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Table 2 Patient characteristics at the time of COVID-19 onset and COVID-19 acute encephalopathy

From: Obstructive sleep apnea: a major risk factor for COVID-19 encephalopathy?

variables

Total (n = 97)

High risk of OSA (n = 79, 81.4%)

no OSA (n = 18, 18.6%)

p-value

General examination and parameter at COVID-19 onset

 dyspnea

54 (55.7%)

42 (53.2%)

12 (66.7%)

0.4311

 cough

60 (63.2%)

50 (64.9%)

10 (55.6%)

0.5881

 fever

80 (82.5%)

67 (84.8%)

13 (72.2%)

0.2991

 FiO2

32.31 (± 17.30)

33.35 (± 18.31)

27.84 (± 11.38)

0.1132

Percentage of lung parenchyma with COVID-19 lesions (pulmonary CT scan)

0.5832

 0–30%

13 (20.0%)

11 (20.4%)

2 (18.2%)

 

 30–50%

22 (33.8%)

19 (35.2%)

3 (27.3%)

 

 50–70%

17 (26.2%)

14 (25.9%)

3 (27.3%)

 

  > 70%

13 (20.0%)

10 (18.5%)

3 (27.3%)

 

Neurological signs at COVID-19 acute encephalopathy

 fluctuation

87 (89.7%)

73 (92.4%)

14 (77.8%)

0.0851

 inattention

86 (88.7%)

74 (93.7%)

12 (66.7%)

0.0051

 thought disturbance

68 (74.7%)

61 (82.4%)

7 (41.2%)

0.0011

 alertness trouble

48 (48.5%)

44 (54.4%)

4 (22.2%)

0.0261

 drowsiness

51 (52.6%)

42 (53.2%)

9 (50.0%)

0.9991

 agitation

33 (34.0%)

29 (36.7%)

4 (22.2%)

0.2831

 psychomotor slowdown

63 (65.6%)

55 (70.5%)

8 (44.4%)

0.0531

 obnubilation

32 (34.4%)

28 (36.8%)

4 (23.5%)

0.4011

 perseveration

53 (58.2%)

47 (64.4%)

6 (33.3%)

0.0311

 disorientation

48 (54.5%)

43 (60.6%)

5 (29.4%)

0.0301

 hallucination

17 (19.3%)

14 (19.4%)

3 (18.8%)

0.9991

 focal neurological sign

27 (27.8%)

23 (29.1%)

4 (22.2%)

0.7721

COVID-19 acute encephalopathy features

 CAM

2.97 (± 1.05)

3.18 (± 0.89)

2.06 (± 1.21)

0.0013

 RASS ≤ -3

8 (8.2%)

7 (8.9%)

1 (5.6%)

0.1681

 mutism

14 (14.4%)

12 (15.2%)

2 (11.1%)

0.9991

 severe encephalopathya

72 (74.2%)

67 (84.8%)

5 (27.8%)

 < 0.0011

 duration of encephalopathy (days)

25.8 (± 59.3)

27.9 (± 65.5)

16.9 (± 12.4)

0.0183

Biological results in the blood

 C-reactive protein (mg/l)

89.85 (39.2–163.4)

89.6 (41.9—163.6)

90.1 (9.7—159.3)

0,5042

 leucocytes (/mm3)

9.88 (7.3–12.2)

9.84 (7.2—12)

11.35 (8.5—14.2)

0,2152

 lymphocytes (/mm3)

0.82 (0.5–1.1)

0.79 (0.5—1)

0.97 (0.7—1.2)

0,2302

 segmented neutrophils (/mm3)

7.47 (5.5–10.4)

7.35 (5.1—10)

9.09 (6.4—11.7)

0,2722

 monocytes (/mm3)

0.53 (0.3–0.8)

0.52 (0.3—0.8)

0.58 (0.4—0.7)

0,9982

 thrombocytes (/mm3)

298 (232–354.5)

307 (241—356.8)

264 (167—319)

0,3452

Brain MRI

missing valuesb

35

27

8

 

 leucoencephalopathy

   

0.0501

  0

23 (31.5%)

17 (28.3%)

6 (46.2%)

 

  1

32 (43.8%)

30 (50.0%)

2 (15.4%)

 

  2

7 (9.6%)

6 (10.0%)

1 (7.7%)

 

  3

11 (15.1%)

7 (11.7%)

4 (30.8%)

 

 stroke (DWI lesion)

34 (47.2%)

26 (44.1%)

8 (61.5%)

0.3591

 hyperT2 lesion (number)

7.12 (± 6.22%)

7.3 (± 6.2)

6.31 (± 6.54)

0.6233

 microbleed (number)

3.03 (± 7.43%)

2.9 (± 7.75)

3.62 (± 5.92)

0.7143

 number of vessels with endotheliitisc

   

 < 0.0011

  0

9 (14.5%)

1 (1.9%)

8 (80.0%)

 

  1

18 (29.0%)

16 (30.8%)

2 (20.0%)

 

  2

16 (25.8%)

16 (30.8%)

0

 

  3

19 (30.6%)

19 (36.5%)

0

 

 circumferential endotheliitisc

48 (77.4%)

48 (92.3%)

0

 < 0.0011

 endotheliitisc

   

 < 0.0011

  unilateral

26 (41.9%)

24 (46.2%)

2 (20.0%)

 

  bilateral

27 (43.5%)

27 (51.9%)

0

 

 stenosis

3 (4.1%)

3 (5.0%)

0

 

EEG slowing

47 (53.4%)

40 (55.6%)

7 (43.8%)

0.4201

Epidemiological features

 intensive care unit

62 (63.9%)

50 (63.3%)

12 (66.7%)

0.9993

 hospitalization time

43.5 [25.0–61.5]

43.5 [25.0–61.0]

42.5 [28.0–66.0]

0.7962

 mRS at discharge

   

0.0081

  0

9 (9.3%)

8 (10.1%)

1 (5.6%)

 

  1

23 (23.7%)

13 (16.5%)

10 (55.6%)

 

  2

16 (16.5%)

12 (15.2%)

4 (22.2%)

 

  3

22 (22.7%)

21 (26.6%)

1 (5.6%)

 

  4

14 (14.4%)

13 (16.5%)

1 (5.6%)

 

  5

1 (1.0%)

1 (1.3%)

0 (0.0%)

 

  6 (death)

12 (12.4%)

11 (13.9%)

1 (5.6%)

 

 mRS at discharge ≥ 3

49 (50.5%)

46 (58.2%)

3 (16.7%)

0.0021

  1. This table presents patient characteristics at the time of COVID-19 onset (general examination data and COVID-19 pulmonary imaging status) and at COVID-19 acute encephalopathy paroxysm (neurological signs, encephalopathy features, epidemiological features, biological data from blood and CSF, brain MRI data and EEG results)
  2. Abbreviations: CAM Confusion Assessment Method, COVID-19 AE COVID-19 acute encephalopathy, DWI Diffusion-weighted imaging, OSA Obstructive sleep apnea, mRS modified Rankin Scale, RASS Richmond Agitation Sedation Scale
  3. 1Fisher's exact test. Table results were given in number of patients (percentage of total number of patients per group)
  4. 2Mann-Whitney u test. Table results were given in median (± interquartile ratio)
  5. 3t-test. Table results were given in median (± interquartile ratio)
  6. asevere encephalopathy was defined on a RASS <  − 3 at worst presentation ─ meaning deep sedation, no response to voice but possible movement or eye, opening to physical stimulation; or on a CAM score ≥ 3 among patients with a RASS ≥ -3 ─ meaning displaying 3 out of 4 items among symptoms fluctuation, inattention, thought disturbance, and altered alertness
  7. bMissing value. Brain MRI were missing in many patients because of the inability to perform these tests due to patient compliance at the acute phase of COVID-19 encephalopathy
  8. cThe term “endotheliitis” referred to homogeneous gadolinium contrast enhancement of the inner part of the vessel wall (injected brain MRI) without stenosis. Circumferential endotheliitis referred to contrast enhancement of the vessel wall greater than 50% of the circumference