Table 1. Distribution of clinical findings amongst Neuro-COVID patients with different ages
Variable
|
Age Group (years)
|
Total
(n = 352)
No. (%)
|
<20
(n = 37)
No. (%)
|
20-39
(n = 193)
No. (%)
|
40-59
(n = 60)
No. (%)
|
60-79
(n = 55)
No. (%)
|
≥80
(n = 7)
No. (%)
|
P -value
|
Gender
|
|
|
|
|
|
|
|
Female
|
183 (52.0)
|
18 (48.6)
|
107 (55.4)
|
28 (46.7)
|
26 (47.3)
|
4 (57.1)
|
0.675
|
Male
|
169 (48.0)
|
19 (51.4)
|
86 (44.6)
|
32 (53.3)
|
29 (52.7)
|
3 (42.9)
|
|
Comorbidities**
|
161 (45.7)
|
8 (21.6)
|
56 (29.0)
|
40 (66.7)
|
51 (92.7)
|
6 (85.7)
|
<0.0011
|
Neurological
|
24 (6.8)
|
1 (2.7)
|
6 (3.1)
|
4 (6.7)
|
12 (21.8)
|
1 (14.3)
|
0.0011
|
Stroke
|
13 (3.7)
|
0
|
1 (0.5)
|
1 (1.7)
|
10 (18.2)
|
1 (14.3)
|
<0.0011
|
Brain/ spinal cord tumour
|
5 (1.4)
|
0
|
2 (1.0)
|
2 (3.6)
|
0
|
0
|
0.510
|
Epilepsy
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Alzheimer
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Hemiplegia
|
1 (0.3)
|
0
|
1 (0.5)
|
0
|
0
|
0
|
1.000
|
Cerebral palsy
|
1 (0.3)
|
0
|
0
|
1 (1.7)
|
0
|
0
|
0.450
|
Migraine
|
1 (0.3)
|
0
|
1 (0.5)
|
0
|
0
|
0
|
1.000
|
CVST
|
1 (0.3)
|
0
|
1 (0.5)
|
0
|
0
|
0
|
1.000
|
Myopathy
|
2 (0.6)
|
1 (2.7)
|
0
|
1 (1.7)
|
0
|
0
|
0.171
|
Psychiatric disorder
|
3 (0.9)
|
0
|
1 (0.5)
|
0
|
2 (3.6)
|
0
|
0.176
|
Non- Neurological
|
155 (44.0)
|
7 (18.9)
|
54 (28.0)
|
40 (66.7)
|
48 (87.3)
|
6 (85.7)
|
<0.0011
|
Hypertension
|
65 (18.5)
|
0
|
7 (3.6)
|
21 (35.0)
|
33 (60.0)
|
4 (57.1)
|
<0.0011
|
Diabetes
|
51 (14.5)
|
1 (2.7)
|
4 (2.1)
|
15 (25.0)
|
28 (50.9)
|
3 (42.9)
|
<0.0011
|
Asthma
|
25 (7.1)
|
5 (13.5)
|
12 (6.2)
|
6 (10.0)
|
2 (3.6)
|
0
|
0.286
|
Chronic sinusitis
|
12 (3.4)
|
0
|
12 (6.2)
|
0
|
0
|
0
|
0.0451
|
Renal disease
|
24 (6.8)
|
0
|
0
|
9 (15.0)
|
14 (25.5)
|
1 (14.3)
|
<0.0011
|
Cardiovascular disease
|
21 (6.0)
|
0
|
3 (1.6)
|
3 (5.0)
|
13 (23.6)
|
2 (28.6)
|
<0.0011
|
Malignancy
|
15 (4.3)
|
0
|
6 (3.1)
|
5 (8.3)
|
4 (7.3)
|
0
|
0.161
|
Benign tumour
|
2 (0.6)
|
0
|
1 (0.5)
|
0
|
1 (1.8)
|
0
|
0.519
|
Liver disease
|
11 (3.1)
|
0
|
2 (1.0)
|
3 (5.0)
|
4 (7.3)
|
2 (28.6)
|
0.0011
|
Blood disorder
|
9 (2.6)
|
0
|
3 (1.6)
|
6 (10.0)
|
0
|
0
|
0.0151
|
GIT disease
|
9 (2.6)
|
0
|
5 (2.6)
|
3 (5.0)
|
0
|
1 (14.3)
|
0.081
|
Rheumatic disease
|
9 (2.6)
|
1 (2.7)
|
2 (1.0)
|
4 (6.7)
|
2 (3.6)
|
0
|
0.177
|
Thyroid disease
|
3 (0.9)
|
0
|
1 (0.5)
|
2 (3.3)
|
0
|
0
|
0.223
|
PCOS
|
1 (0.3)
|
0
|
1 (0.5)
|
0
|
0
|
0
|
1.000
|
Smoking
|
9 (2.6)
|
0
|
3 (1.6)
|
1 (1.7)
|
2 (3.6)
|
3 (42.9)
|
<0.0011
|
Substance abuse
|
7 (2.0)
|
0
|
3 (1.6)
|
1 (1.7)
|
2 (3.6)
|
1 (14.3)
|
0.156
|
Clinical Presentations 2
|
|
|
|
|
|
|
|
CNS
|
164 (46.6)
|
11 (29.7)
|
77 (39.9)
|
31 (51.7)
|
41 (74.5)
|
4 (57.1)
|
<0.0011
|
Headache
|
100 (28.4)
|
11 (29.7)
|
64 (33.2)
|
17 (28.3)
|
8 (14.5)
|
0
|
0.038*
|
Altered LOC
|
56 (15.9)
|
0
|
10 (5.2)
|
14 (23.3)
|
28 (5.09)
|
4 (57.1)
|
<0.0011
|
Dizziness
|
12 (3.4)
|
0
|
4 (2.1)
|
3 (5.0)
|
4 (7.3)
|
1 (14.3)
|
0.076
|
Seizure
|
4 (1.1)
|
0
|
0
|
2 (3.3)
|
1 (1.8)
|
1 (14.3)
|
0.0141
|
Paraparesis/ Paraplegia
|
4 (1.1)
|
0
|
1 (0.5)
|
2 (3.3)
|
1 (1.8)
|
0
|
0.318
|
Hemiparesis
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Aphasia
|
2 (0.6)
|
0
|
0
|
1 (1.7)
|
1 (1.8)
|
0
|
0.227
|
Dysarthria
|
2 (0.6)
|
0
|
0
|
2 (3.3)
|
0
|
0
|
0.102
|
UMN facial palsy
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Unequal pupils
|
1 (0.3)
|
0
|
0
|
1 (1.7)
|
0
|
0
|
0.450
|
Signs of meningitis
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Paraesthesia
|
3 (0.9)
|
0
|
2 (1.0)
|
1 (1.7)
|
0
|
0
|
1.000
|
Faecal incontinence
|
2 (0.6)
|
0
|
1 (0.5)
|
0
|
1 (1.8)
|
0
|
0.519
|
Urinary retention
|
1 (0.3)
|
0
|
1 (0.5)
|
0
|
0
|
0
|
1.000
|
PNS
|
125 (35.5)
|
22 (59.5)
|
86 (44.6)
|
14 (23.3)
|
3 (5.5)
|
0
|
<0.0011
|
Anosmia
|
118 (33.5)
|
22 (59.5)
|
81 (42.0)
|
13 (21.7)
|
2 (3.6)
|
0
|
<0.0011
|
Hyposmia
|
3 (0.9)
|
0
|
2 (1.0)
|
0
|
1 (1.8)
|
0
|
0.847
|
Ageusia
|
80 (22.7)
|
17 (45.9)
|
56 (29.0)
|
6 (10.0)
|
1 (1.8)
|
0
|
<0.0011
|
Hypogeusia
|
4 (1.1)
|
0
|
3 (1.6)
|
0
|
1 (1.8)
|
0
|
0.728
|
Blurred vision
|
2 (0.6)
|
0
|
1 (0.5)
|
1 (1.7)
|
0
|
0
|
0.704
|
NMS
|
240 (68.2)
|
30 (81.1)
|
148 (76.7)
|
39 (65.0)
|
20 (36.4)
|
3 (42.9)
|
<0.0011
|
Myalgia
|
215 (61.1)
|
27 (73.0)
|
133 (68.9)
|
34 (56.7)
|
18 (32.7)
|
3 (42.9)
|
<0.0011
|
Arthralgia
|
43 (12.2)
|
6 (16.2)
|
25 (13.0)
|
9 (15.0)
|
3 (5.5)
|
0
|
0.354
|
PSY
|
4 (1.1)
|
0
|
1 (0.5)
|
2 (3.3)
|
1 (1.8)
|
0
|
0.318
|
Visual Hallucination
|
2 (0.6)
|
0
|
0
|
1 (1.7)
|
1 (1.8)
|
0
|
0.227
|
Agitation
|
2 (0.6)
|
0
|
1 (0.5)
|
0
|
1 (1.8)
|
0
|
0.519
|
Depressed mood
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Insomnia
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Suicidal thoughts
|
1 (0.3)
|
0
|
0
|
0
|
1 (1.8)
|
0
|
0.279
|
Psychosis
|
1 (0.3)
|
0
|
0
|
1 (1.7)
|
0
|
0
|
0.450
|
Disease Severity
|
|
|
|
|
|
|
|
Moderate
|
271 (77.0)
|
37 (100.0)
|
176 (91.2)
|
41 (68.3)
|
16 (29.1)
|
1 (14.3)
|
<0.0011
|
Severe
|
29 (8.2)
|
0
|
8 (4.1)
|
8 (13.3)
|
11 (20.0)
|
2 (28.6)
|
<0.0011
|
Critical
|
52 (14.8)
|
0
|
9 (4.7)
|
11 (18.3)
|
28 (50.9)
|
4 (57.1)
|
<0.0011
|
Clinical Outcome
|
|
|
|
|
|
|
|
Deaths
|
48 (13.6)
|
0
|
8 (4.1)
|
11 (18.3)
|
24 (43.6)
|
5 (71.4)
|
<0.0011
|
Discharges
|
304 (86.4)
|
37 (100.0)
|
185 (95.9)
|
49 (81.7)
|
31 (56.4)
|
2 (28.6)
|
|
Abbreviations: CVST, cerebral venous sinus thrombosis; GIT, gastrointestinal tract; PCOS, polycystic ovary syndrome; CNS, central nervous system; LOC, loss of consciousness; UMN, upper motor neuron; PNS, peripheral nervous system; NMS, neuromusculoskeletal; PSY, psychiatric
1 P -value <0.05 was considered statistically significant.
2 Patients were not mutually exclusive within this variable.
Table 2. Distribution of clinical findings amongst Neuro-COVID patients with comorbidities
Variable
|
Comorbidities
|
With comorbidities
(n = 161)
No. (%)
|
Without comorbidities
(n = 191)
No. (%)
|
P -value
|
Gender
|
|
|
|
Female
|
84 (52.2)
|
99 (51.8)
|
0.949
|
Male
|
77 (47.8)
|
92 (48.2)
|
|
Age Group, (years)
|
|
|
|
<20
|
8 (5.0)
|
29 (15.2)
|
0.0021
|
20-39
|
56 (34.8)
|
137 (71.7)
|
<0.0011
|
40-59
|
40 (24.8)
|
20 (10.5)
|
<0.0011
|
60-79
|
51 (31.7)
|
4 (2.1)
|
<0.0011
|
≥80
|
6 (3.7)
|
1 (0.5)
|
0.051
|
Clinical Presentation2
|
|
|
|
CNS
|
94 (58.4)
|
70 (36.6)
|
<0.0011
|
Headache
|
42 (26.1)
|
58 (30.4)
|
0.375
|
Altered level LOC
|
45 (28.0)
|
11 (5.8)
|
<0.0011
|
Dizziness
|
9 (5.6)
|
3 (1.6)
|
0.0381
|
Seizure
|
4 (2.5)
|
0
|
0.0431
|
Paraparesis/ Paraplegia
|
4 (2.5)
|
0
|
0.0431
|
Hemiparesis
|
1 (0.6)
|
0
|
0.457
|
Aphasia
|
2 (1.2)
|
0
|
0.208
|
Dysarthria
|
2 (1.2)
|
0
|
0.208
|
UMN facial palsy
|
1 (0.6)
|
0
|
0.457
|
Unequal pupils
|
0
|
1 (0.5)
|
1.000
|
Signs of meningitis
|
1 (0.6)
|
0
|
0.457
|
Paraesthesia
|
2 (1.2)
|
1 (0.5)
|
0.595
|
Faecal incontinence
|
2 (1.2)
|
0
|
0.208
|
Urinary retention
|
1 (0.6)
|
0
|
0.457
|
PNS
|
41 (25.5)
|
84 (44.0)
|
<0.0011
|
Anosmia
|
36 (22.4)
|
82 (42.9)
|
<0.0011
|
Hyposmia
|
1 (0.6)
|
2 (1.0)
|
1.000
|
Ageusia
|
22 (13.7)
|
58 (30.4)
|
<0.0011
|
Hypogeusia
|
1 (0.6)
|
3 (1.6)
|
0.628
|
Blurred vision
|
2 (1.2)
|
0
|
0.208
|
NMS
|
92 (57.2)
|
148 (77.5)
|
<0.0011
|
Myalgia
|
84 (52.2)
|
131 (68.6)
|
0.0021
|
Arthralgia
|
18 (11.2)
|
25 (13.1)
|
0.586
|
PSY
|
3 (1.9)
|
1 (0.5)
|
0.336
|
Visual Hallucination
|
2 (1.2)
|
0
|
0.208
|
Agitation
|
1 (0.6)
|
1 (0.5)
|
1.000
|
Depressed mood
|
1 (0.6)
|
0
|
0.457
|
Insomnia
|
1 (0.6)
|
0
|
0.457
|
Suicidal thoughts
|
1 (0.6)
|
0
|
0.457
|
Psychosis
|
1 (0.6)
|
0
|
0.457
|
Disease Severity
|
|
|
|
Moderate
|
92 (57.1)
|
179 (93.7)
|
<0.0011
|
Severe
|
24 (14.9)
|
5 (2.6)
|
<0.0011
|
Critical
|
45 (28.0)
|
7 (3.7)
|
<0.0011
|
Clinical Outcome
|
|
|
|
Deaths
|
43 (26.7)
|
5 (2.8)
|
<0.0011
|
Discharges
|
118 (73.3)
|
186 (97.4)
|
|
Abbreviations: CVST, cerebral venous sinus thrombosis; GIT, gastrointestinal tract; PCOS, polycystic ovary syndrome; CNS, central nervous system; LOC, loss of consciousness; UMN, upper motor neuron; PNS, peripheral nervous system; NMS, neuromusculoskeletal; PSY, psychiatric
1 P -value <0.05 was considered statistically significant.
2 Patients were not mutually exclusive within this variable.
Table 3. Distribution of clinical findings for the disease severity spectrum and predictors of severity amongst Neuro-COVID patients.
Variable
|
Disease Severity
|
Severe1
|
Critical2
|
Moderate
(n = 271)
No. (%)
|
Severe
(n = 29)
No. (%)
|
Critical (n = 52)
No. (%)
|
P -value
|
UVA3
OR (95% CI)
|
P -value
|
MVA4
OR (95% CI)
|
P -value
|
UVA3
OR (95% CI)
|
P -value
|
MVA5
OR (95% CI)
|
P -value
|
Gender
|
|
|
|
|
|
|
|
|
|
|
|
|
Female
|
135 (49.8)
|
13 (44.8)
|
35 (67.3)
|
0.050
|
0.82 (0.38 - 1.77)
|
0.610
|
|
|
2.07 (1.11 - 3.88)
|
0.027
|
2.67 (1.10 - 6.48)
|
0.0307
|
Male6
|
136 (50.2)
|
16 (55.2)
|
17 (32.7)
|
|
Ref
|
|
|
|
Ref
|
|
|
|
Age Group, (years)
|
|
|
|
|
|
|
|
|
|
|
|
|
<20
|
37 (13.7)
|
0
|
0
|
0.0027
|
-
|
-
|
|
|
-
|
-
|
|
|
20-39
|
176 (64.9)
|
8 (27.6)
|
9 (17.3)
|
<0.0017
|
0.02 (0.002 - 0.28)
|
0.0037
|
0.04 (0.003 - 0.54)
|
0.0167
|
0.01 (0.001 - 0.13)
|
<0.0017
|
0.04 (0.003 - 0.62)
|
0.0217
|
40-59
|
41 (15.1)
|
8 (27.6)
|
11 (21.2)
|
0.165
|
0.10 (0.008 - 1.21)
|
0.070
|
0.10 (0.007 - 1.44)
|
0.091
|
0.07 (0.007 - 0.66)
|
0.0217
|
0.08 (0.006 - 1.27)
|
0.074
|
60-79
|
16 (5.9)
|
11 (37.9)
|
28 (53.8)
|
<0.0017
|
0.34 (0.03 - 4.27)
|
0.406
|
0.22 (0.02 - 3.12)
|
0.262
|
0.44 (0.05 - 4.26)
|
0.476
|
0.26 (0.02 - 3.77)
|
0.320
|
≥80¶
|
1 (0.4)
|
2 (6.9)
|
4 (7.7)
|
0.0017
|
Ref
|
|
Ref
|
|
Ref
|
|
Ref
|
|
Comorbidities8
|
92 (33.9)
|
24 (82.8)
|
45 (86.5)
|
<0.0017
|
0.11 (0.04 - 0.29)
|
<0.0017
|
|
|
0.08 (0.04 - 0.18)
|
<0.0017
|
|
|
Neurological
|
7 (2.6)
|
5 (17.2)
|
12 (23.1)
|
<0.0017
|
0.13 (0.04 - 0.43)
|
0.001*
|
0.27 (0.07 - 1.09)
|
0.066
|
0.09 (0.03 - 0.24)
|
<0.0017
|
0.30 (0.08 - 1.13)
|
0.075
|
Stroke
|
3 (1.1)
|
2 (6.9)
|
8 (15.4)
|
<0.0017
|
0.15 (0.02 - 0.94)
|
0.0437
|
|
|
0.06 (0.002 - 0.24)
|
<0.0017
|
|
|
Brain/ spinal cord tumour
|
1 (0.4)
|
2 (6.9)
|
2 (3.8)
|
0.0087
|
0.05 (0.004 - 0.57)
|
0.0167
|
|
|
0.09 (0.008 - 1.04)
|
0.054
|
|
|
Epilepsy
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
Alzheimer
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
Hemiplegia
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
Cerebral palsy
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Migraine
|
1 (0.4)
|
0
|
0
|
1.000
|
-
|
-
|
|
|
-
|
-
|
|
|
CVST
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Myopathy
|
1 (0.4)
|
0
|
1 (1.9)
|
0.406
|
-
|
-
|
|
|
0.19 (0.01 - 3.07)
|
0.241
|
|
|
Psychiatric disorder
|
1 (0.4)
|
1 (3.4)
|
1 (1.9)
|
0.132
|
0.10 (0.006 -1.70)
|
0.113
|
|
|
0.19 (0.01 - 3.07)9
|
0.241
|
|
|
Non- Neurological
|
89 (32.8)
|
21 (72.4)
|
45 (86.5)
|
<0.0017
|
0.17 (0.08 - 0.44)
|
<0.0017
|
0.40 (0.15 - 1.09)
|
0.073
|
0.08 (0.03 - 0.18)
|
<0.0017
|
0.14 (0.05 - 0.41)
|
<0.0017
|
Hypertension
|
28 (10.3)
|
14 (48.3)
|
23 (44.2)
|
<0.0017
|
0.12 (0.05 - 0.28)
|
<0.0017
|
|
|
0.15 (0.07 - 0.29)
|
<0.0017
|
|
|
Diabetes
|
24 (8.9)
|
8 (27.6)
|
19 (36.5)
|
<0.0017
|
0.26 (0.10 - 0.64)
|
0.0037
|
|
|
0.17 (0.08 - 0.34)
|
<0.0017
|
|
|
Asthma
|
24 (8.9)
|
0
|
1 (1.9)
|
0.057
|
-
|
-
|
|
|
4.96 (0.66 - 37.47)
|
0.121
|
|
|
Chronic sinusitis
|
12 (4.4)
|
0
|
0
|
0.164
|
-
|
-
|
|
|
-
|
-
|
|
|
Renal disease
|
6 (2.2)
|
4 (13.8)
|
14 (26.9)
|
<0.0017
|
0.14 (0.04 - 0.54)
|
0.0047
|
|
|
0.06 (0.02 - 0.17)
|
<0.0017
|
|
|
Cardiovascular disease
|
9 (3.3)
|
4 (13.8)
|
8 (15.4)
|
0.0027
|
0.22 (0.06 - 0.75)
|
0.0167
|
|
|
0.19 (0.07 - 0.52)
|
0.0017
|
|
|
Malignancy
|
3 (1.1)
|
5 (17.2)
|
7 (13.5)
|
<0.0017
|
0.05 (0.01 - 0.24)
|
<0.0017
|
|
|
0.07 (0.02 - 0.29)
|
<0.0017
|
|
|
Benign tumour
|
1 (0.4)
|
1 (3.4)
|
0
|
0.182
|
0.10 (0.006 - 1.70)
|
0.113
|
|
|
-
|
-
|
|
|
Liver disease
|
2 (0.7)
|
1 (3.4)
|
8 (15.4)
|
<0.0017
|
0.21 (0.02 - 2.37)
|
0.206
|
|
|
0.04 (0.008 - 0.20)
|
<0.0017
|
|
|
Blood disorder
|
6 (2.2)
|
1 (3.4)
|
2 (3.8)
|
0.856
|
0.63 (0.07 - 5.46)
|
0.678
|
|
|
0.57 (0.11 - 2.89)
|
0.493
|
|
|
GIT disease
|
7 (2.6)
|
1 (3.4)
|
1 (1.9)
|
1.000
|
0.74 (0.09 - 6.26)
|
0.784
|
|
|
1.35 (0.16 - 11.23)
|
0.780
|
|
|
Rheumatic disease
|
5 (1.8)
|
0
|
4 (7.7)
|
0.060
|
-
|
-
|
|
|
0.23 (0.06 - 0.87)
|
0.0317
|
|
|
Thyroid disease
|
3 (1.1)
|
0
|
0
|
1.000
|
-
|
-
|
|
|
-
|
-
|
|
|
PCOS
|
1 (0.4)
|
0
|
0
|
1.000
|
-
|
-
|
|
|
-
|
-
|
|
|
Smoking
|
4 (1.5)
|
2 (6.9)
|
3 (5.8)
|
0.070
|
0.02 (0.04 - 1.16)
|
0.072
|
|
|
0.25 (0.05 - 1.13)
|
0.071
|
|
|
Substance abuse
|
0
|
2 (6.9)
|
5 (9.6)
|
<0.0017
|
-
|
-
|
|
|
-
|
-
|
|
|
Clinical Presentations8
|
|
|
|
|
|
|
|
|
|
|
|
|
CNS
|
103 (38.0)
|
17 (58.6)
|
44 (84.6)
|
<0.0017
|
0.043 (0.20 - 0.94)
|
0.0357
|
0.87 (0.31 - 2.41)
|
0.783
|
0.11 (0.05 - 0.25)
|
<0.0017
|
0.47 (0.15 - 1.48)
|
0.197
|
Headache
|
88 (32.5)
|
6 (20.7)
|
6 (11.5)
|
0.0067
|
1.84 (0.73 - 4.69)
|
0.199
|
|
|
3.69 (1.52 - 8.96)
|
0.0047
|
|
|
Altered LOC
|
6 (2.2)
|
12 (41.4)
|
38 (73.1)
|
<0.0017
|
0.03 (0.01 - 0.10)
|
<0.0017
|
|
|
0.008 (0.003 - 0.02)
|
<0.0017
|
|
|
Dizziness
|
9 (3.3)
|
2 (6.9)
|
1 (1.9)
|
0.533
|
0.46 (0.01 - 2.26)
|
0.341
|
|
|
1.75 (0.22 - 14.13)
|
0.599
|
|
|
Seizure
|
1 (0.4)
|
0
|
3 (5.8)
|
0.0137
|
-
|
-
|
|
|
0.06 (0.006- 0.59)
|
0.0167
|
|
|
Paraparesis/ Paraplegia
|
1 (0.4)
|
2 (6.9)
|
1 (1.9)
|
0.0227
|
0.05 (0.004 - 0.57)
|
0.0167
|
|
|
0.19 (0.01 - 3.07)
|
0.241
|
|
|
Hemiparesis
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
Aphasia
|
0
|
1 (3.4)
|
1 (1.9)
|
0.0497
|
-
|
-
|
|
|
-
|
-
|
|
|
Dysarthria
|
0
|
2 (6.9)
|
0
|
0.0067
|
-
|
-
|
|
|
-
|
-
|
|
|
UMN facial palsy
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
Unequal pupils
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
Signs of meningitis
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Paraesthesia
|
2 (0.7)
|
0
|
1 (1.9)
|
0.546
|
-
|
-
|
|
|
0.38 (0.03 - 4.26)
|
0.432
|
|
|
Faecal incontinence
|
0
|
0
|
2 (3.8)
|
0.0277
|
-
|
-
|
|
|
-
|
-
|
|
|
Urinary retention
|
0
|
0
|
1 (1.9)
|
0.228
|
-
|
-
|
|
|
-
|
-
|
|
|
PNS
|
119 (43.9)
|
5 (17.2)
|
1 (1.9)
|
<0.0017
|
3.76 (1.39 - 10.14)
|
0.0097
|
2.19 (0.67 - 7.15)
|
0.194
|
39.93 (5.44 - 293.14)
|
<0.0017
|
19.54 (2.30 - 166.09)
|
0.0067
|
Anosmia
|
114 (42.1)
|
3 (10.3)
|
1 (1.9)
|
<0.0017
|
6.29 (1.86 - 21.30)
|
0.0037
|
|
|
37.03 (5.04 - 271.92)
|
<0.0017
|
|
|
Hyposmia
|
3 (1.1)
|
0
|
0
|
1.000
|
-
|
-
|
|
|
-
|
-
|
|
|
Ageusia
|
78 (28.8)
|
2 (6.9)
|
0
|
<0.0017
|
5.46 (1.27 - 23.50)
|
0.0237
|
|
|
-
|
-
|
|
|
Hypogeusia
|
4 (1.5)
|
0
|
0
|
0.727
|
-
|
-
|
|
|
-
|
-
|
|
|
Blurred vision
|
0
|
2 (6.9)
|
0
|
0.0067
|
-
|
-
|
|
|
-
|
-
|
|
|
NMS
|
208 (76.8)
|
16 (55.2)
|
16 (30.8)
|
<0.0017
|
2.68 (1.22 - 5.88)
|
0.0147
|
1.90 (0.65 - 5.58)
|
0.243
|
7.43 (3.87 - 14.27)
|
<0.0017
|
4.35 (1.47 - 12.87)
|
0.0087
|
Myalgia
|
186 (68.6)
|
14 (48.3)
|
15 (28.8)
|
<0.0017
|
2.345 (1.08 - 5.08)
|
0.0317
|
|
|
5.40 (2.81 - 10.37)
|
<0.0017
|
|
|
Arthralgia
|
40 (14.8)
|
1 (3.4)
|
2 (3.8)
|
0.0297
|
4.85 (0.64 - 36.65)
|
0.126
|
|
|
4.33 (1.01 - 18.50)
|
0.0487
|
|
|
PSY
|
0
|
4 (13.8)
|
0
|
<0.0017
|
-
|
-
|
|
|
-
|
-
|
|
|
Visual Hallucination
|
0
|
2 (6.9)
|
0
|
0.0067
|
-
|
-
|
|
|
-
|
-
|
|
|
Agitation
|
0
|
2 (6.9)
|
0
|
0.0067
|
-
|
-
|
|
|
-
|
-
|
|
|
Depressed mood
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Insomnia
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Suicidal thoughts
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Psychosis
|
0
|
1 (3.4)
|
0
|
0.082
|
-
|
-
|
|
|
-
|
-
|
|
|
Clinical Outcome
|
|
|
|
|
|
|
|
|
|
|
|
|
Deaths
|
0
|
7 (24.1)
|
41 (78.8)
|
<0.0017
|
|
|
|
|
|
|
|
|
Discharges
|
271 (100.0)
|
22 (75.9)
|
11 (21.2)
|
|
|
|
|
|
|
|
|
|
Abbreviations: CVST, cerebral venous sinus thrombosis; GIT, gastrointestinal tract; PCOS, polycystic ovary syndrome; CNS, central nervous system; LOC, loss of consciousness; UMN, upper motor neuron; PNS, peripheral nervous system; NMS, neuromusculoskeletal; PSY, psychiatric; UVA, univariate analysis; MVA, multivariate analysis; OR, odds ratio; CI, confidence interval; Ref, reference
1 Comparing severe cases to moderate cases.
2 Comparing critical cases to moderate cases.
3 Variables with frequency = 0 were not included in UVA; clinical outcome not included in UVA since it cannot be considered as potential predictor of severity.
4 Selected variables with UVA P -value <0.05 were included in MVA; MVA adjusted for age group, neurological comorbidities, non- neurological comorbidities, CNS presentations, PNS presentations, NMS presentations; using multinomial logistic regression model.
5 Selected variables with UVA P -value <0.05 were included in the MVA; MVA adjusted for gender, age group, neurological comorbidities, non- neurological comorbidities, CNS presentations, PNS presentations, NMS presentations; using multinomial logistic regression model.
6 Reference category for UVA and MVA within this group variable; all other variables were dichotomous (Presence versus Absence); Presence = reference category, Absence = tabulated OR (95% CI).
7 P -value <0.05 was considered statistically significant.
8 Patients were not mutually exclusive within this variable.
Table 4. Distribution of clinical findings for outcome and predictors of mortalities amongst Neuro-COVID patients.
Variable
|
Clinical Outcome
|
Deaths1
|
Deaths
(n = 48)
No. (%)
|
Discharges
(n = 304)
No. (%)
|
P -value
|
UVA2
OR (95% CI)
|
P -value
|
MVA3
OR (95% CI)
|
P -value
|
Gender
|
|
|
|
|
|
|
|
Female
|
28 (58.3)
|
155 (51.0s)
|
0.344
|
1.35 (0.73 - 2.49)
|
0.345
|
|
|
Male4
|
20 (41.7)
|
149 (49.0)
|
|
Ref
|
|
|
|
Age group (years)
|
|
|
|
|
|
|
|
<20
|
0
|
37 (12.2)
|
0.0115
|
-
|
-
|
|
|
20-39
|
8 (16.7)
|
185 (60.9)
|
<0.0015
|
0.02 (0.003 - 0.10)
|
<0.0015
|
0.19 (0.009 - 3.72)
|
0.271
|
40-59
|
11 (22.9)
|
49 (16.1)
|
0.244
|
0.09 (0.02 - 0.53)
|
0.0075
|
0.24 (0.01 - 4.58)
|
0.339
|
60-79
|
24 (50.0)
|
31 (10.2)
|
<0.0015
|
0.31 (0.06 - 1.74)
|
0.183
|
0.13 (0.007 - 2.27)
|
0.161
|
≥804
|
5 (10.4)
|
2 (0.7)
|
0.0015
|
Ref
|
|
Ref
|
|
Comorbidities6
|
43 (89.6)
|
118 (38.8)
|
<0.0015
|
13.56 (5.22 - 35.21)
|
<0.0015
|
|
|
Neurological
|
10 (20.8)
|
14 (4.6)
|
<0.0015
|
5.45 (2.26 - 13.13)
|
<0.0015
|
0.71 (0.17 - 3.07)
|
0.650
|
Stroke
|
6 (12.5)
|
7 (2.3)
|
0.0045
|
6.06 (1.94 - 18.90)
|
0.0025
|
|
|
Brain/ spinal cord tumour
|
2 (4.2)
|
3 (1.0)
|
0.139
|
4.36 (0.71 - 26.81)
|
0.112
|
|
|
Epilepsy
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Alzheimer
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Hemiplegia
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Cerebral palsy
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Migraine
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
CVST
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Myopathy
|
1 (2.1)
|
1 (0.3)
|
0.254
|
6.45 (0.40 - 104.83)
|
0.190
|
|
|
Psychiatric disorder
|
1 (2.1)
|
2 (0.7)
|
0.357
|
3.21 (0.29 - 36.13)
|
0.345
|
|
|
Non- Neurological
|
43 (89.6)
|
112 (38.8)
|
<0.0015
|
14.74 (5.67 - 38.31)
|
<0.0015
|
4.27 - (0.89 - 20.44)
|
0.069
|
Hypertension
|
22 (45.8)
|
43 (14.1)
|
<0.0015
|
5.14 (2.67 - 9.87)
|
<0.0015
|
|
|
Diabetes
|
18 (37.5)
|
33 (10.9)
|
<0.0015
|
4.93 (2.48 - 9.80)
|
<0.0015
|
|
|
Asthma
|
0
|
25 (8.2)
|
0.0345
|
-
|
-
|
|
|
Chronic sinusitis
|
0
|
12 (3.9)
|
0.383
|
-
|
-
|
|
|
Renal disease
|
13 (27.1)
|
11 (3.6)
|
<0.0015
|
9.90 (4.12 - 23.76)
|
<0.0015
|
|
|
Cardiovascular disease
|
9 (18.8)
|
12 (3.9)
|
0.0015
|
5.62 (2.22 - 14.18)
|
<0.0015
|
|
|
Malignancy
|
10 (20.8)
|
5 (1.6)
|
<0.0015
|
15.74 (5.11 - 48.49)
|
<0.0015
|
|
|
Benign tumour
|
0
|
2 (0.7)
|
1.000
|
-
|
-
|
|
|
Liver disease
|
7 (14.6)
|
4 (1.3)
|
<0.0015
|
12.81 (3.59 - 45.65)
|
<0.0015
|
|
|
Blood disorders
|
3 (6.3)
|
6 (2.0)
|
0.110
|
3.31 (0.80 - 13.71)
|
0.099
|
|
|
GIT disease
|
2 (4.2)
|
7 (2.3)
|
0.353
|
1.85 (0.37 - 9.15)
|
0.454
|
|
|
Rheumatic disease
|
4 (8.3)
|
5 (1.6)
|
0.0235
|
5.44 (1.41 - 21.02)
|
0.0145
|
|
|
Thyroid disease
|
0
|
3 (1.0)
|
1.000
|
-
|
-
|
|
|
PCOS
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Smoking
|
5 (10.4)
|
4 (1.3)
|
0.0035
|
8.72 (2.25 - 33.74)
|
0.0025
|
|
|
Substance abuse
|
5 (10.4)
|
2 (0.7)
|
0.0015
|
17.56 (3.30 - 93.33)
|
0.0015
|
|
|
Clinical Presentations6
|
|
|
|
|
|
|
|
CNS
|
39 (81.3)
|
125 (41.1)
|
<0.0015
|
6.21 (2.90 - 13.27)
|
<0.0015
|
0.70 (0.10 - 4.80)
|
0.717
|
Headache
|
7 (14.6)
|
93 (30.6)
|
0.0225
|
0.39 (0.17 - 0.90)
|
0.0275
|
|
|
Altered level of consciousness
|
32 (66.7)
|
24 (7.9)
|
<0.0015
|
23.33 (11.24 - 48.45)
|
<0.0015
|
|
|
Dizziness
|
3 (6.3)
|
9 (3.0)
|
0.216
|
2.19 (0.57 - 8.38)
|
0.254
|
|
|
Seizure
|
2 (4.2)
|
2 (0.7)
|
0.091
|
6.57 (0.90 - 47.76)
|
0.063
|
|
|
Paraparesis/ Paraplegia
|
3 (6.3)
|
1 (0.3)
|
0.0095
|
20.20 (2.06 - 198.43)
|
0.0105
|
|
|
Hemiparesis
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Aphasia
|
2 (4.2)
|
0
|
0.0185
|
-
|
-
|
|
|
Dysarthria
|
1 (2.1)
|
1 (0.3)
|
0.254
|
6.45 (0.40 - 104.83)
|
0.190
|
|
|
UMN facial palsy
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Unequal pupils
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Signs of meningitis
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Paraesthesia
|
1 (2.1)
|
2 (0.7)
|
0.357
|
3.21 (0.27 - 36.13)
|
0.345
|
|
|
Faecal incontinence
|
2 (4.2)
|
0
|
0.0185
|
-
|
-
|
|
|
Urinary retention
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
PNS
|
1 (2.1)
|
124 (40.8)
|
<0.0015
|
0.03 (0.004 - 0.23)
|
0.0015
|
0.25 (0.02 - 4.01)
|
0.330
|
Anosmia
|
1 (2.1)
|
117 (38.5)
|
<0.0015
|
0.03 (0.005 - 0.25)
|
0.0015
|
|
|
Hyposmia
|
0
|
3 (1.0)
|
1.000
|
-
|
-
|
|
|
Ageusia
|
0
|
80 (26.3)
|
<0.0015
|
-
|
-
|
|
|
Hypogeusia
|
0
|
4 (1.3)
|
1.000
|
-
|
-
|
|
|
Blurred vision
|
0
|
2 (0.7)
|
1.000
|
-
|
-
|
|
|
NMS
|
16 (33.3)
|
224 (73.7)
|
<0.0015
|
0.18 (0.09 - 0.34)
|
<0.0015
|
0.65 (0.12 - 3.46)
|
0.613
|
Myalgia
|
15 (31.3)
|
200 (65.8)
|
<0.0015
|
0.24 (0.12 - 0.46)
|
<0.0015
|
|
|
Arthralgia
|
2 (4.2)
|
41 (13.5)
|
0.067
|
0.28 (0.07 - 1.19)
|
0.085
|
|
|
PSY
|
2 (4.2)
|
2 (0.7)
|
0.091
|
6.57 (0.90 - 47.76)
|
0.063
|
|
|
Visual Hallucination
|
1 (2.1)
|
1 (0.3)
|
0.254
|
6.45 (0.40 - 104.83)
|
0.190
|
|
|
Agitation
|
0
|
2 (0.7)
|
1.000
|
-
|
-
|
|
|
Depressed mood
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Insomnia
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Suicidal thoughts
|
0
|
1 (0.3)
|
1.000
|
-
|
-
|
|
|
Psychosis
|
1 (2.1)
|
0
|
0.136
|
-
|
-
|
|
|
Disease Severity
|
|
|
|
|
|
|
|
Moderate
|
0
|
271 (89.1)
|
<0.0015
|
-
|
-
|
|
|
Severe4
|
7 (14.6)
|
22 (7.2)
|
0.093
|
Ref
|
|
Ref
|
|
Critical
|
41 (85.4)
|
11 (3.6)
|
<0.0015
|
11.71 (3.98 - 34.49)
|
<0.0015
|
12.06 (3.41 - 42.64)
|
<0.005
|
Abbreviations: CVST, cerebral venous sinus thrombosis; GIT, gastrointestinal tract; PCOS, polycystic ovary syndrome; CNS, central nervous system; LOC, loss of consciousness; UMN, upper motor neuron; PNS, peripheral nervous system; NMS, neuromusculoskeletal; PSY, psychiatric; UVA, univariate analysis; MVA, multivariate analysis; OR, odds ratio; CI, confidence interval; Ref, reference
1 Comparing deaths to discharges.
2 Variables with frequency = 0 were not included in UVA.
3 Selected variables with UVA P -value <0.05 were included in MVA; MVA adjusted for age group, neurological comorbidities, non- neurological comorbidities, CNS presentations, PNS presentations, NMS presentations, disease severity; using multinomial logistic regression model.
4 Reference category for UVA and MVA within this group variable; all other variables were dichotomous (Presence versus Absence); Absence = reference category, Presence = tabulated OR (95% CI).
5 P -value <0.05 was considered statistically significant.
6 Patients were not mutually exclusive within this variable.
Table 5. Summary of statistically significant clinical findings amongst Neuro-COVID patients.
Variable
|
Clinical Findings
(n = 352)
|
Comorbidities
|
Disease Severity
|
Clinical Outcome
|
With
%
|
Without
%
|
Moderate
%
|
Severe
%
|
Critical
%
|
Deaths
%
|
Discharges
%
|
Age Group, (years)
|
|
|
|
|
|
|
|
<20
|
5.0*
|
15.2*
|
13.7*
|
0
|
0
|
0
|
12.2*
|
20-39
|
34.8*
|
71.7*
|
64.9*
|
27.6*
|
17.3*
|
16.7*
|
60.9*
|
40-59
|
24.8*
|
10.5*
|
15.1*
|
27.6*
|
21.2*
|
22.9
|
16.1
|
60-79
|
31.7*
|
2.1*
|
5.9*
|
37.9*
|
53.8*
|
50.0*
|
10.2*
|
≥80
|
3.7
|
0.5
|
0.4*
|
6.9*
|
7.7*
|
10.4*
|
0.7*
|
Comorbidities**
|
|
|
|
|
|
|
|
Neurological
|
-
|
-
|
2.6*
|
17.2*
|
23.1*
|
20.8*
|
4.6*
|
Non- Neurological
|
-
|
-
|
32.8*
|
72.4*
|
86.5*
|
89.6*
|
38.8*
|
Clinical Presentations**
|
|
|
|
|
|
|
|
CNS
|
58.4*
|
36.6*
|
38.0*
|
58.6*
|
84.6*
|
81.3*
|
41.1*
|
PNS
|
25.5*
|
44.0*
|
43.9*
|
17.2*
|
1.9*
|
2.1*
|
40.8*
|
NMS
|
57.2*
|
77.5*
|
76.8*
|
55.2*
|
30.8*
|
33.3*
|
73.7*
|
PSY
|
1.9
|
0.5
|
0
|
13.8*
|
0
|
4.2
|
0.7
|
Disease Severity
|
|
|
|
|
|
|
|
Moderate
|
57.1*
|
93.7*
|
-
|
-
|
-
|
0
|
89.1*
|
Severe
|
14.9*
|
2.6*
|
-
|
-
|
-
|
14.6
|
7.2
|
Critical
|
28.0*
|
3.7*
|
-
|
-
|
-
|
85.4*
|
3.6*
|
Clinical Outcome
|
|
|
|
|
|
|
|
Deaths
|
26.7*
|
2.8*
|
0
|
24.1*
|
78.8*
|
-
|
-
|
Discharges
|
73.3*
|
97.4*
|
100.0*
|
75.9*
|
21.2*
|
-
|
-
|
|
Variable (Predictor)
|
Predictors of Severity and Mortality
|
Severe†
|
Critical††
|
Deaths†††
|
Univariate
OR
|
Multivariate
OR
|
Univariate
OR
|
Multivariate
OR
|
Univariate
OR
|
Multivariate
OR
|
Gender
|
|
|
|
|
|
|
Female
|
0.82
|
-
|
2.07*
|
2.67*
|
1.35*
|
-
|
Male
|
Ref ¶
|
-
|
Ref ¶
|
-
|
Ref ¶¶
|
-
|
Age Group, (years)
|
|
|
|
|
|
|
<20
|
-
|
-
|
-
|
-
|
-
|
-
|
20-39
|
0.02*
|
0.04*
|
0.01*
|
0.04*
|
0.02*
|
0.19
|
40-59
|
0.10
|
0.10
|
0.07*
|
0.08
|
0.09*
|
0.24
|
60-79
|
0.34
|
0.22
|
0.44
|
0.26
|
0.31
|
0.13
|
≥80 ¶
|
Ref ¶
|
Ref ¶
|
Ref ¶
|
Ref ¶
|
Ref ¶¶
|
Ref ¶¶
|
Comorbidities**
|
|
|
|
|
|
|
Neurological
|
0.13*
|
0.27
|
0.09*
|
0.30
|
5.45*
|
0.71
|
Non- Neurological
|
0.17*
|
0.40
|
0.08*
|
0.14*
|
14.74*
|
4.27
|
Clinical Presentations**
|
|
|
|
|
|
|
CNS
|
0.043*
|
0.87
|
0.11*
|
0.47
|
6.21*
|
0.70
|
PNS
|
3.76*
|
2.19
|
39.93*
|
19.54*
|
0.03*
|
0.25
|
NMS
|
2.68*
|
1.90
|
7.43*
|
4.35*
|
0.18*
|
0.65
|
PSY
|
-
|
-
|
-
|
-
|
6.57
|
-
|
Disease Severity
|
|
|
|
|
|
|
Moderate
|
-
|
-
|
-
|
-
|
-
|
-
|
Severe
|
-
|
-
|
-
|
-
|
Ref ¶¶
|
Ref ¶¶
|
Critical
|
-
|
-
|
-
|
-
|
11.71
|
12.06
|
Abbreviations: CNS, central nervous system; PNS, peripheral nervous system; NMS, neuromusculoskeletal; PSY, psychiatric; OR, odds ratio; Ref, reference
* P -value was <0.05 and considered statistically significant.
** Patients were not mutually exclusive within this variable.
† Comparing severe cases to moderate cases; OR tabulated; refer to Table 3 for 95% confidence interval.
†† Comparing critical cases to moderate cases; OR tabulated; refer to Table 3 for 95% confidence interval.
††† Comparing deaths to discharges; OR tabulated; refer to Table 4 for 95% confidence interval
¶ Reference category for univariate analysis and multivariate analysis within this group variable; all other variables were dichotomous (Presence versus Absence); Presence = reference category, Absence = tabulated OR.
¶¶ Reference category for univariate analysis and multivariate analysis within this group variable; all other variables were dichotomous (Presence versus Absence); Absence = reference category, Presence = tabulated OR.