Neurological symptoms and complications in predominantly hospitalized COVID-19 patients: Results of the European multinational Lean European Open Survey on SARS-Infected Patients (LEOSS)

  • 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.

Export metadata

Additional Services

Share in Twitter Search Google Scholar
Author:Nina Natascha KleinebergORCiDGND, Samuel Knauss, Eileen GülkeORCiDGND, Hans O. Pinnschmidt, Carolin Ellen Marianne JakobORCiDGND, Paul Lingor, Kerstin Hellwig, Achim BertheleORCiDGND, Günter Höglinger, Gereon R. FinkORCiDGND, Matthias Endres, Christian Gerloff, Christine Klein, Melanie StecherORCiDGND, Annika Claßen, Siegbert RiegORCiDGND, Stefan BorgmannGND, Frank HansesORCiDGND, Maria Madeleine RüthrichGND, Martin HowerORCiDGND, Lukas TomettenORCiDGND, Martina Maria HaselbergerGND, Christiane Piepel, Uta MerleORCiDGND, Sebastian Conrad Johannes DolffORCiDGND, Christian Degenhardt, Björn-Erik Ole Jensen, Maria J. G. T. VehreschildORCiDGND, Johanna ErberORCiDGND, Christiana FrankeORCiD, Clemens WarnkeORCiDGND
Parent Title (English):European journal of neurology
Place of publication:Oxford [u.a.]
Document Type:Article
Date of Publication (online):2021/08/19
Date of first Publication:2021/08/19
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Contributing Corporation:LEOSS Study Group
Release Date:2022/04/19
Tag:COVID-19; SARS-CoV-2; neurological manifestations
Page Number:13
First Page:3925
Last Page:3937
The German Neurological Society funded SK, NNK and EG for COVID-19 related research. No further or specific funding was received for this study.
Open Access funding enabled and organized by Projekt DEAL
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0