Higher risk of COVID-19 mortality among patients with preexisting neurological disease

Introduction: Neurotropism of the SARS-CoV-2 has been reported We evaluated the risk of poor outcomes associated with preexisting neurological disease (PEND) among COVID-19 patients Methods: We analyzed data from COVID-19 Outcomes Registry (CURATOR) at Houston Methodist All adult (≥ 18 years) patients tested for SARS-CoV-2 RNA in nasopharyngeal specimens were included Utilizing ICD-10 diagnoses codes, we classified PEND patients as those with documented history of ischemic or hemorrhagic stroke, transient ischemic attack, mild cognitive impairment, Alzheimer's disease and related dementias including vascular dementia, primary and metastatic brain tumors, epilepsy, motor neuron disease, amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, spinal cord injury, and traumatic brain injury Logistic regression models were fitted to assess the odds of COVID-19 mortality associated with PEND Odds ratios (OR) and 95% Confidence Intervals (CI) are reported Results: Between March 3 and August 10, 2020, 86,614 individuals were tested for SARS-CoV-2, of whom 14,233 (16 4%) tested positive, with 4,473 (31 4%) hospitalizations, and 431 (9 6%) deaths Overall 11,473 (13 2%) individuals had PEND, of whom 1,458 (12 7%) tested positive, 966 (66 3%) were hospitalized and 165 (17 1%) died Among positive cases, PEND (vs non-PEND) patients were older (67 1 vs 46 4 years) and had a higher overall comorbidity burden (median Charlson Comorbidity Index: 6 vs 1) The proportion of PEND patients was significantly higher among COVID-19 patients who died (vs those who were discharged alive) (38 3% vs 19 8%, crude OR, CI: 2 51, 2 03 - 3 09) In the fully adjusted model for socio-demographic, comorbidity and clinical factors, PEND was independently associated with higher risk of COVID-19 mortality OR (CI): 1 42 (1 04, 1 95) (graphic) Conclusions: Biological mechanisms of higher COVID-19 mortality among patients with PEND need to be evaluated