Evidence map›Paper›PMID 38620037›Full record

ArticlePLOS digital health2024

Neurological diagnoses in hospitalized COVID-19 patients associated with adverse outcomes: A multinational cohort study.

Meghan R Hutch, Jiyeon Son, Trang T Le, Chuan Hong, Xuan Wang, Zahra Shakeri Hossein Abad, Michele Morris, Alba Gutiérrez-Sacristán, Jeffrey G Klann, Anastasia Spiridou and 39 more

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in PLOS digital health, 2024. 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 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 30% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

49 authors at 20 institutions in 7 countries.

Meghan R HutchDepartment of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America.ORCID https://orcid.org/0000-0001-8130-9429
Jiyeon SonDepartment of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0002-8895-775X
Trang T LeDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0003-3737-6565
Chuan HongDepartment of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0001-7056-9559
Xuan WangDepartment of Population Health Sciences, University of Utah, Salt Lake City, Utah, United States of America.
Zahra Shakeri Hossein AbadDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0003-4519-864X
Michele MorrisDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0002-3255-5727
Alba Gutiérrez-SacristánDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-1245-198X
Jeffrey G KlannDepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0003-2043-1601
Anastasia SpiridouDigital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, London, United Kingdom.ORCID https://orcid.org/0000-0001-6576-0244
Ashley BatugoDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.
Riccardo BellazziDepartment of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
Vincent BenoitIT Department, Innovation & Data, APHP Greater Paris University Hospital, Paris, France.ORCID https://orcid.org/0000-0002-7868-5869
Clara-Lea BonzelDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0001-5238-1413
William A BryantDigital Research, Informatics and Virtual Environments (DRIVE), Great Ormond Street Hospital for Children, London, United Kingdom.ORCID https://orcid.org/0000-0002-2135-0662
Lorenzo ChiudinelliUOC Ricerca, Innovazione e Brand reputation, ASST Papa Giovanni XXIII, Bergamo, Italy.ORCID https://orcid.org/0000-0002-5903-1843
Kelly ChoPopulation Health and Data Science, VA Boston Healthcare System, Boston Massachusetts, United States of America.
Priyam DasDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.
Tomás González GonzálezHealth Informatics, Hospital Universitario 12 de Octubre, Madrid, Spain.
David A HanauerDepartment of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, United States of America.ORCID https://orcid.org/0000-0001-6931-3791
Darren W HendersonCenter for Clinical and Translational Science, University of Kentucky, Lexington, Kentucky, United States of America.ORCID https://orcid.org/0000-0001-6198-1912
Yuk-Lam HoMassachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America.ORCID https://orcid.org/0000-0003-3305-3830
Ne Hooi Will LohDepartment of Anaesthesia, National University Health System, Kent Ridge, Singapore.ORCID https://orcid.org/0000-0002-4114-1286
Adeline MakoudjouInstitute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-2496-7086
Simran MakwanaDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0003-4116-2084
Alberto MaloviniLaboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy.ORCID https://orcid.org/0000-0003-2857-5773
Bertrand MoalIAM Unit, Bordeaux University Hospital, Bordeaux, France.ORCID https://orcid.org/0000-0001-9197-721X
Danielle L MoweryDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0003-3802-4457
Antoine NeurazDepartment of biomedical informatics, Hôpital Necker-Enfants Malade, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, Paris, France.
Malarkodi Jebathilagam SamayamuthuDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0003-0061-8196
Fernando J Sanz VidorretaDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America.ORCID https://orcid.org/0000-0001-7165-0949
Emily R SchriverData Analytics Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, United States of America.
Petra SchubertMassachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-6135-0173
Jeffery TalbertDivision of Biomedical Informatics, University of Kentucky, Lexington, Kentucky, United States of America.ORCID https://orcid.org/0000-0002-4304-5167
Amelia L M TanDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0003-0623-6623
Byorn W L TanDepartment of Medicine, National University Hospital, Singapore, Kent Ridge, Singapore.ORCID https://orcid.org/0000-0002-1658-259X
Bryce W Q TanDepartment of Medicine, National University Hospital, Singapore, Kent Ridge, Singapore.
Valentina TibolloLaboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy.ORCID https://orcid.org/0000-0003-2687-3822
Patric TippmanInstitute of Medical Biometry and University of Freiburg, Medical Center, Freiburg, Germany.
Guillaume VerdyIAM Unit, Bordeaux University Hospital, Bordeaux, France.
William YuanDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.
Paul AvillachDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-0235-7543
Nils GehlenborgDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0003-0327-8297
Gilbert S OmennDepartments of Computational Medicine & Bioinformatics, Internal Medicine, Human Genetics, Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
Consortium for Clinical Characterization of COVID-19 by EHR (4CE)
Shyam VisweswaranDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0002-2079-8684
Tianxi CaiDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, United States of America.
Yuan LuoDepartment of Preventive Medicine, Northwestern University, Chicago, Illinois, United States of America.ORCID https://orcid.org/0000-0003-0195-7456
Zongqi XiaDepartment of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.ORCID https://orcid.org/0000-0003-1500-2589
Harvard University · USUniversity of Pittsburgh · USUniversity of Pennsylvania · USVA Boston Healthcare System · USGreat Ormond Street Hospital · GBIstituti Clinici Scientifici Maugeri · ITNational University Hospital · SGNorthwestern University · USUniversity of Freiburg · DEUniversity of Kentucky · USUniversity of Michigan · USDuke University · USHôpital Necker-Enfants Malades · FRHospital Universitario 12 De Octubre · ESMassachusetts General Hospital · USNational University Health System · SGOspedale Papa Giovanni XXIII · ITUniversité Sorbonne Paris Nord · FRUniversity of California, Los Angeles · USUniversity of Pavia · IT

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3M
UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Phenotypic Diversity in COVID-19UL1TR001878 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2016 to 2025
$102.4M
Michigan Institute for Clinical and Health Research (MICHR)UL1TR002240 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LUMENG, JULIE C, MASHOUR, GEORGE ALEXANDER · 2017 to 2022
$54.9M
Kentucky Center for Clinical and Translational ScienceUL1TR001998 · NCATS · UNIVERSITY OF KENTUCKY · PI HARTMANN, KATHERINE E, KERN, PHILIP A · 2016 to 2025
$34.2M
Strategic Vision & Impact on Environmental HealthP30ES017885 · NIEHS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Dana Dolinoy · 2011 to 2026
$21.3M
RESEARCH TRAINING IN PEDIATRIC EMERGENCY MEDICINET32HD040128 · NICHD · CHILDREN'S HOSPITAL BOSTON · PI Kenneth D. Mandl · 2001 to 2026
$5.0M
CRITICAL: Collaborative Resource for Intensive care Translational science, Informatics, Comprehensive Analytics, and LearningU01TR003528 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI CIMINO, JAMES J, LUO, YUAN · 2021 to 2024
$4.9M
Leveraging electronic health records to optimize treatment selection and response in multiple sclerosisR01NS098023 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Zongqi Xia · 2016 to 2026
$4.6M
University of Michigan Proteogenomics Data Analysis CenterU24CA210967 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHINNAIYAN, ARUL M, DHANASEKARAN, SARAVANA M · 2016 to 2020
$4.1M
Modeling the Incompleteness and Biases of Health DataR01LM013337 · NLM · NORTHWESTERN UNIVERSITY AT CHICAGO · PI LUO, YUAN · 2020 to 2023
$1.3M
Real-world impact of the COVID-19 pandemic in people with multiple sclerosisR01NS124882 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI XIA, ZONGQI · 2022 to 2024
$1.2M
British Heart Foundation FS/19/52/34563NCATS NIH HHS U01 TR003528NCATS NIH HHS UL1 TR001857NCATS NIH HHS UL1 TR001878NCATS NIH HHS UL1 TR001881NCATS NIH HHS UL1 TR001998NCATS NIH HHS UL1 TR002240NCI NIH HHS U24 CA210967NICHD NIH HHS T32 HD040128NIEHS NIH HHS P30 ES017885NINDS NIH HHS R01 NS098023NINDS NIH HHS R01 NS124882NLM NIH HHS R01 LM013337
6 · The paper itself

Abstract

Few studies examining the patient outcomes of concurrent neurological manifestations during acute COVID-19 leveraged multinational cohorts of adults and children or distinguished between central and peripheral nervous system (CNS vs. PNS) involvement. Using a federated multinational network in which local clinicians and informatics experts curated the electronic health records data, we evaluated the risk of prolonged hospitalization and mortality in hospitalized COVID-19 patients from 21 healthcare systems across 7 countries. For adults, we used a federated learning approach whereby we ran Cox proportional hazard models locally at each healthcare system and performed a meta-analysis on the aggregated results to estimate the overall risk of adverse outcomes across our geographically diverse populations. For children, we reported descriptive statistics separately due to their low frequency of neurological involvement and poor outcomes. Among the 106,229 hospitalized COVID-19 patients (104,031 patients ≥18 years; 2,198 patients <18 years, January 2020-October 2021), 15,101 (14%) had at least one CNS diagnosis, while 2,788 (3%) had at least one PNS diagnosis. After controlling for demographics and pre-existing conditions, adults with CNS involvement had longer hospital stay (11 versus 6 days) and greater risk of (Hazard Ratio = 1.78) and faster time to death (12 versus 24 days) than patients with no neurological condition (NNC) during acute COVID-19 hospitalization. Adults with PNS involvement also had longer hospital stay but lower risk of mortality than the NNC group. Although children had a low frequency of neurological involvement during COVID-19 hospitalization, a substantially higher proportion of children with CNS involvement died compared to those with NNC (6% vs 1%). Overall, patients with concurrent CNS manifestation during acute COVID-19 hospitalization faced greater risks for adverse clinical outcomes than patients without any neurological diagnosis. Our global informatics framework using a federated approach (versus a centralized data collection approach) has utility for clinical discovery beyond COVID-19.

Identifiers

PMID38620037
PMCPMC11018281
OpenAlexW4394805778

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.