In patients with COVID-19, AMS on presentation to the ED is most frequently caused by metabolic encephalopathy (delirium). Age, pre-existing dementia and cerebrovascular disease, and impaired renal function were independent predictors of AMS. Of the 7 patients with indeterminant causes, only 1 was suspicious for encephalitis (0.6%). Neurological causes of AMS occurred in a total 20 patients (12%) and as the sole factor in 5 (3.0%) 10 (6.0%) cases were seizure related and 10 (6.0%) were cerebrovascular events. Hypoxia 103 (62.0%) and renal failure 75 (45.2%) were the most common underlying mechanisms. Metabolic encephalopathy was diagnosed as the cause in 154 (92.8%), with 118 (71.1%) categorized as multifactorial ME and 36 (21.7%) with single-cause ME. Overall, 166 patients presented to the ED with AMS. Multivariable analysis was used to assess independent predictors. Underlying causes of AMS on arrival to the emergency department (ED) were categorized as (1) neurological causes (stroke, seizure, encephalitis) (2) metabolic encephalopathy (3) indeterminant. We conducted a retrospective observational study of patients presenting with AMS to three New York hospitals, from March 1 to April 16, 2020. We aimed to identify the common causes of AMS in patients with COVID-19 presenting to the emergency department with AMS on arrival. The principal causes of AMS have yet to be determined. (f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.Altered mental status (AMS) is a common neurological manifestation of COVID-19 infection in hospitalized patients.(e) cases in which a more precise diagnosis was not available for any other reason.(d) cases referred elsewhere for investigation or treatment before the diagnosis was made.(c) provisional diagnosis in a patient who failed to return for further investigation or care.
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