Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves
Objective The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves. Methods In this single-center cohort study, we included all patients w...
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| Veröffentlicht in: | Neurological sciences 2022-05, Vol.43 (5), p.2923-2927 |
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| creator | Cristillo, Viviana Pilotto, Andrea Benussi, Alberto Libri, Ilenia Giunta, Marcello Morotti, Andrea Gipponi, Stefano Locatelli, Martina Piccinelli, Stefano Cotti Mazzoleni, Valentina di Cola, Francesca Schiano Masciocchi, Stefano Pezzini, Debora Scalvini, Andrea Premi, Enrico Cottini, Elisabetta Gamba, Massimo Magoni, Mauro Fontanella, Marco Maria Padovani, Alessandro |
| description | Objective
The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves.
Methods
In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic.
Results
Two hundred twenty-three patients were included, of whom 112 and 111 were hospitalized during the first and second pandemic waves, respectively. Patients admitted during the second wave were younger and exhibited pulmonary COVID-19 severity, resulting in less oxygen support (
n
= 41, 36.9% vs
n
= 79, 70.5%,
p
|
| doi_str_mv | 10.1007/s10072-022-05946-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8852998</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2652409897</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-fe7d392019518bcb4384708cc3ea36022eeeeea9429dd1028a2a246107ba06963</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhSMEoqXwB1igSGzYBPyMbRZI1ZSWSpW6AbaW47kzcZXYg-3M0P76Op2hPBZY8kP2d4_v0amq1xi9xwiJD2leSYNImVyxtpFPqmPMFWooE_Lp4YylYEfVi5RuEEKYYfq8OqIcC84YOa5-LgbnnTVDHaZswwh1WNUephiGsH6435jswOdU71zu68X198uzBquPde6hduPG2DyX9GCG3FsTi0BcG-_uSlnwMxHDFsaiUHeQdwC-3pktpJfVs5UZErw67CfVt_PPXxdfmqvri8vF6VVjmWC5WYFYUkUQVhzLznaMSiaQtJaCoW2xDvMwihG1XGJEpCGGsBYj0RnUqpaeVJ_2upupG2FpSyPRDHoT3WjirQ7G6b9fvOv1Omy1lJwoJYvAu4NADD8mSFmPLlkYBuMhTEmTlijJOacz-vYf9CZM0Rd7heKEISWVKBTZUzaGlCKsHpvBSM-R6n2wurjTD8HqWfrNnzYeS34lWQC6B1J58muIv__-j-w9XGuv_A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2652409897</pqid></control><display><type>article</type><title>Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Cristillo, Viviana ; Pilotto, Andrea ; Benussi, Alberto ; Libri, Ilenia ; Giunta, Marcello ; Morotti, Andrea ; Gipponi, Stefano ; Locatelli, Martina ; Piccinelli, Stefano Cotti ; Mazzoleni, Valentina ; di Cola, Francesca Schiano ; Masciocchi, Stefano ; Pezzini, Debora ; Scalvini, Andrea ; Premi, Enrico ; Cottini, Elisabetta ; Gamba, Massimo ; Magoni, Mauro ; Fontanella, Marco Maria ; Padovani, Alessandro</creator><creatorcontrib>Cristillo, Viviana ; Pilotto, Andrea ; Benussi, Alberto ; Libri, Ilenia ; Giunta, Marcello ; Morotti, Andrea ; Gipponi, Stefano ; Locatelli, Martina ; Piccinelli, Stefano Cotti ; Mazzoleni, Valentina ; di Cola, Francesca Schiano ; Masciocchi, Stefano ; Pezzini, Debora ; Scalvini, Andrea ; Premi, Enrico ; Cottini, Elisabetta ; Gamba, Massimo ; Magoni, Mauro ; Fontanella, Marco Maria ; Padovani, Alessandro</creatorcontrib><description>Objective
The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves.
Methods
In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic.
Results
Two hundred twenty-three patients were included, of whom 112 and 111 were hospitalized during the first and second pandemic waves, respectively. Patients admitted during the second wave were younger and exhibited pulmonary COVID-19 severity, resulting in less oxygen support (
n
= 41, 36.9% vs
n
= 79, 70.5%,
p
< 0.001) and lower mortality rates (14.4% vs 31.3%,
p
= 0.004). The different healthcare strategies and early steroid treatment emerged as significant predictors of mortality independently from age, pre-morbid conditions and COVID-19 severity in Cox regression analyses.
Conclusions
Differences in healthcare strategies during the second phase of the COVID-19 pandemic probably explain the differences in clinical outcomes independently of disease severity, underlying the importance of standardized early management of neurological patients with SARS-CoV-2 infection.</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-022-05946-8</identifier><identifier>PMID: 35175442</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Clinical outcomes ; Cohort Studies ; Coronaviruses ; COVID-19 ; Delivery of Health Care ; Health care ; Humans ; Medicine ; Medicine & Public Health ; Mortality ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Pandemics ; Patients ; Psychiatry ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2</subject><ispartof>Neurological sciences, 2022-05, Vol.43 (5), p.2923-2927</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-fe7d392019518bcb4384708cc3ea36022eeeeea9429dd1028a2a246107ba06963</citedby><cites>FETCH-LOGICAL-c474t-fe7d392019518bcb4384708cc3ea36022eeeeea9429dd1028a2a246107ba06963</cites><orcidid>0000-0003-2457-8168</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10072-022-05946-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10072-022-05946-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35175442$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cristillo, Viviana</creatorcontrib><creatorcontrib>Pilotto, Andrea</creatorcontrib><creatorcontrib>Benussi, Alberto</creatorcontrib><creatorcontrib>Libri, Ilenia</creatorcontrib><creatorcontrib>Giunta, Marcello</creatorcontrib><creatorcontrib>Morotti, Andrea</creatorcontrib><creatorcontrib>Gipponi, Stefano</creatorcontrib><creatorcontrib>Locatelli, Martina</creatorcontrib><creatorcontrib>Piccinelli, Stefano Cotti</creatorcontrib><creatorcontrib>Mazzoleni, Valentina</creatorcontrib><creatorcontrib>di Cola, Francesca Schiano</creatorcontrib><creatorcontrib>Masciocchi, Stefano</creatorcontrib><creatorcontrib>Pezzini, Debora</creatorcontrib><creatorcontrib>Scalvini, Andrea</creatorcontrib><creatorcontrib>Premi, Enrico</creatorcontrib><creatorcontrib>Cottini, Elisabetta</creatorcontrib><creatorcontrib>Gamba, Massimo</creatorcontrib><creatorcontrib>Magoni, Mauro</creatorcontrib><creatorcontrib>Fontanella, Marco Maria</creatorcontrib><creatorcontrib>Padovani, Alessandro</creatorcontrib><title>Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>Objective
The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves.
Methods
In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic.
Results
Two hundred twenty-three patients were included, of whom 112 and 111 were hospitalized during the first and second pandemic waves, respectively. Patients admitted during the second wave were younger and exhibited pulmonary COVID-19 severity, resulting in less oxygen support (
n
= 41, 36.9% vs
n
= 79, 70.5%,
p
< 0.001) and lower mortality rates (14.4% vs 31.3%,
p
= 0.004). The different healthcare strategies and early steroid treatment emerged as significant predictors of mortality independently from age, pre-morbid conditions and COVID-19 severity in Cox regression analyses.
Conclusions
Differences in healthcare strategies during the second phase of the COVID-19 pandemic probably explain the differences in clinical outcomes independently of disease severity, underlying the importance of standardized early management of neurological patients with SARS-CoV-2 infection.</description><subject>Clinical outcomes</subject><subject>Cohort Studies</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Delivery of Health Care</subject><subject>Health care</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Psychiatry</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUtv1DAUhSMEoqXwB1igSGzYBPyMbRZI1ZSWSpW6AbaW47kzcZXYg-3M0P76Op2hPBZY8kP2d4_v0amq1xi9xwiJD2leSYNImVyxtpFPqmPMFWooE_Lp4YylYEfVi5RuEEKYYfq8OqIcC84YOa5-LgbnnTVDHaZswwh1WNUephiGsH6435jswOdU71zu68X198uzBquPde6hduPG2DyX9GCG3FsTi0BcG-_uSlnwMxHDFsaiUHeQdwC-3pktpJfVs5UZErw67CfVt_PPXxdfmqvri8vF6VVjmWC5WYFYUkUQVhzLznaMSiaQtJaCoW2xDvMwihG1XGJEpCGGsBYj0RnUqpaeVJ_2upupG2FpSyPRDHoT3WjirQ7G6b9fvOv1Omy1lJwoJYvAu4NADD8mSFmPLlkYBuMhTEmTlijJOacz-vYf9CZM0Rd7heKEISWVKBTZUzaGlCKsHpvBSM-R6n2wurjTD8HqWfrNnzYeS34lWQC6B1J58muIv__-j-w9XGuv_A</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Cristillo, Viviana</creator><creator>Pilotto, Andrea</creator><creator>Benussi, Alberto</creator><creator>Libri, Ilenia</creator><creator>Giunta, Marcello</creator><creator>Morotti, Andrea</creator><creator>Gipponi, Stefano</creator><creator>Locatelli, Martina</creator><creator>Piccinelli, Stefano Cotti</creator><creator>Mazzoleni, Valentina</creator><creator>di Cola, Francesca Schiano</creator><creator>Masciocchi, Stefano</creator><creator>Pezzini, Debora</creator><creator>Scalvini, Andrea</creator><creator>Premi, Enrico</creator><creator>Cottini, Elisabetta</creator><creator>Gamba, Massimo</creator><creator>Magoni, Mauro</creator><creator>Fontanella, Marco Maria</creator><creator>Padovani, Alessandro</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2457-8168</orcidid></search><sort><creationdate>20220501</creationdate><title>Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves</title><author>Cristillo, Viviana ; Pilotto, Andrea ; Benussi, Alberto ; Libri, Ilenia ; Giunta, Marcello ; Morotti, Andrea ; Gipponi, Stefano ; Locatelli, Martina ; Piccinelli, Stefano Cotti ; Mazzoleni, Valentina ; di Cola, Francesca Schiano ; Masciocchi, Stefano ; Pezzini, Debora ; Scalvini, Andrea ; Premi, Enrico ; Cottini, Elisabetta ; Gamba, Massimo ; Magoni, Mauro ; Fontanella, Marco Maria ; Padovani, Alessandro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-fe7d392019518bcb4384708cc3ea36022eeeeea9429dd1028a2a246107ba06963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Clinical outcomes</topic><topic>Cohort Studies</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Delivery of Health Care</topic><topic>Health care</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Psychiatry</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cristillo, Viviana</creatorcontrib><creatorcontrib>Pilotto, Andrea</creatorcontrib><creatorcontrib>Benussi, Alberto</creatorcontrib><creatorcontrib>Libri, Ilenia</creatorcontrib><creatorcontrib>Giunta, Marcello</creatorcontrib><creatorcontrib>Morotti, Andrea</creatorcontrib><creatorcontrib>Gipponi, Stefano</creatorcontrib><creatorcontrib>Locatelli, Martina</creatorcontrib><creatorcontrib>Piccinelli, Stefano Cotti</creatorcontrib><creatorcontrib>Mazzoleni, Valentina</creatorcontrib><creatorcontrib>di Cola, Francesca Schiano</creatorcontrib><creatorcontrib>Masciocchi, Stefano</creatorcontrib><creatorcontrib>Pezzini, Debora</creatorcontrib><creatorcontrib>Scalvini, Andrea</creatorcontrib><creatorcontrib>Premi, Enrico</creatorcontrib><creatorcontrib>Cottini, Elisabetta</creatorcontrib><creatorcontrib>Gamba, Massimo</creatorcontrib><creatorcontrib>Magoni, Mauro</creatorcontrib><creatorcontrib>Fontanella, Marco Maria</creatorcontrib><creatorcontrib>Padovani, Alessandro</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni 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Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cristillo, Viviana</au><au>Pilotto, Andrea</au><au>Benussi, Alberto</au><au>Libri, Ilenia</au><au>Giunta, Marcello</au><au>Morotti, Andrea</au><au>Gipponi, Stefano</au><au>Locatelli, Martina</au><au>Piccinelli, Stefano Cotti</au><au>Mazzoleni, Valentina</au><au>di Cola, Francesca Schiano</au><au>Masciocchi, Stefano</au><au>Pezzini, Debora</au><au>Scalvini, Andrea</au><au>Premi, Enrico</au><au>Cottini, Elisabetta</au><au>Gamba, Massimo</au><au>Magoni, Mauro</au><au>Fontanella, Marco Maria</au><au>Padovani, Alessandro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves</atitle><jtitle>Neurological sciences</jtitle><stitle>Neurol Sci</stitle><addtitle>Neurol Sci</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>43</volume><issue>5</issue><spage>2923</spage><epage>2927</epage><pages>2923-2927</pages><issn>1590-1874</issn><eissn>1590-3478</eissn><abstract>Objective
The aim of this study is to evaluate the differences in clinical presentations and the impact of healthcare organization on outcomes of neurological COVID-19 patients admitted during the first and second pandemic waves.
Methods
In this single-center cohort study, we included all patients with SARS-CoV-2 infection admitted to a Neuro-COVID Unit. Demographic, clinical, and laboratory data were compared between patients admitted during the first and second waves of the COVID-19 pandemic.
Results
Two hundred twenty-three patients were included, of whom 112 and 111 were hospitalized during the first and second pandemic waves, respectively. Patients admitted during the second wave were younger and exhibited pulmonary COVID-19 severity, resulting in less oxygen support (
n
= 41, 36.9% vs
n
= 79, 70.5%,
p
< 0.001) and lower mortality rates (14.4% vs 31.3%,
p
= 0.004). The different healthcare strategies and early steroid treatment emerged as significant predictors of mortality independently from age, pre-morbid conditions and COVID-19 severity in Cox regression analyses.
Conclusions
Differences in healthcare strategies during the second phase of the COVID-19 pandemic probably explain the differences in clinical outcomes independently of disease severity, underlying the importance of standardized early management of neurological patients with SARS-CoV-2 infection.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>35175442</pmid><doi>10.1007/s10072-022-05946-8</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-2457-8168</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Neurological sciences, 2022-05, Vol.43 (5), p.2923-2927 |
| issn | 1590-1874 1590-3478 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8852998 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Clinical outcomes Cohort Studies Coronaviruses COVID-19 Delivery of Health Care Health care Humans Medicine Medicine & Public Health Mortality Neurology Neuroradiology Neurosciences Neurosurgery Pandemics Patients Psychiatry SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 |
| title | Clinical outcome of neurological patients with COVID-19: the impact of healthcare organization improvement between waves |
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