ArticleAnnals of neurology2023
Fewer COVID-19 Neurological Complications with Dexamethasone and Remdesivir.
Article in Annals of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- A Systematic Review and Meta-analysis of the Effectiveness of Remdesivir to Treat SARS-CoV-2 in Hospitalized Patients: Have the Guidelines Evolved With the Evidence?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Pooled it
- Remdesivir for the treatment of COVID-19.The Cochrane database of systematic reviews · 2023Pooled it
- Article
- Viral Infection and the Blood-Brain Barrier: Molecular Research Insights and Therapies.The Journal of infectious diseases · 2025Review
- Femtosecond laser-ablative aqueous synthesis of multi-drug antiviral nanoparticles.Nanomedicine (London, England) · 2025Article
- Patients with neurological or psychiatric complications of COVID-19 have worse long-term functional outcomes: COVID-CNS-A multicentre case-control study.Scientific reports · 2025Article
- Cognitive deficits after COVID-19 associated with brain injury biomarkers and volume loss.Nature medicine · 2025Article
- Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction.Nature medicine · 2025Article
- Impact of Baseline SARS-CoV-2 Load in Plasma and Upper Airways on the Incidence of Acute Extrapulmonary Complications of COVID-19: A Multicentric, Prospective, Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Neurological complications caused by SARS-CoV-2.Clinical microbiology reviews · 2024Review
- Neuropsychiatric Burden of SARS-CoV-2: A Review of Its Physiopathology, Underlying Mechanisms, and Management Strategies.Viruses · 2024Review
- Prevalence and Risk Factors of Headache Associated with COVID-19.Journal of clinical medicine · 2024Article
- Neutrophil membrane-derived nanoparticles protect traumatic brain injury via inhibiting calcium overload and scavenging ROS.Journal of nanobiotechnology · 2024Article
- Cerebellitis following COVID-19 infection: A case-based systematic review and pooled analysis.Heliyon · 2024Article
- Pulmonary SARS-CoV-2 infection leads to para-infectious immune activation in the brain.Frontiers in immunology · 2024Article
- A Review of Hematological Complications and Treatment in COVID-19.Hematology reports · 2023Review
- Emerging Landscape of Preclinical Models for Studying COVID-19 Neurologic Diseases.ACS pharmacology & translational science · 2023Review
- Incidence and Long-term Functional Outcome of Neurologic Disorders in Hospitalized Patients With COVID-19 Infected With Pre-Omicron Variants.Neurology · 2023Article
- [COVID-19: Neurological manifestations and complications during the acute phase of the disease].Bulletin de l'Academie nationale de medecine · 2023Review
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12 authors at 7 institutions in 1 country.
Funding
Abstract
objectiveThe objective of this study was to assess the impact of treatment with dexamethasone, remdesivir or both on neurological complications in acute coronavirus diease 2019 (COVID-19).
methodsWe used observational data from the International Severe Acute and emerging Respiratory Infection Consortium World Health Organization (WHO) Clinical Characterization Protocol, United Kingdom. Hospital inpatients aged ≥18 years with laboratory-confirmed severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection admitted between January 31, 2020, and June 29, 2021, were included. Treatment allocation was non-blinded and performed by reporting clinicians. A propensity scoring methodology was used to minimize confounding. Treatment with remdesivir, dexamethasone, or both was assessed against the standard of care. The primary outcome was a neurological complication occurring at the point of death, discharge, or resolution of the COVID-19 clinical episode.
resultsOut of 89,297 hospital inpatients, 64,088 had severe COVID-19 and 25,209 had non-hypoxic COVID-19. Neurological complications developed in 4.8% and 4.5%, respectively. In both groups, neurological complications were associated with increased mortality, intensive care unit (ICU) admission, worse self-care on discharge, and time to recovery. In patients with severe COVID-19, treatment with dexamethasone (n = 21,129), remdesivir (n = 1,428), and both combined (n = 10,846) were associated with a lower frequency of neurological complications: OR = 0.76 (95% confidence interval [CI] = 0.69-0.83), OR = 0.69 (95% CI = 0.51-0.90), and OR = 0.54 (95% CI = 0.47-0.61), respectively. In patients with non-hypoxic COVID-19, dexamethasone (n = 2,580) was associated with less neurological complications (OR = 0.78, 95% CI = 0.62-0.97), whereas the dexamethasone/remdesivir combination (n = 460) showed a similar trend (OR = 0.63, 95% CI = 0.31-1.15).
interpretationTreatment with dexamethasone, remdesivir, or both in patients hospitalized with COVID-19 was associated with a lower frequency of neurological complications in an additive manner, such that the greatest benefit was observed in patients who received both drugs together. ANN NEUROL 2023;93:88-102.
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