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, di...

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Published in:European journal of neurology 2021-12, Vol.28 (12), p.3925-3937
Main Authors: Kleineberg, Nina N., Knauss, Samuel, Gülke, Eileen, Pinnschmidt, Hans O., Jakob, Carolin E. M., Lingor, Paul, Hellwig, Kerstin, Berthele, Achim, Höglinger, Günter, Fink, Gereon R., Endres, Matthias, Gerloff, Christian, Klein, Christine, Stecher, Melanie, Classen, Annika Y., Rieg, Siegbert, Borgmann, Stefan, Hanses, Frank, Rüthrich, Maria M., Hower, Martin, Tometten, Lukas, Haselberger, Martina, Piepel, Christiane, Merle, Uta, Dolff, Sebastian, Degenhardt, Christian, Jensen, Björn‐Erik O., Vehreschild, Maria J. G. T., Erber, Johanna, Franke, Christiana, Warnke, Clemens
Format: Article
Language:English
Subjects:
All Neurologists
Anticoagulants
Complications
Confidence intervals
Coronaviruses
COVID-19
Disease
Extracorporeal membrane oxygenation
Hospitalization
Infections
Ischemia
Mental disorders
Nausea
Neurodegenerative diseases
Neurological complications
Neurological diseases
neurological manifestations
Olfaction
Original
Oxygenation
Patients
Polls & surveys
SARS‐CoV‐2
Severe acute respiratory syndrome
Signs and symptoms
Smell
Statistical analysis
Therapeutic applications
Vascular diseases
Viral diseases
Vomiting
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Summary: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. We retrospectively analyzed data from 6537 predominantly hospitalized COVID‐19 patients registered in the European multinational Lean European Open Survey on SARS‐Infected Patients (LEOSS) registry between January 2020 and February 2021. Common neurological symptoms were 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%). Most frequent neurological complications were ischemic stro
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.15072