Prolonged Unconsciousness is Common in COVID‐19 and Associated with Hypoxemia

• DOI: 10.1002/ana.26342
• Publication Date: 2022-03-07T14:21:36Z
• Authors: Greer Waldrop; Seyed A. Safavynia; Megan E. Barra; Sachin Agarwal; David A. Berlin; Amelia K Boehme; Daniel Brodie; Jacky M. Choi; Kevin Doyle; Joseph J. Fins; Wolfgang Ganglberger; Katherine Hoffman; Aaron M. Mittel; David Roh; Shibani S. Mukerji; Caroline Der Nigo...; Soojin Park; Edward J. Schenck; John Salazar‐Schi...; Qi Shen; Evan Sholle; Angela G. Velazquez; Maria C. Walline; M. Brandon Westover; Emery N. Brown; Jonathan Victor; Brian L. Edlow; Nicholas D. Schiff; Jan Claassen
• Keywords: Unconsciousness

Objective The purpose of this study was to estimate the time recovery command‐following and associations between hypoxemia with command‐following. Methods In multicenter, retrospective, cohort during initial surge United Statesʼ pandemic (March–July 2020) we from intubation command‐following, using Kaplan Meier cumulative‐incidence curves Cox proportional hazard models. Patients were included if they admitted 1 3 hospitals because severe coronavirus disease 2019 (COVID‐19), required endotracheal for at least 7 days, experienced impairment consciousness (Glasgow Coma Scale motor score <6). Results Five hundred seventy‐one patients 795 recovered median 30 days (95% confidence interval [CI] = 27–32 days). Median increased by 16 one episode an arterial partial pressure oxygen (PaO 2 ) value ≤55 mmHg ( p < 0.001), 25% ≥10 after cessation mechanical ventilation. associated ratio [HR] 0.56, 95% CI 0.46–0.68; PaO ≤70 HR 0.88, 0.85–0.91), each additional day decreased likelihood recovery, accounting confounders including sedation. These findings confirmed among without any imagining evidence structural brain injury (n 199), in a non‐overlapping second (N 427, October 2020 April 2021). Interpretation Survivors COVID‐19 commonly recover weeks Long periods are more hypoxemia. This relationship is not explained sedation or identified on clinical imaging should inform decisions about life‐sustaining therapies. ANN NEUROL 2022;91:740–755