Prevention of Neurological Complications During COVID-19: Protocol for a Retrospective Analysis of the ISARIC4C National Cohort
20 Pages Posted: 24 Feb 2022
Date Written: February 17, 2022
Neurological complications such as stroke and encephalopathies affect 4% of adults with acute COVID-19 infection, causing significant morbidity with long term health and economic consequences. Dexamethasone reduces the 28-day mortality in hospitalised patients requiring supplemental oxygen, while remdesivir has antiviral action against SARS-CoV-2 and reduces the severity of COVID-19 in these patients. We hypothesise that adding either remdesivir, dexamethasone or both to standard of care in patients hospitalised with COVID-19 may reduce the incidence of COVID-19-associated neurological complications. This retrospective analysis of the ISARIC4C cohort will analyse data from patients aged 18 years and older admitted to hospital with COVID-19 between 31 Jan 2020 and 29 Jun 2021. The incidence of neurological complications following COVID-19 in patients receiving standard of care and either remdesivir, dexamethasone or both will be compared against the standard of care using propensity scoring methodology. The effect of neurological complications on markers of disease severity, as well as clinical outcome, will be assessed using multivariable linear and logistic regression.
Funding: Gilead, the manufacturer of remdesivir has provided funding to IG to support this analysis.
Declaration of Interests: None of the authors have any conflicts of interest to declare in relation to this study.
Ethics Approval Statement: Only patients who provided biological samples were required to provide informed, written consent. All other patients had routinely collected clinical data collated for which written consent was not required under UK health research regulations. ISARIC WHO CCP-UK received ethical approval from the South Central—Oxford C Research Ethics Committee in England (13/SC/0149) and by the Scotland A Research Ethics Committee in Scotland (20/SS/0028).
Keywords: COVID-19, neurological complications, dexamethasone, remdesivir
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