The wide spectrum of COVID-19 neuropsychiatric complications within a multidisciplinary centre
Cécile Delorme, Marion Houot, Charlotte Rosso, Stéphanie Carvalho, Thomas Nédelec, Redwan Maatoug, Victor Pitron, Salimata Gassama, Sara Sambin, Stéphanie Bombois, Bastien Herlin, Gaëlle Ouvrard, Gaëlle Bruneteau, Adèle Hesters, Ana Gales, Bruno Millet, Foudil Lamari, Stéphane Lehéricy, Vincent Navarro, Benjamin Rohaut, Sophie Demeret, Thierry Maisonobe, Marion Yger, Bertrand Degos, Louise‐Laure Mariani, Christophe Bouché, Nathalie Dzierzynski, Bruno Oquendo, Flora Ketz, An-Hung Nguyen, Aurélie Kas, Catherine Lubetzki, Jean‐Yves Delattre, Jean‐Christophe Corvol, CoCo-Neurosciences Study Group, Cécile Delorme, Jean‐Christophe Corvol, Jean‐Yves Delattre, Stéphanie Carvalho, Sandrine Sagnes, Bruno Dubois, Vincent Navarro, Céline Louapre, Tanya Stojkovic, Ahmed Idbaih, Charlotte Rosso, David Grabli, Ana Gales, Bruno Millet, Benjamin Rohaut, É. Bayen, S. Dupont, Gaëlle Bruneteau, Stéphane Lehéricy, Danielle Seilhean, Alexandra Dürr, Foudil Lamari, Vanessa Batista Brochard, Catherine Lubetzki, P. Pradat-Diehl, Khê Hoang‐Xuan, Bertrand Fontaine, Lionel Naccache, Philippe Fossati, Isabelle Arnulf, Alexandre Carpentier, Yves Edel, G. Robain, Philippe Thoumie, Bertrand Degos, Tarek Sharshar, Sonia Alamowitch, Emmanuelle Apartis-Bourdieu, Charles-Siegried Peretti, Rénata Ursu, Nathalie Dzierzynski, Kiyoka Kinugawa Bourron, Joel Belmin, Bruno Oquendo, Éric Pautas, Marc Verny, Yves Samson, Sara Leder, Anne Leger, Sandrine Deltour, Flore Baronnet, Stéphanie Bombois, Mehdi Touat, Marc Sanson, Caroline Dehais, Caroline Houillier, Florence Laigle–Donadey, Dimitri Psimaras, Agusti Alenton, Nadia Younan, Nicolas Villain, Maria del Mar Amador, Louise‐Laure Mariani, Nicolas Mezouar, Graziella Mangone
Abstract
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.