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; Merle, Uta; Hower, Martin; Höglinger, Günter; Hellwig, Kerstin; Rieg, Siegbert; Borgmann, Stefan; Lingor, Paul; Erber, Johanna; Dolff, Sebastian; Tometten, Lukas; Klein, Christine; Jakob, Carolin E. M.; Piepel, Christiane; Haselberger, Martina; Hanses, Frank; Stecher, Melanie; Warnke, Clemens; Pinnschmidt, Hans O.; Berthele, Achim; Fink, Gereon R.; Vehreschild, Maria J. G. T.; Jensen, Björn-Erik O.; Gerloff, Christian; Rüthrich, Maria M.; Classen, Annika Y.; Gülke, Eileen; Franke, Christiana; Endres, Matthias; Degenhardt, Christian

doi:10.1111/ene.15072

Items
Marc 21

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005			20230217124531.0
024	7	_	\|a 10.1111/ene.15072 \|2 doi
024	7	_	\|a 1351-5101 \|2 ISSN
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037	_	_	\|a FZJ-2021-03869
041	_	_	\|a English
082	_	_	\|a 610
100	1	_	\|a Kleineberg, Nina N. \|0 P:(DE-Juel1)171203 \|b 0 \|e Corresponding author
245	_	_	\|a Neurological symptoms and complications in predominantly hospitalized COVID‐19 patients: Results of the European multinational Lean European Open Survey on SARS‐Infected Patients (LEOSS)
260	_	_	\|a Oxford \|c 2021 \|b Blackwell Science
264	_	1	\|3 online \|2 Crossref \|b Wiley \|c 2021-09-03
264	_	1	\|3 print \|2 Crossref \|b Wiley \|c 2021-12-01
264	_	1	\|3 print \|2 Crossref \|b Wiley \|c 2021-12-01
336	7	_	\|a article \|2 DRIVER
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336	7	_	\|a Journal Article \|b journal \|m journal \|0 PUB:(DE-HGF)16 \|s 1637935400_9026 \|2 PUB:(DE-HGF)
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520	_	_	\|a 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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700	1	_	\|a Knauss, Samuel \|0 P:(DE-HGF)0 \|b 1
700	1	_	\|a Gülke, Eileen \|0 P:(DE-HGF)0 \|b 2
700	1	_	\|a Pinnschmidt, Hans O. \|0 P:(DE-HGF)0 \|b 3
700	1	_	\|a Jakob, Carolin E. M. \|0 P:(DE-HGF)0 \|b 4
700	1	_	\|a Lingor, Paul \|0 P:(DE-HGF)0 \|b 5
700	1	_	\|a Hellwig, Kerstin \|0 P:(DE-HGF)0 \|b 6
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700	1	_	\|a Klein, Christine \|0 P:(DE-HGF)0 \|b 12
700	1	_	\|a Stecher, Melanie \|0 P:(DE-HGF)0 \|b 13
700	1	_	\|a Classen, Annika Y. \|0 P:(DE-HGF)0 \|b 14
700	1	_	\|a Rieg, Siegbert \|0 P:(DE-HGF)0 \|b 15
700	1	_	\|a Borgmann, Stefan \|0 P:(DE-HGF)0 \|b 16
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700	1	_	\|a Rüthrich, Maria M. \|0 P:(DE-HGF)0 \|b 18
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700	1	_	\|a Haselberger, Martina \|0 P:(DE-HGF)0 \|b 21
700	1	_	\|a Piepel, Christiane \|0 P:(DE-HGF)0 \|b 22
700	1	_	\|a Merle, Uta \|0 P:(DE-HGF)0 \|b 23
700	1	_	\|a Dolff, Sebastian \|0 P:(DE-HGF)0 \|b 24
700	1	_	\|a Degenhardt, Christian \|0 P:(DE-HGF)0 \|b 25
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700	1	_	\|a Vehreschild, Maria J. G. T. \|0 P:(DE-HGF)0 \|b 27
700	1	_	\|a Erber, Johanna \|0 P:(DE-HGF)0 \|b 28
700	1	_	\|a Franke, Christiana \|0 0000-0002-5609-2472 \|b 29
700	1	_	\|a Warnke, Clemens \|0 0000-0002-3510-9255 \|b 30
773	1	8	\|a 10.1111/ene.15072 \|b Wiley \|d 2021-09-03 \|n 12 \|p 3925-3937 \|3 journal-article \|2 Crossref \|t European Journal of Neurology \|v 28 \|y 2021 \|x 1351-5101
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Marc 21

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