Carregant...
Tipus de document
ArticleVersió
Versió publicadaData de publicació
Tots els drets reservats
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/176032
Incidence, clinical characteristics, risk factors and outcomes of meningoencephalitis in patients with COVID-19
Títol de la revista
Director/Tutor
ISSN de la revista
Títol del volum
Recurs relacionat
Resum
We investigated the incidence, clinical characteristics, risk factors, and outcome of meningoencephalitis (ME) in patients with COVID-19 attending emergency departments (ED), before hospitalization. We retrospectively reviewed all COVID patients diagnosed with ME in 61 Spanish EDs (20% of Spanish EDs, COVID-ME) during the COVID pandemic. We formed two control groups: non-COVID patients with ME (non-COVID-ME) and COVID patients without ME (COVID-non-ME). Unadjusted comparisons between cases and controls were performed regarding 57 baseline and clinical characteristics and 4 outcomes. Cerebrospinal fluid (CSF) biochemical and serologic findings of COVID-ME and non-COVID-ME were also investigated. We identified 29 ME in 71,904 patients with COVID-19 attending EDs (0.40‰, 95%CI=0.27-0.58). This incidence was higher than that observed in non-COVID patients (150/1,358,134, 0.11‰, 95%CI=0.09-0.13; OR=3.65, 95%CI=2.45-5.44). With respect to non-COVID-ME, COVID-ME more frequently had dyspnea and chest X-ray abnormalities, and neck stiffness was less frequent (OR=0.3, 95%CI=0.1-0.9). In 69.0% of COVID-ME, CSF cells were predominantly lymphocytes, and SARS-CoV-2 antigen was detected by RT-PCR in 1 patient. The clinical characteristics associated with a higher risk of presenting ME in COVID patients were vomiting (OR=3.7, 95%CI=1.4-10.2), headache (OR=24.7, 95%CI=10.2-60.1), and altered mental status (OR=12.9, 95%CI=6.6-25.0). COVID-ME patients had a higher in-hospital mortality than non-COVID-ME patients (OR=2.26; 95%CI=1.04-4.48), and a higher need for hospitalization (OR=8.02; 95%CI=1.19-66.7) and intensive care admission (OR=5.89; 95%CI=3.12-11.14) than COVID-non-ME patients. ME is an unusual form of COVID presentation (<0.5‰ cases), but is more than 4-fold more frequent than in non-COVID patients attending the ED. As the majority of these MEs had lymphocytic predominance and in one patient SARS-CoV-2 antigen was detected in CSF, SARS-CoV-2 could be the cause of most of the cases observed. COVID-ME patients had a higher unadjusted in-hospital mortality than non-COVID-ME patients.
Matèries
Matèries (anglès)
Citació
Citació
FRAGIEL, Marcos, MIRÓ I ANDREU, Òscar, LLORENS, Pere, JIMÉNEZ, Sònia, PIÑERA SALMERÓN, Pascual, BURILLO PUTZE, Guillermo, MARTÍN, Alfonso, MARTÍN SÁNCHEZ, Francisco javier, GARCÍA LAMBERECHTS, Eric jorge, JACOB, Javier, ALQUÉZAR ARBÉ, Aitor, LLOPIS ROCA, Ferran, PEDRAZA GARCÍA, Jorge, CALVO LÓPEZ, Ricardo, MAZA VERA, María teresa, LUCAS IMBERNÓN, Francisco javier, GONZÁLEZ MARTINEZ, Félix, JUÁREZ, Ricardo, EXPÓSITO RODRIGUEZ, Marcos, MARTINEZ BAUTISTA, Beatriz maria, NIEMBRO VALDÉS, Ana patricia, SANCHEZ NICOLAS, Jose andres, FERRERAS AMEZ, José maría, PORTA-ETESSAM, Jesús, CALVO, Elpidio, GONZÁLEZ DEL CASTILLO, Juan, Spanish Investigators on Emergency Situations TeAm (SIESTA) network. Incidence, clinical characteristics, risk factors and outcomes of meningoencephalitis in patients with COVID-19. _European Journal of Clinical Microbiology & Infectious Diseases_. 2021. [consulta: 21 de gener de 2026]. [Disponible a: https://hdl.handle.net/2445/176032]