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, 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, M...     »

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.      «

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 d...     »