Dataset Information

Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series.

ABSTRACT: OBJECTIVES:To describe the risk factors for and outcomes after myoclonus in a cohort of patients with coronavirus disease 2019. DESIGN:Multicenter case series. SETTING:Three tertiary care hospitals in Massachusetts, Georgia, and Virginia. PATIENTS:Eight patients with clinical myoclonus in the setting of coronavirus disease 2019. INTERVENTIONS & MEASUREMENTS AND MAIN RESULTS:Outcomes in patients with myoclonus were variable, with one patient who died during the study period and five who were successfully extubated cognitively intact and without focal neurologic deficits. In five cases, the myoclonus completely resolved within 2 days of onset, while in three cases, it persisted for 10 days or longer. Seven patients experienced significant metabolic derangements, hypoxemia, or exposure to sedating medications that may have contributed to the development of myoclonus. One patient presented with encephalopathy and developed prolonged myoclonus in the absence of clear systemic provoking factors. CONCLUSIONS:Our findings suggest that myoclonus may be observed in severe acute respiratory syndrome coronavirus 2 infected patients, even in the absence of hypoxia. This association warrants further evaluation in larger cohorts to determine whether the presence of myoclonus may aid in the assessment of disease severity, neurologic involvement, or prognostication.

SUBMITTER: Anand P

PROVIDER: S-EPMC7448712 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series.

Anand Pria P Zakaria Asma A Benameur Karima K Ong Charlene C Putman Maryann M O'Shea Sarah S Greer David D Cervantes-Arslanian Anna M AM

Critical care medicine 20201101 11

<h4>Objectives</h4>To describe the risk factors for and outcomes after myoclonus in a cohort of patients with coronavirus disease 2019.<h4>Design</h4>Multicenter case series.<h4>Setting</h4>Three tertiary care hospitals in Massachusetts, Georgia, and Virginia.<h4>Patients</h4>Eight patients with clinical myoclonus in the setting of coronavirus disease 2019.<h4>Interventions & measurements and main results</h4>Outcomes in patients with myoclonus were variable, with one patient who died during the ...[more]

PMID: 32804787

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Project description:To determine if early CNS symptoms are associated with severe coronavirus disease 2019.DesignA retrospective, observational case series study design.SettingElectronic health records were reviewed for patients from five healthcare systems across the state of Florida, United States.PatientsA clinical sample (n = 36,615) of patients with confirmed diagnosis of coronavirus disease 2019 were included. Twelve percent (n = 4,417) of the sample developed severe coronavirus disease 2019, defined as requiring critical care, mechanical ventilation, or diagnosis of acute respiratory distress syndrome, sepsis, or severe inflammatory response syndrome.InterventionsNone.Measurement and main resultsWe reviewed the electronic health record for diagnosis of early CNS symptoms (encephalopathy, headache, ageusia, anosmia, dizziness, acute cerebrovascular disease) between 14 days before the diagnosis of coronavirus disease 2019 and 8 days after the diagnosis of coronavirus disease 2019, or before the date of severe coronavirus disease 2019 diagnosis, whichever came first. Hierarchal logistic regression models were used to examine the odds of developing severe coronavirus disease 2019 based on diagnosis of early CNS symptoms. Severe coronavirus disease 2019 patients were significantly more likely to have early CNS symptoms (32.8%) compared with nonsevere patients (6.11%; χ2[1] = 3,266.08, p < 0.0001, φ = 0.29). After adjusting for demographic variables and pertinent comorbidities, early CNS symptoms were significantly associated with severe coronavirus disease 2019 (odds ratio = 3.21). Diagnosis of encephalopathy (odds ratio = 14.38) was associated with greater odds of severe coronavirus disease 2019; whereas diagnosis of anosmia (odds ratio = 0.45), ageusia (odds ratio = 0.46), and headache (odds ratio = 0.63) were associated with reduced odds of severe coronavirus disease 2019.ConclusionsEarly CNS symptoms, and specifically encephalopathy, are differentially associated with risk of severe coronavirus disease 2019 and may serve as an early marker for differences in clinical disease course. Therapies for early coronavirus disease 2019 are scarce, and further identification of subgroups at risk may help to advance understanding of the severity trajectories and enable focused treatment.

Dataset Information

Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series.

Publications

Myoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series.

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