Evidence map›Paper›PMID 33443111›Full record

ArticleNeurology2021

Neurologic Syndromes Predict Higher In-Hospital Mortality in COVID-19.

Emad Nader Eskandar, David J Altschul, Rafael de la Garza Ramos, Phillip Cezayirli, Santiago R Unda, Joshua Benton, Joseph Dardick, Aureliana Toma, Nikunj Patel, Avinash Malaviya and 22 more

Erratum issuedOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 50 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 4 pooled it
7.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 103 citations in OpenAlex.

  1. Pooled it
  2. The association between stroke and COVID-19-related mortality: a systematic review and meta-analysis based on adjusted effect estimates.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors at 2 institutions in 1 country.

Emad Nader EskandarFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
David J AltschulFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY. daltschu@montefiore.org.ORCID 0000-0002-5130-1378
Rafael de la Garza RamosFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Phillip CezayirliFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0002-1165-0952
Santiago R UndaFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0001-7319-6794
Joshua BentonFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Joseph DardickFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Aureliana TomaFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Nikunj PatelFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0002-0287-1825
Avinash MalaviyaFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
David FlomenbaumFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Jenelys Fernandez-TorresFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Jenny LuFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Ryan HollandFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Elisabetta BurchiFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Richard ZampolinFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Kevin HsuFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Andrew McClellandFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0001-5241-799X
Judah BurnsFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Amichai ErdfarbFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0002-3888-4687
Rishi MalhotraFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Michelle GongFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Peter SemczukFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Jonathan GurskyFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Victor FerastraoaruFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Jillian RosengardFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Daniel AntonielloFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Daniel LabovitzFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0003-0754-4345
Charles EsenwaFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Mark MilsteinFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.ORCID 0000-0002-4791-5609
Alexis BoroFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Mark F MehlerFrom the Departments of Neurological Surgery (E.N.E., D.J.A., R.d.l.G.R., P.C., S.R.U., J. Benton, J.D., A.T., J.F.-T., J.L., R.H., E.B.), Neurology (N.P., A. Malaviya, D.F., D.A., D.L., J.G., V.F., J.R., C.E., M.M., A.B., M.F.M.), Radiology (R.Z., K.H., A. McClelland, J. Burns, A.E.), and Critical Care Medicine (R.M., M.G.), Albert Einstein College of Medicine, Montefiore Medical Center (P.S., V.F., J.R.), Bronx, NY.
Montefiore Medical Center · USAnna Needs Neuroblastoma Answers · US

Funding

Huntington's disease: a novel developmental oligodendrogliopathyR01NS096144 · NINDS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI MEHLER, MARK F · 2016 to 2020
$1.8M
NINDS NIH HHS R01 NS096144
6 · The paper itself

Abstract

objectiveSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is protean in its manifestations, affecting nearly every organ system. However, nervous system involvement and its effect on disease outcome are poorly characterized. The objective of this study was to determine whether neurologic syndromes are associated with increased risk of inpatient mortality.

methodsA total of 581 hospitalized patients with confirmed SARS-CoV-2 infection, neurologic involvement, and brain imaging were compared to hospitalized non-neurologic patients with coronavirus disease 2019 (COVID-19). Four patterns of neurologic manifestations were identified: acute stroke, new or recrudescent seizures, altered mentation with normal imaging, and neuro-COVID-19 complex. Factors present on admission were analyzed as potential predictors of in-hospital mortality, including sociodemographic variables, preexisting comorbidities, vital signs, laboratory values, and pattern of neurologic manifestations. Significant predictors were incorporated into a disease severity score. Patients with neurologic manifestations were matched with patients of the same age and disease severity to assess the risk of death.

resultsA total of 4,711 patients with confirmed SARS-CoV-2 infection were admitted to one medical system in New York City during a 6-week period. Of these, 581 (12%) had neurologic issues of sufficient concern to warrant neuroimaging. These patients were compared to 1,743 non-neurologic patients with COVID-19 matched for age and disease severity admitted during the same period. Patients with altered mentation (n = 258,

conclusionsThe incidence of altered mentation or stroke on admission predicts a modest but significantly higher risk of in-hospital mortality independent of disease severity. While other biomarker factors also predict mortality, measures to identify and treat such patients may be important in reducing overall mortality of COVID-19.

Indexed as

Hospital MortalityAgedAged, 80 and overAgeusiaAnosmiaAtaxiaConfusionConsciousness DisordersCOVID-19Cranial Nerve DiseasesDeliriumFemaleHeadacheHumansMaleMiddle Aged

Identifiers

PMID33443111
PMCPMC8032378
OpenAlexW3113311499

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