{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:46:14Z","timestamp":1793090774549,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Covid\u201019 can involve multiple organs including the nervous system. We sought to characterize the neurologic manifestations, their risk factors, and associated outcomes in hospitalized patients with Covid\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined neurologic manifestations in 509 consecutive patients admitted with confirmed Covid\u201019 within a hospital network in Chicago, Illinois. We compared the severity of Covid\u201019 and outcomes in patients with and without neurologic manifestations. We also identified independent predictors of any neurologic manifestations, encephalopathy, and functional outcome using binary logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Neurologic manifestations were present at Covid\u201019 onset in 215 (42.2%), at hospitalization in 319 (62.7%), and at any time during the disease course in 419 patients (82.3%). The most frequent neurologic manifestations were myalgias (44.8%), headaches (37.7%), encephalopathy (31.8%), dizziness (29.7%), dysgeusia (15.9%), and anosmia (11.4%). Strokes, movement disorders, motor and sensory deficits, ataxia, and seizures were uncommon (0.2 to 1.4% of patients each). Severe respiratory disease requiring mechanical ventilation occurred in 134 patients (26.3%). Independent risk factors for developing any neurologic manifestation were severe Covid\u201019 (OR 4.02; 95% CI 2.04\u20138.89; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and younger age (OR 0.982; 95% CI 0.968\u20130.996; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.014). Of all patients, 362 (71.1%) had a favorable functional outcome at discharge (modified Rankin Scale 0\u20132). However, encephalopathy was independently associated with worse functional outcome (OR 0.22; 95% CI 0.11\u20130.42; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and higher mortality within 30\u00a0days of hospitalization (35 [21.7%] vs. 11 [3.2%] patients; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Neurologic manifestations occur in most hospitalized Covid\u201019 patients. Encephalopathy was associated with increased morbidity and mortality, independent of respiratory disease severity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51210","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T10:42:12Z","timestamp":1601894532000},"page":"2221-2230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":422,"title":["Frequent neurologic manifestations and encephalopathy\u2010associated morbidity in Covid\u201019 patients"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3182-585X","authenticated-orcid":false,"given":"Eric M.","family":"Liotta","sequence":"first","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4783-5801","authenticated-orcid":false,"given":"Ayush","family":"Batra","sequence":"additional","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Clark","sequence":"additional","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan A.","family":"Shlobin","sequence":"additional","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary S.","family":"Orban","sequence":"additional","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-1468","authenticated-orcid":false,"given":"Igor J.","family":"Koralnik","sequence":"additional","affiliation":[{"name":"Ken &amp; Ruth Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"WHO Coronavirus Disease (COVID\u201019) Dashboard. Geneva: World Health Organization; 2020 [7\/28\/2020]; Available from:https:\/\/covid19.who.int\/."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001017"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13365-020-00840-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30221-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25807"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09896-z"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009455"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa240"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30287-X"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.12603"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.183"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301372"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-12-941"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201307-1256OC"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009937"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa203"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4031"},{"key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"781","DOI":"10.3389\/fneur.2020.00781","article-title":"Neurological comorbidity is a predictor of death in Covid\u201019 disease: a cohort study on 576 patients","volume":"11","author":"Garc\u00eda\u2010Azor\u00edn D","year":"2020","journal-title":"Front Neurolo"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1001\/jama.2010.1013","article-title":"Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta\u2010analysis","volume":"28","author":"Witlox J","year":"2010","journal-title":"JAMA"},{"key":"e_1_2_7_23_1","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1056\/NEJMra1208705","article-title":"Sedation and delirium in the intensive care unit","volume":"30","author":"Reade MC","year":"2014","journal-title":"N Engl J Med"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-006-0092-4"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1643-z"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.3596"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2018.01.027"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2020.110055"}],"container-title":["Annals of Clinical and Translational Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.51210","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acn3.51210","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.51210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T05:10:09Z","timestamp":1693717809000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/acn3.51210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,5]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1002\/acn3.51210"],"URL":"https:\/\/doi.org\/10.1002\/acn3.51210","archive":["Portico"],"relation":{},"ISSN":["2328-9503","2328-9503"],"issn-type":[{"value":"2328-9503","type":"print"},{"value":"2328-9503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,5]]},"assertion":[{"value":"2020-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}