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000901854 0247_ $$2doi$$a10.1111/ene.15072
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000901854 1001_ $$0P:(DE-Juel1)171203$$aKleineberg, Nina N.$$b0$$eCorresponding author
000901854 245__ $$aNeurological symptoms and complications in predominantly hospitalized COVID‐19 patients: Results of the European multinational Lean European Open Survey on SARS‐Infected Patients (LEOSS)
000901854 260__ $$aOxford$$bBlackwell Science$$c2021
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000901854 520__ $$aBackground 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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000901854 7001_ $$0P:(DE-HGF)0$$aPinnschmidt, Hans O.$$b3
000901854 7001_ $$0P:(DE-HGF)0$$aJakob, Carolin E. M.$$b4
000901854 7001_ $$0P:(DE-HGF)0$$aLingor, Paul$$b5
000901854 7001_ $$0P:(DE-HGF)0$$aHellwig, Kerstin$$b6
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000901854 7001_ $$0P:(DE-HGF)0$$aHöglinger, Günter$$b8
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000901854 7001_ $$0P:(DE-Juel1)178757$$aGerloff, Christian$$b11$$ufzj
000901854 7001_ $$0P:(DE-HGF)0$$aKlein, Christine$$b12
000901854 7001_ $$0P:(DE-HGF)0$$aStecher, Melanie$$b13
000901854 7001_ $$0P:(DE-HGF)0$$aClassen, Annika Y.$$b14
000901854 7001_ $$0P:(DE-HGF)0$$aRieg, Siegbert$$b15
000901854 7001_ $$0P:(DE-HGF)0$$aBorgmann, Stefan$$b16
000901854 7001_ $$0P:(DE-HGF)0$$aHanses, Frank$$b17
000901854 7001_ $$0P:(DE-HGF)0$$aRüthrich, Maria M.$$b18
000901854 7001_ $$0P:(DE-HGF)0$$aHower, Martin$$b19
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000901854 7001_ $$0P:(DE-HGF)0$$aDolff, Sebastian$$b24
000901854 7001_ $$0P:(DE-HGF)0$$aDegenhardt, Christian$$b25
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000901854 7001_ $$00000-0002-5609-2472$$aFranke, Christiana$$b29
000901854 7001_ $$00000-0002-3510-9255$$aWarnke, Clemens$$b30
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