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<p>It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case–control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases). Among the 651 patients, [362 (55%) cases and 289 (45%) controls], a higher proportion of cases had impairment in ADLs (199 [68.9%] vs 101 [51.8%], OR 2.06, p &lt; 0.0002) and reported symptoms impacting employment (159 [58.2%] vs 69 [35.6%] OR 2.53, p &lt; 0.0001). There was no significant difference in the proportion with depression or anxiety between case and control groups overall. For cases, impairment of ADLs was associated with increased risk in female sex, age &gt; 50&#xa0;years and hypertension (OR 5.43, p &lt; 0.003, 3.11, p = 0.02, 3.66, p = 0.04). Those receiving either statins or angiotensin converting enzyme&#xa0;(ACE) inhibitors had a lower risk of impairment in ADLs (OR 0.09, p = 0.0006, 0.17, p = 0.03). Patients with neurological or psychiatric complications of COVID-19 had worse functional outcomes than those with respiratory COVID-19 alone in terms of ADLs and employment. Female sex, age &gt; 50&#xa0;years, and hypertension were associated with worse outcomes, and statins or ACE inhibitors with better outcomes.</p>

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Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS—A multicentre case–control study

  • 期刊论文

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  • 发表日期：

    2025年1月27日

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  • Rajish S. K. Shil,
  • Adam Seed,
  • Nkongho Egbe Franklyn,
  • Brendan F. Sargent,
  • Greta K. Wood,
  • Yun Huang,
  • Katherine C. Dodd,
  • James B. Lilleker,
  • Thomas A. Pollak,
  • Sylviane Defres,
  • Thomas M. Jenkins,
  • Nicholas W. S. Davies,
  • David A. Cousins,
  • Michael S. Zandi,
  • Thomas A. Jackson,
  • Laura A. Benjamin,
  • Ava Easton,
  • Tom Solomon,
  • John R. Bradley,
  • Patrick F. Chinnery,
  • Craig J. Smith,
  • Timothy R. Nicholson,
  • Alan Carson,
  • Rhys H. Thomas,
  • Mark Alexander Ellul,
  • Nicholas W. Wood,
  • Gerome Breen,
  • Benedict Daniel Michael,
  • John P. Aggleton,
  • Ali M. Aggleton,
  • Ammar Al-Chalabi,
  • Christopher M. Allen,
  • Jay Amin,
  • Cherie Armour,
  • Mark R. Baker,
  • Suzanne Barret,
  • Neil Basu,
  • Rahul Batra,
  • Alex Berry,
  • Laura Benjamin,
  • Richard A. I. Bethlehem,
  • Bethan Blackledge,
  • Sarah A. Boardman,
  • John Bradley,
  • David P. Breen,
  • Gerome Breen,
  • Judith Breuer,
  • Matthew Broome,
  • Ed Bullmore,
  • Matthew Butler,
  • Alan Carson,
  • Hannah Castell,
  • Jonathan Cavanagh,
  • Patrick Chinnery,
  • David Christmas,
  • David M. Christmas,
  • Jonathan R. I. Coleman,
  • Alaistair Coles,
  • Ceryce Collie,
  • Nadine Cossette,
  • David Cousins,
  • Colm Cunningham,
  • Alastair Darby,
  • Anthony S. David,
  • Nicholas Davies,
  • Sylviane Defres,
  • Katherine C. Dodd,
  • Alex Dregan,
  • Eugene Duff,
  • Cordelia Dunai,
  • Ava Easton,
  • Franklyn N. Egbe,
  • Mark A. Ellul,
  • Nikos Evangelou,
  • Bethany Facer,
  • Peter M. Fernandes,
  • Richard Francis,
  • Ian Galea,
  • Afagh Garjani,
  • Lily George,
  • Valentina Giunchiglia,
  • Kiran Glen,
  • Rebecca Gregory,
  • Michael Griffiths,
  • Victoria Grimbly,
  • Alexander Grundmann,
  • Savini Gunatilake,
  • Shahd H. M. Hamid,
  • Adam Hampshire,
  • Marc Hardwick,
  • Jade D. Harris,
  • Ewan Harrison,
  • NeiL A. Harrison,
  • Paul J. Harrison,
  • Monika Hartmann,
  • Peter J. Hellyer,
  • Claire Hetherington,
  • Orla Hilton,
  • Julian Hiscox,
  • Eva Maria Hodel,
  • Angela E. Holland,
  • Matthew Hotopf,
  • Yun Huang,
  • Stella Hughes,
  • Masud Husain,
  • Sarosh Irani,
  • Thomas A. Jackson,
  • Thomas M. Jackson,
  • Peter Jezzard,
  • Johan Kallberg Zvrskovec,
  • Gursharan Kalsi,
  • Simon Keller,
  • Nathalie Kingston,
  • Sandar Kyaw,
  • E. Charles Leek,
  • Gabriella Lewis,
  • James B. Lilleker,
  • Michael P. P. Lunn,
  • Claire L. MacIver,
  • Daniel Madarshahian,
  • Parisa Mansoori,
  • Naomi Martin,
  • Gavin McDonnell,
  • Emily McGlinchey,
  • Stephen McKeever,
  • Ryan McIlwaine,
  • Andrew M. McIntosh,
  • David K. Menon,
  • Benedict D. Michael,
  • Karla L. Miller,
  • Dina Monssen,
  • Christopher M. Morris,
  • Ciaran Mulholland,
  • Akshay Nair,
  • Edward Needham,
  • Virginia Newcombe,
  • Nathalie Nicholas,
  • Timothy R. Nicholson,
  • Ronan O’Malley,
  • Obioma Orazulume,
  • Marlies Ostermann,
  • Stella-Maria Paddick,
  • Alish Palmos,
  • Arvind Patel,
  • Sharon Peacock,
  • Sophie L. Pendered,
  • Sarah L. Pett,
  • Thomas A. Pollak,
  • Angela Roberts,
  • Henry C. Rogers,
  • Silvia Rota,
  • Rustam Al-Shahi Salman,
  • Merna Samuel,
  • Brendan F. Sargent,
  • Stephen J. Sawcer,
  • Adam W. Seed,
  • Scott Semple,
  • Pamela J. Shaw,
  • Rajish S. K. Shil,
  • Adam Sieradzki,
  • Bhagteshwar Singh,
  • Craig J. Smith,
  • Jacqueline Smith,
  • Stephen M. Smith,
  • Tom Solomon,
  • Leonie Taams,
  • Arina Tamborska,
  • John-Paul Taylor,
  • Kukatharmini Tharmaratnam,
  • Rhys H. Thomas,
  • Emma Thomson,
  • William Trender,
  • Zain-Ul-Abideen Ahmad,
  • Jonathan Underwood,
  • Rachel Upthegrove,
  • Tonny Veenith,
  • Annalena Venneri,
  • Angela Vincent,
  • Daniel j. van Wamelen,
  • Guy Williams,
  • Steven Williams,
  • Sui Hsien Wong,
  • Greta K. Wood,
  • Nicholas Wood,
  • Michael S. Zandi,
  • Fernando Zelaya,
  • Kathleen E. Stirrups,
  • Laura Cocking,
  • Rose Eichenberger,
  • Debbie Clapham,
  • Hannah Stark

摘要

It is established that patients hospitalised with COVID-19 often have ongoing morbidity affecting activity of daily living (ADL), employment, and mental health. However, little is known about the relative outcomes in patients with COVID-19 neurological or psychiatric complications. We conducted a UK multicentre case–control study of patients hospitalised with COVID-19 (controls) and those who developed COVID-19 associated acute neurological or psychiatric complications (cases). Among the 651 patients, [362 (55%) cases and 289 (45%) controls], a higher proportion of cases had impairment in ADLs (199 [68.9%] vs 101 [51.8%], OR 2.06, p < 0.0002) and reported symptoms impacting employment (159 [58.2%] vs 69 [35.6%] OR 2.53, p < 0.0001). There was no significant difference in the proportion with depression or anxiety between case and control groups overall. For cases, impairment of ADLs was associated with increased risk in female sex, age > 50 years and hypertension (OR 5.43, p < 0.003, 3.11, p = 0.02, 3.66, p = 0.04). Those receiving either statins or angiotensin converting enzyme (ACE) inhibitors had a lower risk of impairment in ADLs (OR 0.09, p = 0.0006, 0.17, p = 0.03). Patients with neurological or psychiatric complications of COVID-19 had worse functional outcomes than those with respiratory COVID-19 alone in terms of ADLs and employment. Female sex, age > 50 years, and hypertension were associated with worse outcomes, and statins or ACE inhibitors with better outcomes.