Journal Article

FZJ-2021-03869

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png 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, N. N. (Corresponding author)FZJ* ; Knauss, S. ; Gülke, E. ; Pinnschmidt, H. O. ; Jakob, C. E. M. ; Lingor, P. ; Hellwig, K. ; Berthele, A. ; Höglinger, G. ; Fink, G. R.FZJ* ; Endres, M. ; Gerloff, C.FZJ* ; Klein, C. ; Stecher, M. ; Classen, A. Y. ; Rieg, S. ; Borgmann, S. ; Hanses, F. ; Rüthrich, M. M. ; Hower, M. ; Tometten, L. ; Haselberger, M. ; Piepel, C. ; Merle, U. ; Dolff, S. ; Degenhardt, C. ; Jensen, B. O. ; Vehreschild, M. J. G. T. ; Erber, J. ; Franke, C. ; Warnke, C.

2021
Blackwell Science Oxford

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Please use a persistent id in citations: http://hdl.handle.net/2128/29184  doi:10.1111/ene.15072

Abstract: Background and purposeDuring 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.MethodsWe 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.ResultsA 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.ConclusionOur 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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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)
2. Jara-Institut Quantum Information (INM-11)

Research Program(s):

1. 5251 - Multilevel Brain Organization and Variability (POF4-525) (POF4-525)

Appears in the scientific report 2021

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Database coverage:
; ; ; BIOSIS Previews ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; IF < 5 ; JCR ; NCBI Molecular Biology Database ; SCOPUS ; Science Citation Index Expanded ; Thomson Reuters Master Journal List ; Web of Science Core Collection

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