Pre-Existing Neurological Conditions and COVID-19 Risk: A Commissioned Rapid Review

17 Pages Posted: 23 Aug 2021

See all articles by Mashina Chomba

Mashina Chomba

Cornell University - Department of Neurology

Nicoline Schiess

World Health Organization - Brain Health Unit

Katrin Seeher

World Health Organization - Brain Health Unit

Albert Akpalu

University of Ghana

Julia Baila

Columbia University Medical Center, Department of Neurology

Abhilasha P. Boruah

Case Western Reserve University - School of Medicine

Marissa Caldwell

Columbia University Medical Center, Department of Neurology

Alla Guekht

N. I. Pirogov Russian National Research Medical University (RSMU)

Fan Kee Hoo

Universiti Putra Malaysia - Neurology Unit

Samuel Knauss

Charité - Universitätsmedizin Berlin - Klinik und Hochschulambulanz für Neurologie

Emily McNeill

Columbia University Medical Center, Department of Neurology

Benedict Daniel Michael

University of Liverpool - Department of Clinical Infection, Microbiology and Immunology

Carlos A. Pardo-Villamizar

Johns Hopkins University - School of Medicine

Andrea Winkler

Technische Universität München (TUM)

Greta Wood

University of Liverpool - Department of Clinical Infection, Microbiology and Immunology

Tom Solomon

University of Liverpool - Institute of Infection, Veterinary and Ecological Sciences

Kiran T. Thakur

Department of Neurology - Columbia University Irving Medical Center

Date Written: June 18, 2021

Abstract

Background: Pre-existing diseases are considered risk factors for severe COVID-19 and death. However, there is lack of consolidated global data on this risk among individuals with pre-existing neurological disease.

Aim: Investigate the impact of pre-existing neurological disease on the clinical course and outcome of COVID-19.

Methods: A rapid review of literature from PubMed and the World Health Organization (WHO) COVID-19 database was conducted for articles published between 1st January 2020 and 4th April 2021. The review included individuals with COVID-19 and pre-existing neurological disease using pre-generated search terms to capture chronic neurological diseases in all age-groups. Articles included in the review were systematic reviews and meta-analysis, cohort studies, retrospective studies, case-control studies and case series. From the included studies, demographic data and Odds Ratios (OR) were extracted, and pooled ORs were generated for the outcomes of COVID-19 severity and death.

Results: Twenty-six articles from 12 countries across three continents with a total of 379,947 COVID-19 patients was included. The mean age was 57 years (SD 10.93), 51.3% of whom were female. Pre-existing neurological disease, particularly cerebrovascular disease and dementia, was shown to be a risk factor for severe COVID-19 with a pooled OR of 1.99 (1.81 – 2.18). There was also an increased risk of death with a pooled OR for pre-existing neurological disease overall of 1.74 (1.56 – 1.94).

Conclusion: The findings suggest that pre-existing neurological disease is a significant risk factor for severe COVID-19 and mortality. Further investigations to consolidate these findings are required through large multi-national cohort studies.

Note: Funding: None.

Declaration of Interests: MC received honorarium for the search and screening of articles for this rapid review from the World Health Organization; honorarium for an article written for Medline not related to this work and grants from the Multiple Sclerosis International Federation (MSIF) and the National Institutes for Health (NIH) not related to this work. CAP declares grants from the NIH for research not related to this work. TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections (NIHR200907) at the University of Liverpool (Liverpool, UK). KTT declares funding from NIH for research not related to this work. All other authors have no conflicts of interest to declare that are relevant to the contents of this article.

Keywords: COVID-19, SARS-CoV-2, neurology, comorbidities

Suggested Citation

Chomba, Mashina and Schiess, Nicoline and Seeher, Katrin and Akpalu, Albert and Baila, Julia and Boruah, Abhilasha P. and Caldwell, Marissa and Guekht, Alla and Hoo, Fan Kee and Knauss, Samuel and McNeill, Emily and Michael, Benedict Daniel and A. Pardo-Villamizar, Carlos and Winkler, Andrea and Wood, Greta and Solomon, Tom and Thakur, Kiran T., Pre-Existing Neurological Conditions and COVID-19 Risk: A Commissioned Rapid Review (June 18, 2021). Available at SSRN: https://ssrn.com/abstract=3907265 or http://dx.doi.org/10.2139/ssrn.3907265

Mashina Chomba (Contact Author)

Cornell University - Department of Neurology ( email )

New York, NY
United States
+260977275037 (Phone)

Nicoline Schiess

World Health Organization - Brain Health Unit

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

Katrin Seeher

World Health Organization - Brain Health Unit

20 Avenue Appia
Geneva 27, CH-1211
Switzerland

Albert Akpalu

University of Ghana

PO Box 25
Legon, Accra LG
Ghana

Julia Baila

Columbia University Medical Center, Department of Neurology

College of Physicians and Surgeons
630 West 168th Street, 3rd Floor, Suite 3-470
New York, NY 10032-3784
United States

Abhilasha P. Boruah

Case Western Reserve University - School of Medicine

2511 Overlook Road
Cleveland Heights, OH 44106
United States

Marissa Caldwell

Columbia University Medical Center, Department of Neurology

College of Physicians and Surgeons
630 West 168th Street, 3rd Floor, Suite 3-470
New York, NY 10032-3784
United States

Alla Guekht

N. I. Pirogov Russian National Research Medical University (RSMU)

Ostrovityanova Street
Moscow, 117997
Russia

Fan Kee Hoo

Universiti Putra Malaysia - Neurology Unit

Seri Kembangan, Selangor 43400
Malaysia

Samuel Knauss

Charité - Universitätsmedizin Berlin - Klinik und Hochschulambulanz für Neurologie

Berlin
Germany

Emily McNeill

Columbia University Medical Center, Department of Neurology

College of Physicians and Surgeons
630 West 168th Street, 3rd Floor, Suite 3-470
New York, NY 10032-3784
United States

Benedict Daniel Michael

University of Liverpool - Department of Clinical Infection, Microbiology and Immunology

Chatham Street
Brownlow Hill
Liverpool, L69 7ZA
United Kingdom

Carlos A. Pardo-Villamizar

Johns Hopkins University - School of Medicine ( email )

733 North Broadway
Suite G-49
Baltimore, MD 21205-2196
United States

Andrea Winkler

Technische Universität München (TUM) ( email )

Arcisstrasse 21
Munich, DE 80333
Germany

Greta Wood

University of Liverpool - Department of Clinical Infection, Microbiology and Immunology

Chatham Street
Brownlow Hill
Liverpool, L69 7ZA
United Kingdom

Tom Solomon

University of Liverpool - Institute of Infection, Veterinary and Ecological Sciences ( email )

Kiran T. Thakur

Department of Neurology - Columbia University Irving Medical Center ( email )

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