AUTHOR=García-Azorín David , Martínez-Pías Enrique , Trigo Javier , Hernández-Pérez Isabel , Valle-Peñacoba Gonzalo , Talavera Blanca , Simón-Campo Paula , de Lera Mercedes , Chavarría-Miranda Alba , López-Sanz Cristina , Gutiérrez-Sánchez María , Martínez-Velasco Elena , Pedraza María , Sierra Álvaro , Gómez-Vicente Beatriz , Guerrero Ángel , Ezpeleta David , Peñarrubia María Jesús , Gómez-Herreras Jose Ignacio , Bustamante-Munguira Elena , Abad-Molina Cristina , Orduña-Domingo Antonio , Ruiz-Martin Guadalupe , Jiménez-Cuenca María Isabel , Juarros Santiago , del Pozo-Vegas Carlos , Dueñas-Gutierrez Carlos , de Paula Jose María Prieto , Cantón-Álvarez Belén , Vicente Jose Manuel , Arenillas Juan Francisco 

TITLE=Neurological Comorbidity Is a Predictor of Death in Covid-19 Disease: A Cohort Study on 576 Patients

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00781

DOI=10.3389/fneur.2020.00781

ISSN=1664-2295

ABSTRACT=<p><bold>Introduction:</bold> Prognosis of Coronavirus disease 2019 (Covid-19) patients with vascular risk factors, and certain comorbidities is worse. The impact of chronic neurological disorders (CND) on prognosis is unclear. We evaluated if the presence of CND in Covid-19 patients is a predictor of a higher in-hospital mortality. As secondary endpoints, we analyzed the association between CND, Covid-19 severity, and laboratory abnormalities during admission.</p><p><bold>Methods:</bold> Retrospective cohort study that included all the consecutive hospitalized patients with confirmed Covid-19 disease from March 8th to April 11th, 2020. The study setting was Hospital Clínico, tertiary academic hospital from Valladolid. CND was defined as those neurological conditions causing permanent disability. We assessed demography, clinical variables, Covid-19 severity, laboratory parameters and outcome. The primary endpoint was in-hospital all-cause mortality, evaluated by multivariate cox-regression log rank test. We analyzed the association between CND, covid-19 severity and laboratory abnormalities.</p><p><bold>Results:</bold> We included 576 patients, 43.3% female, aged 67.2 years in mean. CND were present in 105 (18.3%) patients. Patients with CND were older, more disabled, had more vascular risk factors and comorbidities and fewer clinical symptoms of Covid-19. They presented 1.43 days earlier to the emergency department. Need of ventilation support was similar. Presence of CND was an independent predictor of death (HR 2.129, 95% CI: 1.382–3.280) but not a severer Covid-19 disease (OR: 1.75, 95% CI: 0.970–3.158). Frequency of laboratory abnormalities was similar, except for procalcitonin and INR.</p><p><bold>Conclusions:</bold> The presence of CND is an independent predictor of mortality in hospitalized Covid-19 patients. That was not explained neither by a worse immune response to Covid-19 nor by differences in the level of care received by patients with CND.</p>