Kleineberg, Nina N., Knauss, Samuel, Guelke, Eileen, Pinnschmidt, Hans O., Jakob, Carolin E. M., Lingor, Paul, Hellwig, Kerstin, Berthele, Achim, Hoeglinger, Guenter, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Endres, Matthias, Gerloff, Christian, Klein, Christine, Stecher, Melanie, Classen, Annika Y., Rieg, Siegbert, Borgmann, Stefan, Hanses, Frank ORCID: 0000-0002-0007-8014, Ruethrich, Maria M., Hower, Martin, Tometten, Lukas ORCID: 0000-0002-5968-8335, Haselberger, Martina, Piepel, Christiane, Merle, Uta, Dolff, Sebastian, Degenhardt, Christian, Jensen, Bjoern-Erik O., Vehreschild, Maria J. G. T., Erber, Johanna ORCID: 0000-0001-6614-6051, Franke, Christiana ORCID: 0000-0002-5609-2472 and Warnke, Clemens (2021). Neurological symptoms and complications in predominantly hospitalized COVID-19 patients: Results of the European multinational Lean European Open Survey on SARS-Infected Patients (LEOSS). Eur. J. Neurol., 28 (12). S. 3925 - 3938. HOBOKEN: WILEY. ISSN 1468-1331

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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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Kleineberg, Nina N.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knauss, SamuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guelke, EileenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pinnschmidt, Hans O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jakob, Carolin E. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lingor, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellwig, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berthele, AchimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoeglinger, GuenterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Endres, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerloff, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klein, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stecher, MelanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Classen, Annika Y.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rieg, SiegbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borgmann, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hanses, FrankUNSPECIFIEDorcid.org/0000-0002-0007-8014UNSPECIFIED
Ruethrich, Maria M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hower, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tometten, LukasUNSPECIFIEDorcid.org/0000-0002-5968-8335UNSPECIFIED
Haselberger, MartinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Piepel, ChristianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Merle, UtaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dolff, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Degenhardt, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jensen, Bjoern-Erik O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, Maria J. G. T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Erber, JohannaUNSPECIFIEDorcid.org/0000-0001-6614-6051UNSPECIFIED
Franke, ChristianaUNSPECIFIEDorcid.org/0000-0002-5609-2472UNSPECIFIED
Warnke, ClemensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-607090
DOI: 10.1111/ene.15072
Journal or Publication Title: Eur. J. Neurol.
Volume: 28
Number: 12
Page Range: S. 3925 - 3938
Date: 2021
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1468-1331
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Clinical Neurology; NeurosciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60709

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