%0 Journal Article
%A Fragiel, Marcos
%A Miró, Òscar
%A Llorens, Pere
%A Jiménez, Sònia
%A Piñera Salmerón, Pascual
%A Burillo-Putze, Guillermo
%A Martín, Alfonso
%A Martín-Sánchez, Francisco Javier
%A García Lamberechts, Eric Jorge
%A Jacob, Javier
%A Alquézar-Arbé, Aitor
%A Llopis-Roca, Ferran
%A Pedraza García, Jorge
%A Calvo López, Ricardo
%A Maza Vera, María Teresa
%A Lucas-Imbernón, Francisco Javier
%A González Martinez, Félix
%A Juárez, Ricardo
%A Expósito Rodriguez, Marcos
%A Martinez Bautista, Beatriz Maria
%A Niembro Valdés, Ana Patricia
%A Sanchez Nicolas, Jose Andres
%A Ferreras Amez, José María
%A Porta-Etessam, Jesús
%A Calvo, Elpidio
%A González Del Castillo, Juan
%A Spanish Investigators on Emergency Situations TeAm (SIESTA) network
%T Incidence, clinical characteristics, risk factors and outcomes of meningoencephalitis in patients with COVID-19.
%D 2021
%U http://hdl.handle.net/10668/17331
%X We investigated the incidence, clinical characteristics, risk factors, and outcome of meningoencephalitis (ME) in patients with COVID-19 attending emergency departments (ED), before hospitalization. We retrospectively reviewed all COVID patients diagnosed with ME in 61 Spanish EDs (20% of Spanish EDs, COVID-ME) during the COVID pandemic. We formed two control groups: non-COVID patients with ME (non-COVID-ME) and COVID patients without ME (COVID-non-ME). Unadjusted comparisons between cases and controls were performed regarding 57 baseline and clinical characteristics and 4 outcomes. Cerebrospinal fluid (CSF) biochemical and serologic findings of COVID-ME and non-COVID-ME were also investigated. We identified 29 ME in 71,904 patients with COVID-19 attending EDs (0.40‰, 95%CI=0.27-0.58). This incidence was higher than that observed in non-COVID patients (150/1,358,134, 0.11‰, 95%CI=0.09-0.13; OR=3.65, 95%CI=2.45-5.44). With respect to non-COVID-ME, COVID-ME more frequently had dyspnea and chest X-ray abnormalities, and neck stiffness was less frequent (OR=0.3, 95%CI=0.1-0.9). In 69.0% of COVID-ME, CSF cells were predominantly lymphocytes, and SARS-CoV-2 antigen was detected by RT-PCR in 1 patient. The clinical characteristics associated with a higher risk of presenting ME in COVID patients were vomiting (OR=3.7, 95%CI=1.4-10.2), headache (OR=24.7, 95%CI=10.2-60.1), and altered mental status (OR=12.9, 95%CI=6.6-25.0). COVID-ME patients had a higher in-hospital mortality than non-COVID-ME patients (OR=2.26; 95%CI=1.04-4.48), and a higher need for hospitalization (OR=8.02; 95%CI=1.19-66.7) and intensive care admission (OR=5.89; 95%CI=3.12-11.14) than COVID-non-ME patients. ME is an unusual form of COVID presentation (
%K COVID-19
%K Clinical characteristics
%K Incidence
%K Meningoencephalitis
%K Outcome
%K Risk factors
%K SARS-Cov-2
%~