COVID-19 outcomes of 10,881 patients: retrospective study of neurological symptoms and associated manifestations (Philippine CORONA Study)
Authors: Espiritu Adrian I. , Sy Marie Charmaine C. , Anlacan Veeda Michelle M. , Jamora Roland Dominic G. ,   the Philippine CORONA Study Group Investigators, Macalintal Corina Maria Socorro A. , Robles Joanne B. , Cataniag Paulo L. , Flores Manolo Kristoffer C. , Tangcuangco-Trinidad Noreen Jhoanna C. , Juangco Dan Neftalie A. , Paas Giuliani Renz G. , Chua Audrey Marie U. , Estrada Valmarie S. , Mejia Philip Rico P. , Reyes Therese Franz B. , Cañete Maria Teresa A. , Zapata Ferdinand Renfred A. , Castillo Franko Eugenio B. , Esagunde Romulo U. , Gantioque Jean B. , Abbariao Maritoni C. , Acebuque Geramie M. , Corral Evram V. , Escasura Marian Irene C. , Ong Marissa T. , Fowler Krizelle Cleo , Pineda Arnold Angelo M. , Aradani Khasmeen D. , Catindig Joseree-Ann S. , Cinco Mark Timothy T. , Ramos Mark Erving H. , Cruz Romulus Emmanuel H. , Dantes Marita B. , Francisco Norberto A. , Teleg Rosalia A. , Bellosillo Krisverlyn B. , Delfino Jean Paolo M. , Diesta Cid Czarina E. , Espiritu-Picar Rosalina B. , Gamboa Julie Anne V. , Matute Cara Camille M. , Padilla Franzelle P. , Punsalan John Joshua Q. , Collantes Ma. Epifania V. , Que Charmaine B. , Sampao Hanifa A. , Maria Maxine Camela S. Sta. , Fuentes Marita M. , Manzano Jennifer Justice F. , Umali Rizza J. , Molina Marc Conrad C. , Minerva-Ang Hazel Claire , Surdilla Arturo F. , Talabucon Loreto P. , Wabe Natasha F. , Manuel Maria Victoria G. , Pajantoy Al Inde John A. , Roque Josephine Cecilia V. , Yambao Paul Emmanuel L. , Banday Christian Paul B. , Cipriano Chritopher C. , Pangandaman Nehar A. , Wasil Avery Gail C. , Inocian Elrey P. , Vatanagul Jarungchai Anton S. , Apor Almira Doreen Abigail O. , Dioquino Carissa Paz C. , Cruz Prinz Andrew M. Dela , Yumul Maricar P. , Carandang-Concepcion Ma. Alma E. , Desquitado Ma. Caridad V. , Julao Carl Kevin L. , Bornales Dante P. , Maylem Generaldo D. , Cuntapay Mark Joseph F. , Lao-Reyes Annabelle Y. , Lee Aileen Mae B. , Manlegro Nadia O. , Pelere Dave Mar L. , Laxamana Lina C. , Que Diana-Lynn S. , Yu Jeryl Ritzi T. , Martinez Ma. Socorro C. , Matic Alexandria E. , Perez John Angelo Luigi S. , Constantino Glenn Anthony A. , Olano Aldanica R. , Quiles Liz Edenberg P. , Roxas Artemio A. , Soliven Jo Ann R. , Montojo-Tamayo Michael Dorothy Frances , Joson Ma. Lourdes C. , Evangelista Jojo R. , Nuñez Ma. Clarissa B. , Olaivar Marietta C. , Perez Dominique Q. , Armeña Mark Deneb O. , Barja Robert A. , Abejero Joshua Emmanuel E. , Eribal Maritzie R. , Alava Ryndell G. , Kalbi Muktader A. , Radja Nasheera W. , Sali Mohammad Elshad S. 
Published: August 2021

Our study aimed to determine the effects of new-onset neurological symptoms (NNS) on clinically relevant outcomes in hospitalized patients with COVID-19 infection. We conducted a nationwide, comparative, retrospective, cohort study among adult, hospitalized COVID-19 patients involving 37 hospital sites from various regions in the Philippines. We included a total of 10,881 patients with confirmed COVID-19 infection (2008 had NNS while 8873 did not have NNS). The adjusted hazard ratios (aHRs) for mortality among the mild and severe cases were significantly higher by 1.660 (95% CI 1.132–2.435) and by 1.352 (95% CI 1.042–1.752), respectively, in the NNS group compared to those in the non-NNS group. The aHRs for respiratory failure in the NNS group were significantly increased by 1.914 (95% CI 1.346–2.722), by 1.614 (95% CI 1.260–2.068), and by 1.234 (95% CI 1.089–1.398) among the mild, severe, and critical cases, respectively. The aHRs for ICU admission in the NNS group were still significantly higher by 1.973 (95% CI 1.457–2.673) and by 1.831 (95% CI 1.506–2.226) among the mild and severe cases, respectively. Patients who had NNS were not significantly associated with a longer duration of ventilator dependence (adjusted odds ratio (aOR) 0.954, 95% CI 0.772–1.179), longer ICU stay (aOR 0.983, 95% CI 0.772–1.252) and longer hospital admission (aOR 1.045, 95% CI 0.947–1.153). The presence of NNS significantly increases the risk of mortality, respiratory failure and ICU admission among COVID-19 patients. Registration and associated protocol publication: ClinicalTrials.gov website (NCT04386083); Espiritu AI, Sy MCC, Anlacan VMM, Jamora RDG. The Philippine COVID-19 Outcomes: a Retrospective study Of Neurological manifestations and Associated symptoms (The Philippine CORONA study): a protocol study. BMJ Open. 2020;10:e040944.