MI;Bungenberg J;Costa A;Dreher M;Balfanz P;Marx G;Wiesmann M;Reetz K;Tauber SC;Schulz JB
通讯作者：
Schulz JB
DOI：
10.1016/s2352-4642(21)00193-0
发表时间：
2021-09
期刊：
The Lancet. Child & adolescent health
影响因子：
--
作者：
Ray STJ;Abdel-Mannan O;Sa M;Fuller C;Wood GK;Pysden K;Yoong M;McCullagh H;Scott D;McMahon M;Thomas N;Taylor M;Illingworth M;McCrea N;Davies V;Whitehouse W;Zuberi S;Guthrie K;Wassmer E;Shah N;Baker MR;Tiwary S;Tan HJ;Varma U;Ram D;Avula S;Enright N;Hassell J;Ross Russell AL;Kumar R;Mulholland RE;Pett S;Galea I;Thomas RH;Lim M;Hacohen Y;Solomon T;Griffiths MJ;Michael BD;Kneen R;CoroNerve study group
通讯作者：
CoroNerve study group
冠状病毒病 (COVID-19) 与大血管闭塞性脑卒中的关系： 病例对照研究
影响因子：
5
作者：
Kihira, Shingo;Schefflein, Javin;Belani, Puneet
通讯作者：
Belani, Puneet