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Neurological symptoms and complications in predominantly hospitalized COVID-19 patients: Results of the European multinational Lean European Open Survey on SARS-Infected Patients (LEOSS).
Kleineberg, Nina N; Knauss, Samuel; Gülke, Eileen; Pinnschmidt, Hans O; Jakob, Carolin E M; Lingor, Paul; Hellwig, Kerstin; Berthele, Achim; Höglinger, Günter; Fink, Gereon R; Endres, Matthias; Gerloff, Christian; Klein, Christine; Stecher, Melanie; Classen, Annika Y; Rieg, Siegbert; Borgmann, Stefan; Hanses, Frank; Rüthrich, Maria M; Hower, Martin; Tometten, Lukas; Haselberger, Martina; Piepel, Christiane; Merle, Uta; Dolff, Sebastian; Degenhardt, Christian; Jensen, Björn-Erik O; Vehreschild, Maria J G T; Erber, Johanna; Franke, Christiana; Warnke, Clemens.
  • Kleineberg NN; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
  • Knauss S; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany.
  • Gülke E; Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
  • Pinnschmidt HO; DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.
  • Jakob CEM; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Lingor P; Institute of Medical Biometry, Epidemiology University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
  • Hellwig K; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
  • Berthele A; German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany.
  • Höglinger G; Department of Neurology, Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Munich, Germany.
  • Fink GR; Department of Neurology, Katholisches Klinikum Bochum, Klinikum der Ruhr Universität, Bochum, Germany.
  • Endres M; Department of Neurology, Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Munich, Germany.
  • Gerloff C; Department of Neurology with Clinical Neurophysiology, Hannover Medical School, Hannover, Germany.
  • Klein C; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
  • Stecher M; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
  • Classen AY; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany.
  • Rieg S; Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
  • Borgmann S; Center for Stroke Research Berlin, Berlin, Germany.
  • Hanses F; ExcellenceCluster NeuroCure, Berlin, Germany.
  • Rüthrich MM; German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany.
  • Hower M; German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.
  • Tometten L; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Haselberger M; Institute of Neurogenetics, University of Luebeck and University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
  • Piepel C; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
  • Merle U; German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany.
  • Dolff S; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
  • Degenhardt C; German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany.
  • Jensen BO; Division of Infectious Diseases, Department of Medicine II, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Vehreschild MJGT; Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany.
  • Erber J; Emergency Department, University Hospital Regensburg, Regensburg, Germany.
  • Franke C; Department of Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany.
  • Warnke C; Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Jena, Germany.
Eur J Neurol ; 28(12): 3925-3937, 2021 12.
Article in English | MEDLINE | ID: covidwho-1515204
ABSTRACT
BACKGROUND AND

PURPOSE:

During acute coronavirus disease 2019 (COVID-19) infection, neurological signs, symptoms and complications occur. We aimed to assess their clinical relevance by evaluating real-world data from a multinational registry.

METHODS:

We analyzed COVID-19 patients from 127 centers, diagnosed between January 2020 and February 2021, and registered in the European multinational LEOSS (Lean European Open Survey on SARS-Infected Patients) registry. The effects of prior neurological diseases and the effect of neurological symptoms on outcome were studied using multivariate logistic regression.

RESULTS:

A total of 6537 COVID-19 patients (97.7% PCR-confirmed) were analyzed, of whom 92.1% were hospitalized and 14.7% died. Commonly, excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%) were reported. In patients with a complicated or critical disease course (53%) the most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (ICB; 2.2%). ICB peaked in the critical disease phase (5%) and was associated with the administration of anticoagulation and extracorporeal membrane oxygenation (ECMO). Excessive tiredness (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.20-1.68) and prior neurodegenerative diseases (OR 1.32, 95% CI 1.07-1.63) were associated with an increased risk of an unfavorable outcome. Prior cerebrovascular and neuroimmunological diseases were not associated with an unfavorable short-term outcome of COVID-19.

CONCLUSION:

Our data on mostly hospitalized COVID-19 patients show that excessive tiredness or prior neurodegenerative disease at first presentation increase the risk of an unfavorable short-term outcome. ICB in critical COVID-19 was associated with therapeutic interventions, such as anticoagulation and ECMO, and thus may be an indirect complication of a life-threatening systemic viral infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurodegenerative Diseases / Stroke / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: Ene.15072

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurodegenerative Diseases / Stroke / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: Ene.15072