TY  - JOUR
A1  - Kleineberg, Nina Natascha
A1  - Knauss, Samuel
A1  - Gülke, Eileen
A1  - Pinnschmidt, Hans O.
A1  - Jakob, Carolin Ellen Marianne
A1  - Lingor, Paul
A1  - Hellwig, Kerstin
A1  - Berthele, Achim
A1  - Höglinger, Günter
A1  - Fink, Gereon R.
A1  - Endres, Matthias
A1  - Gerloff, Christian
A1  - Klein, Christine
A1  - Stecher, Melanie
A1  - Claßen, Annika
A1  - Rieg, Siegbert
A1  - Borgmann, Stefan
A1  - Hanses, Frank
A1  - Rüthrich, Maria Madeleine
A1  - Hower, Martin
A1  - Tometten, Lukas
A1  - Haselberger, Martina Maria
A1  - Piepel, Christiane
A1  - Merle, Uta
A1  - Dolff, Sebastian Conrad Johannes
A1  - Degenhardt, Christian
A1  - Jensen, Björn-Erik Ole
A1  - Vehreschild, Maria J. G. T.
A1  - Erber, Johanna
A1  - Franke, Christiana
A1  - Warnke, Clemens
T1  - Neurological symptoms and complications in predominantly hospitalized COVID-19 patients: Results of the European multinational Lean European Open Survey on SARS-Infected Patients (LEOSS)
T2  - European journal of neurology
N2  - 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.
KW  - COVID-19
KW  - neurological manifestations
KW  - SARS-CoV-2
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63838
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-638381
SN  - 1468-1331
N1  - The German Neurological Society funded SK, NNK and EG for COVID-19 related research. No further or specific funding was received for this study.
N1  - Open Access funding enabled and organized by Projekt DEAL
VL  - 28
IS  - 12
SP  - 3925
EP  - 3937
PB  - Wiley-Blackwell
CY  - Oxford [u.a.]
ER  -