Comparison of disease profiles and outcomes of patients with neurological disorders without and with COVID-19: An ambispective cohort study

We aimed at comparing the clinical and laboratory characteristics, along with survival and functional outcome in the form of modified Rankin scale at 3 ± 1 month follow-up, between the COVID-19 negative and positive patients, with a neurological illness. Ambispective cohort study - included patients presenting with a neurological disorder, tested positive for COVID-19, and admitted to the hospital’s COVID-19 centre, from April to September 2020. Demographic, clinical, biochemical and treatment profiles of these patients were compared with COVID-19 negative patients admitted to the neurology wards. Information about three months outcome after discharge was assessed telephonically. Data on survival and disability status in the form of mRS were collected. Of a total of 235 patients enrolled from emergency services with neurological disorders, 81 (34.5%) were COVID-19 positive. Mean (SD) age was 49.5 (17.3) years and majority of the patients were male (62.98%). Commonest neurological diagnosis was Acute Ischemic Stroke (AIS) (42.98%). Chronic kidney disease (CKD) patients were more likely to be COVID-19 positive (COVID-19 negative: 4 (2.6%) versus COVID-19 positive: 11 (13.8%), p-value: 0.001). The in-hospital mortality was higher among COVID-19 positive patients (COVID-19 negative: 12 (7.8%) versus COVID-19 positive: 29 (35.8%), p value: <0.001). There were 15 (13.8%) deaths at three months follow up in the COVID-19 negative versus 4 (12.1%) in COVID-19 positive patients (p-value: 1.00). Overall three-month mRS was higher in the COVID-19 positive group assessed via Cochran-Mantel-Haenszel test (p-value < 0.001). Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital mortality and three months disability.