Background and aims
Neurological disorders have been variably associated with SARS-CoV- 2 infection. The aim of this study is to compare clinical and laboratory characteristics and outcomes of neurological patients admitted during the first and second waves of COVID-19 pandemic in a neuro-COVID unit.
Methods
In this retrospective study, we included all adult inpatients with confirmed COVID-19, admitted to a Neuro-COVID Unit during the first (February 21–May 31, 2020) and the second (February 21–May 31, 2020) pandemic wave. Demographic, clinical and laboratory data were extracted from medical records and compared by Mann-Whitney U test, χ2 test or Fisher's exact test where appropriate.
Results
191 patients were included in this study, 112 admitted during the first wave and 79 throughout the second spreading. Second wave patients exhibited a lower qSOFA score on admission (0.59 + 0.7 vs0.88 + 0.7, p = 0.010), resulting in a less oxygen support needed. Steroid treatment was adopted in about 4% of patients admitted during the first wave, but in 53% of second outbreak, adjusted for disease severity (p = 0.001).The incidence of cerebrovascular diseases was significative lower in the second outbreak (n = 28, 34.6% vs n = 73, 65.2%, p = 0.001) with a less severity outcome (mean NIHSS score 1.8 + 4.4 vs 9.36 + 7.3, p < 0.000) and a lower in-hospital mortality rates (n = 12, 14.8% vs n = 35, 31.3%, p = 0.009).
Conclusions
Second wave COVID-19 patients admitted with neurological diseases exhibited a lower incidence and a reduced severity of cerebrovascular disease compared to those of the first outbreak, with less systemic inflammatory response and in-hospital mortality. Longitudinal studies are warranted in order to understand the impact of early immunomodulator treatments in neurological COVID19 patients.