ArticleActa neurologica Scandinavica2021
Association of consciousness impairment and mortality in people with COVID-19.
Article in Acta neurologica Scandinavica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- Randomized, double-blinded, placebo-controlled trial of allogeneic cord blood T-regulatory cells for treatment of COVID-19 ARDS.Blood advances · 2023Trial
- Forecasting COVID-19 inpatient mortality using fundamental parameters in resource-constrained settings: a countrywide multi-center cohort study.BMC infectious diseases · 2025Article
- First episode of psychiatric and neuropsychiatric disease among patients infected with COVID-19: A scoping review.PCN reports : psychiatry and clinical neurosciences · 2025Review
- Evaluation of the performance of disease severity indices (SOFA, SAPS III, and MPM II) for the prediction of mortality rate in COVID-19 patients admitted to the intensive care units: a retrospective cross-sectional study.BMC infectious diseases · 2025Article
- Cross-Section of Neurological Manifestations Among SARS-CoV-2 Omicron Subvariants-Single-Center Study.Brain sciences · 2024Article
- Comparative analysis of prognostic scoring systems in predicting severity and outcomes of Omicron variant COVID-19 pneumonia.Frontiers in medicine · 2024Article
- Clinical profile of hospitalised moderate category COVID-19 patients: Short study from a Tertiary Care Centre in Delhi.Journal of family medicine and primary care · 2023Article
- Case report on meningoenceplapathy in an Indian patient post CoViD vaccination.Bioinformation · 2023Article
- Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study.Infection and drug resistance · 2023Article
- Predictors of death among severe COVID-19 patients admitted in Hawassa City, Sidama, Southern Ethiopia: Unmatched case-control study.PloS one · 2023Article
- Sex-Specific Association between Underlying Diseases and the Severity and Mortality Due to COVID-19 Infection: A Retrospective Observational Cohort Analysis of Clinical Epidemiological Information Collected by the Korea Disease Control and Prevention Agency.Healthcare (Basel, Switzerland) · 2022Article
- Neurological Prognostic Factors in Hospitalized Patients with COVID-19.Brain sciences · 2022Article
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Authors and funding
10 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundTo investigate the association between impairment of consciousness and risk of death in people with COVID-19.
methodsIn this multicentre retrospective study, we enrolled people with confirmed COVID-19 from 44 hospitals in Wuhan and Sichuan, China, between 18 January and 30 March 2020. We extracted demographics, clinical, laboratory data and consciousness level (as measured by the Glasgow Coma Scale (GCS) score) from medical records. We used Cox proportional hazards regression, structural equation modelling and survival time analysis to compare people with different progressions of impaired consciousness.
resultsWe enrolled 1,143 people (average age 51.3 ± standard deviation 17.1-year-old; 50.3% males), of whom 76 died. Increased mortality risk was identified in people with GCS score between 9 and 14 (hazard ratio (HR) 46.76, p < .001) and below 9 (HR 65.86, p < .001). Pathway analysis suggested a significant direct association between consciousness level and death. Other factors, including age, oxygen saturation level and pH, had indirect associations with death mediated by GCS scores. People who developed impaired consciousness more rapidly either from symptoms onset (<10 days vs. 10-19 days, p = .025, <10 days vs. ≥20 days and 10-19 days vs. ≥20 days, <.001) or deterioration of oxygen saturation (≤2 days vs.>2 days, p = .028) had shorter survival times.
conclusionAltered consciousness and its progression had a direct link with death in COVID-19. Interactions with age, oxygen saturation level and pH suggest possible pathophysiology. Further work to confirm these findings explore prevention strategies and interventions to decrease mortality is warranted.
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