Marc Hardwick (United Kingdom)

University Southampton Hospital Clinical neuroscience
I graduated from medical school at the University of Oxford in 2018, where I also studied for an intercalated degree in neuroscience and gained laboratory research experience in influenza virology. After working for two years as a junior doctor, I joined Southampton as a clinical research research fellow in neurology in 2020 and over the past year have worked on principally on COVID-19 associated neurology as well as various projects on multiple sclerosis. I have published articles in immunology, neurology and psychiatry and am particularly interested in the intersection between these disciplines.

Author Of 1 Presentation

 Conference Calendar
Free Communication

SPECTRUM, RISK FACTORS AND OUTCOMES OF NEUROLOGICAL COMPLICATIONS OF COVID-19

Session Type
Free Communication
Session Name
1380 - FREE COMMUNICATION: CNS Infection & COVID-19 Neurology (ID 211)
Date
06.10.2021, Wednesday
Session Time
11:30 - 13:00
Room
Free Communication A
Lecture Time
12:30 - 12:40
Presenter
  • Marc Hardwick (United Kingdom)

Abstract

Background and Aims:

SARS-CoV2 is associated with neurological and psychiatric complications including cerebrovascular events, encephalopathy and peripheral nerve disease. Detailed clinical data is lacking, hampering prediction modelling and targeted therapeutic interventions.

Methods:

We conducted a UK-wide cross-sectional surveillance study of 267 adult hospitalised patients with SARS-CoV2 infection and neurological and psychiatric complications. Detailed demographic and clinical data was provided by reporting physicians from multiple specialities. A priori clinical case definitions were used, with cross-specialty adjudication for discrepant cases.

Results:

Cerebrovascular events were most frequent (n=131), followed by delirium (n=28), central inflammatory (n=25), psychiatric (n=25), and other encephalopathies (n=17), including a severe encephalopathy (n=13) not meeting delirium criteria; and peripheral nerve disease (n=41). COVID-19 associated strokes were younger and had more conventional risk factors compared to pre-pandemic normative data. 27% of strokes occurred in patients under 60 years old: these had delayed onset from respiratory symptoms, higher rates of multi-vessel occlusion (31%) and systemic thrombotic events. Cases with severe encephalopathy were younger and had a greater usage of intensive care compared to delirium. In a multivariable model, increasing age, pre-admission frailty and admission white cell count were more predictive of negative outcomes than diagnostic group.

Conclusions:

COVID-19-associated stroke is more likely to affect younger patients with conventional risk factors, and with a distinct phenotype suggestive of systemic coagulopathy. There is consensus recognition of severe encephalopathy atypical for delirium occuring in patients with severe COVID-19. Overall, pre-morbid factors have the greatest effect on outcome. These findings will inform mechanistic studies and patient stratification in future clinical trials.

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Presenter of 1 Presentation

 Conference Calendar
Free Communication

SPECTRUM, RISK FACTORS AND OUTCOMES OF NEUROLOGICAL COMPLICATIONS OF COVID-19

Session Type
Free Communication
Session Name
1380 - FREE COMMUNICATION: CNS Infection & COVID-19 Neurology (ID 211)
Date
06.10.2021, Wednesday
Session Time
11:30 - 13:00
Room
Free Communication A
Lecture Time
12:30 - 12:40
Presenter
  • Marc Hardwick (United Kingdom)

Abstract

Background and Aims:

SARS-CoV2 is associated with neurological and psychiatric complications including cerebrovascular events, encephalopathy and peripheral nerve disease. Detailed clinical data is lacking, hampering prediction modelling and targeted therapeutic interventions.

Methods:

We conducted a UK-wide cross-sectional surveillance study of 267 adult hospitalised patients with SARS-CoV2 infection and neurological and psychiatric complications. Detailed demographic and clinical data was provided by reporting physicians from multiple specialities. A priori clinical case definitions were used, with cross-specialty adjudication for discrepant cases.

Results:

Cerebrovascular events were most frequent (n=131), followed by delirium (n=28), central inflammatory (n=25), psychiatric (n=25), and other encephalopathies (n=17), including a severe encephalopathy (n=13) not meeting delirium criteria; and peripheral nerve disease (n=41). COVID-19 associated strokes were younger and had more conventional risk factors compared to pre-pandemic normative data. 27% of strokes occurred in patients under 60 years old: these had delayed onset from respiratory symptoms, higher rates of multi-vessel occlusion (31%) and systemic thrombotic events. Cases with severe encephalopathy were younger and had a greater usage of intensive care compared to delirium. In a multivariable model, increasing age, pre-admission frailty and admission white cell count were more predictive of negative outcomes than diagnostic group.

Conclusions:

COVID-19-associated stroke is more likely to affect younger patients with conventional risk factors, and with a distinct phenotype suggestive of systemic coagulopathy. There is consensus recognition of severe encephalopathy atypical for delirium occuring in patients with severe COVID-19. Overall, pre-morbid factors have the greatest effect on outcome. These findings will inform mechanistic studies and patient stratification in future clinical trials.

Hide