COVID-19 Outcomes in Hospitalized Patients With Neurodegenerative Disease: A Retrospective Cohort Study

Abstract: Background: COVID-19 outcomes in patients with neurodegenerative disorders are not well understood, and we hypothesize there may be increased morbidity and mortality in this group. Methods: This is a retrospective cohort study performed at three hospitals in the Chicagoland area. All patients hospitalized with COVID-19 infection with neurodegenerative disorder (ND) during a 3-month period (March 15-June 15, 2020) were included and compared with age-matched controls (CL) at 1:1 ratio. Primary outcomes were death, ICU admission and invasive ventilation. Secondary outcomes included presenting COVID-19 symptoms, development of encephalopathy, supplementary oxygen use, discharge disposition, and risk factors for mortality. Results: The study included 132 neurodegenerative patients and 132 age-matched controls. 90-day mortality (ND 19.7% vs CL 23.5%, p=0.45) and ICU admission (ND 31.5% vs CL 35.9%, p=0.43) rates were not significantly different between the two groups. ND patients had lower rate of invasive ventilation (ND 11.4% vs CL 23.2%, p=0.0075) and supplementary oxygen use (ND 83.2% vs CL 95.1%, p=0.0012). ND patients were also more likely to have “altered mental status or confusion” as their presenting COVID-19 symptom, and less likely to present with respiratory symptoms. ND patients were discharged to nursing home or hospice at higher rates compared to CL. Conclusion: We found there was no difference in short-term mortality of ND patients hospitalized for COVID-19 compared to controls, but they may have higher rates of neurologic complications and disability. Future studies should address long-term outcomes.