Investigate the prognosis of COVID-19 infection associated with cranial nerve manifestations.

Using the Cerner COVID-19 de-identified dataset, we identified patients with COVID-19 infection and cranial neuropathies using ICD-10-CM. We compared outcomes of COVID-19 patients associated with cranial neuropathies (COVID-19C) to: COVID-19 patients without cranial neuropathies (COVID-19NC), non-COVID-19 patients associated with cranial neuropathies (non-COVID-19C), and non-COVID-19 patients without cranial neuropathies (non-COVID-19NC).

Among a total of 117,496 patients, 25,261 were diagnosed with COVID-19. There was a higher incidence of cranial neuropathies in COVID-19 compared to non-COVID-19 patients (1.5% vs. 0.7%). The average length of hospitalization in days (LoS) and mortality rate were significantly lower in COVID-19C compared to COVID-19NC, respectively 4.0, 4.6% vs. 5.4, 8.6% (p<0.05). In non-COVID-19 patients, LoS was significantly higher in non-COVID-19C compared to non-COVID-19NC, respectively 3.0 vs. 2.46 (p<0.05). The mortality rate, however, was significantly higher in non-COVID-19NC compared to non-COVID-19C, respectively 3.5% vs. 2.1% (p<0.05). Discharge rate to skilled nursing facilities (SNF) and to a hospice were significantly lower in COVID-19C compared to COVID-19NC, respectively 5.9%, 1.8% vs. 1.1%, 0.2% (p<0.05).

Our study demonstrated an increased incidence of cranial neuropathies in COVID-19 patients and was associated with better prognosis; the LoS, mortality, and discharge to SNF and hospice were all significantly lower in COVID-19C compared to COVID-19NC. Work is in progress to assess whether the occurrence of cranial neuropathy is an independent marker of good prognosis of COVID-19 infection or whether the prognosis is more dependent on other demographic factors, preexisting comorbid conditions, and complications after the infection.