Clinical course of SARS-CoV-2 infection in patients with severe acquired brain injury and a disorder of consciousness: an observational study

ABSTRACT

Purpose: SARS-CoV-2 infection can cause the coronavirus disease (COVID), ranging from flu-like symptoms to interstitial pneumonia. Mortality is high in COVID pneumonia and it is the highest among the frailest. COVID could be particularly serious in patients with severe acquired brain injury (SABI), such as those with a disorder of consciousness. We here describe a cohort of patients with a disorder of consciousness exposed to SARS-CoV-2 early after their SABI.

Materials and methods: The full cohort of 11 patients with SABI hospitalized in March 2020 in the IRCCS Fondazione Don Gnocchi rehabilitation (Milan, Italy) was recruited. Participants received SARS-CoV-2 testing and different clinical and laboratory data were collected.

Results: Six patients contracted SARS-CoV-2 and four of them developed the COVID. Of these, one patient had ground-glass opacities on the chest CT scan, while the remaining three developed consolidations. No patient died and the overall respiratory involvement was mild, requiring in the worst cases low-flow oxygen.

Conclusions: Here we report the clinical course of a cohort of patients with SABI exposed to SARS-CoV-2. The infection spread among patients and caused COVID in some of them. Unexpectedly, COVID was moderate, caused at most mild respiratory distress and did not result in fatalities.

KEYWORDS:

• COVID-19
• disorder of consciousness
• persistent vegetative state
• minimally conscious state
• hospitals
• rehabilitation
• neurological rehabilitation

Acknowledgments

The current work was possible thanks to the support of professor Maria Chiara Carrozza (head of the Scientific Direction of the IRCCS Fondazione Don Carlo Gnocchi – Italia), professor Mario Clerici (head of the Scientific Direction, IRCCS Fondazione Don Carlo Gnocchi – Milano), professor Anna Mazzucchi (head of the Department for the Rehabilitation of Severe Brain Injury, IRCCS Fondazione Don Carlo Gnocchi) and professor Marisa Megna (head of the Specialisation School in Physical and Rehabilitation Medicine, University of Bari). We are profoundly grateful to them.

Declaration of interest

The authors have no competing interest to declare.