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COVID-19 impact on consecutive neurological patients admitted to the emergency department
  1. Andrea Pilotto1,2,
  2. Alberto Benussi1,
  3. Ilenia Libri1,
  4. Stefano Masciocchi1,
  5. Loris Poli1,
  6. Enrico Premi3,
  7. Antonella Alberici1,
  8. Enrico Baldelli1,
  9. Sonia Bonacina1,
  10. Laura Brambilla4,
  11. Matteo Benini5,
  12. Salvatore Caratozzolo1,
  13. Matteo Cortinovis1,
  14. Angelo Costa3,
  15. Stefano Cotti Piccinelli1,
  16. Elisabetta Cottini1,
  17. Viviana Cristillo1,
  18. Ilenia Delrio3,
  19. Massimiliano Filosto1,
  20. Massimo Gamba3,
  21. Stefano Gazzina6,
  22. Nicola Gilberti3,
  23. Stefano Gipponi1,
  24. Marcello Giunta1,
  25. Alberto Imarisio1,
  26. Paolo Liberini1,
  27. Martina Locatelli1,
  28. Francesca Schiano1,
  29. Ranata Rao1,
  30. Barbara Risi1,
  31. Luca Rozzini1,
  32. Andrea Scalvini1,
  33. Veronica Vergani3,
  34. Irene Volonghi1,
  35. Nicola Zoppi1,
  36. Barbara Borroni1,
  37. Mauro Magoni3,
  38. Matilde Leonardi7,
  39. Gianluigi Zanusso8,
  40. Sergio Ferrari8,
  41. Sara Mariotto8,
  42. Alessandro Pezzini1,
  43. Roberto Gasparotti9,
  44. Ciro Paolillo10,
  45. Alessandro Padovani1
  1. 1 Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
  2. 2 Parkinson's Disease Rehabilitation Centre, FERB Onlus, Trescore Balneario, Lombardia, Italy
  3. 3 Stroke Unit, ASST Spedali Civili di Brescia, Brescia, Italy
  4. 4 Department of Neuroimmunology and Neuromuscular Diseases, Foundation IRCCS Carlo Besta Neurological Institute, Milano, Italy
  5. 5 Neurology Unit, University of Bologna, Bologna, Italy
  6. 6 Neurophysiology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
  7. 7 Neurology, Public Health and Disability Unit, Foundation IRCCS Carlo Besta Neurological Institute, Milano, Italy
  8. 8 Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
  9. 9 Section of Neuroradiology, Department of Medical and Surgical Specialties, University of Brescia, Brescia, Italy
  10. 10 Emergency Department, ASST Spedali Civili di Brescia, Brescia, Italy
  1. Correspondence to Professor Alessandro Padovani, Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy; alessandro.padovani{at}unibs.it

https://doi.org/10.1136/jnnp-2020-323929

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    Introduction

    The outbreak of SARS-CoV-2 hit Italy by the end of February and rapidly spread from Lombardy to the rest of the country, with a number of fatalities beyond 31 000. Although all regions have reported having patients with COVID-19, the highest number of identified cases was in the provinces of eastern Lombardy.1 Several case reports and small series also suggested an association between COVID-19 and cerebrovascular events, and immune or inflammatory-mediated peripheral and central nervous system (CNS) involvement.2 3

    To date, however, no comprehensive large surveys on the impact of COVID-19 on neurological status of patients presenting at the emergency room have been published. In fact, still little is known on which are the most common acute neurological presentations in COVID-19 and whether they differ compared with patients without COVID-19 in terms of severity and outcomes.

    The urgent drift to cope with the rapidly overwhelming number of simultaneously critical patients drew the conversion of the majority of neurological units into non-specialistic wards for broader and generic COVID-19 patient care. The converted units became spokes referring neurological patients to tertiary hub centres for specialty care. This led to the definition in tertiary centres of dedicated medical and nurse teams working in special neuro-COVID units in order to guarantee equal access to acute therapies.

    The aim of this study was to investigate the impact of COVID-19 by recording clinical presentations, laboratory characteristics and management/outcomes of a series of …

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