The wide spectrum of COVID-19 neuropsychiatric complications within a multidisciplinary centre
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Abstract
A variety of neuropsychiatric complications has been described in association with COVID-19 infection. Large scale studies presenting a wider picture of these complications and their relative frequency are lacking. The objective of our study was to describe the spectrum of neurological and psychiatric complications in patients with COVID-19 seen in a multidisciplinary hospital centre over 6 months. We conducted a retrospective, observational study of all patients showing neurological or psychiatric symptoms in the context of COVID-19 seen in the medical and university neuroscience department of Assistance Publique Hopitaux de Paris—Sorbonne University. We collected demographic data, comorbidities, symptoms and severity of COVID-19 infection, neurological and psychiatric symptoms, neurological and psychiatric examination data and, when available, results from CSF analysis, MRI, EEG and EMG. A total of 249 COVID-19 patients with a de novo neurological or psychiatric manifestation were included in the database and 245 were included in the final analyses. One-hundred fourteen patients (47%) were admitted to the intensive care unit and 10 (4%) died. The most frequent neuropsychiatric complications diagnosed were encephalopathy (43%), critical illness polyneuropathy and myopathy (26%), isolated psychiatric disturbance (18%) and cerebrovascular disorders (16%). No patients showed CSF evidence of SARS-CoV-2. Encephalopathy was associated with older age and higher risk of death. Critical illness neuromyopathy was associated with an extended stay in the intensive care unit. The majority of these neuropsychiatric complications could be imputed to critical illness, intensive care and systemic inflammation, which contrasts with the paucity of more direct SARS-CoV-2-related complications or post-infection disorders.
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SciScore for 10.1101/2020.10.21.20216747: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study received the approval of the Sorbonne University Ethics Committee (N°2020 CER-202028). Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources URL https://www.R-project.org/.) and using python 3.8 with the scikit learn 0.23.2 package for decision trees and correlation matrices 22. pythonsuggested: (IPython, RRID:SCR_001658)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the …SciScore for 10.1101/2020.10.21.20216747: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study received the approval of the Sorbonne University Ethics Committee (N°2020 CER-202028). Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources URL https://www.R-project.org/.) and using python 3.8 with the scikit learn 0.23.2 package for decision trees and correlation matrices 22. pythonsuggested: (IPython, RRID:SCR_001658)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has several limitations. Although the study is retrospective, it was implemented early at the onset of the Covid-19 pandemic and data could be collected prospectively by the investigators as they examined new patients. We may have an over representation of complications due to critical illness and critical care as there was a large number of Covid-19-dedicated ICU beds in our institution. We cannot exclude reporting bias and lack of exhaustivity, but the involvement of all physicians of the Department implicated in every step of patient care (ICU, acute hospitalization departments, rehabilitation departments, imaging departments, neurophysiology) limits this bias, especially for the most severe forms of neuropsychiatric manifestations. In stroke patients, one limitation of the study is that we could not determine for all patients the etiology of ischemic strokes and in case of a negative outcome, whether Covid-19 was the trigger.
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04362930 Recruiting Cohort of Patients With Covid-19 Presenting Neurological or … Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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