Conclusions
We report a low but not insignificant prevalence of neurological complications that can be anticipated in hospitalized patients with COVID-19. This study adds to the body of evidence that adults and children have different neurological manifestations and in-hospital complications after acute COVID-19 infection. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age. The results of this study can assist in healthcare planning given the long-term impact of these complications.
Acknowledgements
This work was made possible by the UK Foreign, Commonwealth and Development Office; Wellcome [215091/Z/18/Z] [205228/Z/16/Z] [220757/Z/20/Z]; Bill & Melinda Gates Foundation [OPP1209135]; the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund; CIHR Coronavirus Rapid Research Funding Opportunity OV2170359 and the coordination in Canada by Sunnybrook Research Institute; endorsement of the Irish Critical Care Clinical Trials Group, coordination in Ireland by the Irish Critical Care Clinical Trials Network at University College Dublin and funding by the Health Research Board of Ireland [CTN-2014-12]; the Rapid European COVID-19 Emergency Response research (RECOVER) [H2020 project 101003589] and European Clinical Research Alliance on Infectious Diseases (ECRAID) [965313]; the COVID clinical management team, AIIMS, Rishikesh, India; Cambridge NIHR Biomedical Research Centre; the dedication and hard work of the Groote Schuur Hospital Covid ICU Team; support by the Groote Schuur nursing and University of Cape Town registrar bodies coordinated by the Division of Critical Care at the University of Cape Town; the Liverpool School of Tropical Medicine and the University of Oxford; the dedication and hard work of the Norwegian SARS-CoV-2 study team; the Research Council of Norway Grant No. 312780 and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner; the UK's National Institute for Health Research (NIHR) via Imperial's Biomedical Research Centre (NIHR Imperial BRC), Imperial's Health Protection Research Unit in Respiratory Infections (NIHR HPRU RI), the Comprehensive Local Research Networks (CLRNs) of which P.J.M.O. is an NIHR Senior Investigator (NIHR201385); Innovative Medicines Initiative Joint Undertaking under Grant Agreement No. 115523 COMBACTE, resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007–2013) and EFPIA companies, in-kind contribution; preparedness work conducted by the Short Period Incidence Study of Severe Acute Respiratory Infection; Stiftungsfonds zur Förderung der Bekämpfung der Tuberkulose und anderer Lungenkrankheiten of the City of Vienna, Project Number: APCOV22BGM; Italian Ministry of Health 'Fondi Ricerca corrente–L1P6' to IRCCS Ospedale Sacro Cuore–Don Calabria; Australian Department of Health grant (3273191); Gender Equity Strategic Fund at University of Queensland, Artificial Intelligence for Pandemics (A14PAN) at University of Queensland, the Australian Research Council Centre of Excellence for Engineered Quantum Systems (EQUS, CE170100009), the Prince Charles Hospital Foundation, Australia; grants from Instituto de Salud Carlos III, Ministerio de Ciencia, Spain; Brazil, National Council for Scientific and Technological Development Scholarship number 303953/2018-7; the Firland Foundation, Shoreline, Washington, USA; a grant from foundation Bevordering Onderzoek Franciscus; the French COVID cohort (NCT04262921) is sponsored by INSERM and is funding by the REACTing (REsearch & ACtion emergING infectious diseases) consortium and by a grant of the French Ministry of Health (PHRC n°20-0424); and the South Eastern Norway Health Authority and the Research Council of Norway.
This work uses data/material provided by patients and collected by the NHS as part of their care and support #DataSavesLives. The data/material used for this research were obtained from ISARIC4C. The COVID-19 Clinical Information Network (CO-CIN) data were collated by ISARIC4C Investigators. Data and material provision was supported by grants from: the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059) and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE; award 200907), NIHR HPRU in Respiratory Infections at Imperial College London with PHE (award 200927), Liverpool Experimental Cancer Medicine Centre (grant C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (award IS-BRC-1215-20013) and NIHR Clinical Research Network providing infrastructure support.
Funding
ISARIC4C is funded by National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059) and by the NIHR in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE; award 200907), NIHR HPRU at Imperial College London with PHE (award 200927), Liverpool Experimental Cancer Medicine Centre (grant C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (award IS-BRC-1215-20013) and NIHR Clinical Research Network providing infrastructure support. ISARIC Global (B.W.C and L.M.) is funded by the UK Foreign, Commonwealth and Development Office and Wellcome [215091/Z/18/Z and 225288/Z/22/Z] and the Bill & Melinda Gates Foundation [OPP1209135]. S.M.C. is funded by NHLBI 1K23HL157610. N.W. was funded by an Advance Queensland Industry Research Fellowship (AQIRF076-2020-CV).
Brain. 2023;146(4):1648-1661. © 2023 Oxford University Press