September 28, 2020

Neurological Complications of COVID-19 Are Focus of New NIH Grant Supplement to Cleveland Clinic Researchers

Work will pair predictive modeling and genomic expertise with COVID-19 registry and biobank

20-NEU-1966092_COVID-19 neurologic manifestations_650x450

Many months after its emergence as a global pandemic, COVID-19 is still serving up more questions than answers. Yet like their counterparts around the globe, Cleveland Clinic researchers are continuing to pursue answers, and they’re doing so on multiple fronts. They’ve established a registry of patients tested for COVID-19 (currently at 32,786 enrollees, including 13,171 COVID-19-positive patients), created a biobank of specimens from infected individuals and published over 350 papers on COVID-19 to date, according to Lara Jehi, MD, MHCDS, Chief Research Information Officer for Cleveland Clinic and Director of the Outcomes Research Program in the Epilepsy Center.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Recently, Dr. Jehi expanded efforts on another front by applying for a COVID-19 supplement to a $3.4 million, five-year grant from the National Institutes of Health (NIH) that she and colleagues had received to create a nomogram (risk calculator) to predict seizure outcomes after resective epilepsy surgery. The supplemental grant of $308,000 was awarded for a one-year study to expand the focus to neurological complications of COVID-19 infection.

Leveraging existing infrastructure to study COVID-19

“Neurological complications that occur as a result of SARS-CoV-2 infection were not front and center until a few months into the pandemic,” Dr. Jehi observes. “Since we have experience in predictive modeling and genomic changes, I believed we could pair that expertise with the COVID-19 registry and biobank resources we have developed over the past six months to advance understanding of these neurological complications.”

She viewed the earlier epilepsy outcomes grant from NIH as a good fit for this effort because funding was also awarded to the Mayo Clinic and the University of Campinas in Brazil, giving the research team the ability to study neurological complications of COVID-19 in two of the largest hospital systems in the United States plus one in Latin America.


Focus of the grant supplement

Specifically, the focus of the urgent revision of the grant is to:

  • Characterize the incidence of new-onset seizures, stroke and delirium in all patients diagnosed as COVID-19-positive across the Cleveland Clinic health system
  • Create prediction models that allow for individual risk estimation for neurological complications during disease progression
  • Identify molecular determinants of the underlying mechanisms for these neurological manifestations

The study will have two arms. One will be retrospective, to identify neurological complications observed from the registry data, and one will be prospective, with phone or digital follow-up of patients for six months after infection diagnosis.

COVID-19 nomogram publications

Previous research indicates that older age, smoking, diabetes, hypertension, cardiovascular disease, kidney disease, chronic lung disease and cancer correlate with progression to severe disease in patients hospitalized with COVID-19. “We hypothesize that these factors are similarly associated with a higher risk of neurological complications,” explains Dr. Jehi. “However, because these risk factors are not specific, occur in various combinations and have limited value as isolated indicators of specific neurological complications, there is a need for tools to guide decisions in clinical care and use of resources.”


Dr. Jehi and her Cleveland Clinic colleagues are uniquely qualified to create these tools, given that the nomogram concept originated with Michael Kattan, PhD, Chair of the Department of Quantitative Health Sciences in Cleveland Clinic Lerner Research Institute. Drs. Jehi and Kattan were principal authors of a paper published in Chest in June 2020 that described the first COVID-19 nomogram for use by healthcare providers to predict an individual patient’s likelihood of testing positive for COVID-19, along with outcomes such as disease severity and need for hospitalization. This risk prediction model, which has been deployed as a freely available online risk calculator to prioritize patients for testing, was developed using data from almost 12,000 patients enrolled in the Cleveland Clinic COVID-19 registry. Another paper by the group, published in PLOS One in August 2020, reported on a second nomogram that was developed and validated to help physicians predict which COVID-positive patients at greatest risk for hospitalization.

“Our goal is to create a suite of tools that clinicians can use to deliver personalized care and allocate resources for patients with COVID-19,” Dr. Jehi says.

Related Articles

Stellate Ganglion Block
May 17, 2023
Nerve Block Shows Promise for Long COVID-Related Olfactory or Gustatory Dysfunction

Patients report improved sense of smell and taste

Covid image
April 26, 2023
What Long COVID Means for Rheumatologists (Video)

Clinicians who are accustomed to uncertainty can do well by patients

Covid related skin effects
April 4, 2023
Cutaneous Manifestations of COVID-19 in Special Populations

Unique skin changes can occur after infection or vaccine

February 10, 2023
Effects of COVID-19 on Blood Sugar and Type 2 Diabetes

Cleveland Clinic analysis suggests that obtaining care for the virus might reveal a previously undiagnosed condition

January 13, 2023
Optimal Management of High Risk Immunocompromised Patients in the COVID-19 Era

As the pandemic evolves, rheumatologists must continue to be mindful of most vulnerable patients

covid-19 virus
January 12, 2023
Real World Experience with Tixagevimab/Cilgavimab in B-Cell-Depleted Patients

Early results suggest positive outcomes from COVID-19 PrEP treatment

Eosinophilic Fasciitis
November 29, 2022
New Onset Eosinophilic Fasciitis after COVID-19 Infection

Could the virus have caused the condition or triggered previously undiagnosed disease?

COVID-19 and rash
June 16, 2022
Common Skin Signs of COVID-19 in Adults: An Update

Five categories of cutaneous abnormalities are associated with COVID-19