Comparative features and outcomes of major neurological complications of COVID‐19

Background and purpose The aim of this study was to assess the neurological complications of SARS‐CoV‐2 infection and compare phenotypes and outcomes in infected patients with and without selected neurological manifestations. Methods The data source was a registry established by the European Academy...

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Published in:European journal of neurology 2023-02, Vol.30 (2), p.413-433
Main Authors: Beghi, Ettore, Moro, Elena, Davidescu, Eugenia Irene, Popescu, Bogdan Ovidiu, Grosu, Oxana, Valzania, Franco, Cotelli, Maria Sofia, Kiteva‐Trenchevska, Gordana, Zakharova, Maria, Kovács, Tibor, Armon, Carmel, Brola, Waldemar, Yasuda, Clarissa Lin, Maia, Luís F., Lovrencic‐Huzjan, Arijana, Seabra, Mafalda Maria Laracho, Avalos‐Pavon, Rafael, Aamodt, Anne Hege, Meoni, Sara, Gryb, Victoria, Ozturk, Serefnur, Karadas, Omer, Krehan, Ingomar, Leone, Maurizio A., Lolich, Maria, Bianchi, Elisa, Rass, Verena, Helbok, Raimund, Bassetti, Claudio L. A., Ivan, Paula Andreea, Sandu, Georgiana, Odajiu, Irina, Dragoș Sandu, Constantin, Vitalie, Lisnic, Mikhail, Gavriliuc, Olesea, Odainic, Cavallieri, Francesco, Toschi, Giulia, Zedde, Marialuisa, Turla, Marinella, Bianchi, Marta, Civelli, Patrizia, Cvetkovska, Emilija, Barbov, Ivan, Babunovska, Marija, Kozlova, Alexandra, Abramova, Anna, Daria, Eliseeva, Dobronyi, Levente, Dénes, Kitti, Bereczki, Dániel, Agajany, Netta, Geva, Matan, Kindl, Philipp, Kosno, Krystian, Michał, Lipowski, Silva, Lucas Scardua, Batista João, Rafael, Jung, Simon, Müller, Madlaine, Aires, Elaine, Vinski, Ivana, Lisak, Marijana, Marjiana, Lesiv, Ural, Onur, Kara, Iskender, Öztürk, Bilgin, Caldeiras, Ana Catarina Oliveira, Rodriguez‐Leyva, Ildefonso, Boldingh, Marion, Oertzen, Tim, Jenkins, Thomas M, Riahi, Anis, Taba, Pille, Azzam, Ahmed Y., Wojtecki, Lars, Sellner, Johan, Castillo, Sergio, Bušková, Jitka, Novotny, Vojtech, Jelcic, Ilijas, Dafea, Ahmed, Medina, Marco T., Flemen, Heidi Øyen, Elbahnasawy, Mohamed Gamal, Kohler, Edith, Farmen, Annette Huuse
Format: Article
Language:English
Subjects:
Ataxia
Cognitive ability
Comorbidity
Complications
coronavirus
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
Data collection
Demographics
Dysautonomia
Emergency medical services
Female
Humans
Infections
Infectious Diseases
Movement disorders
Nervous System Diseases - diagnosis
Nervous System Diseases - epidemiology
Nervous System Diseases - etiology
Neurological complications
Neurology
Original
Pandemics
Peripheral neuropathy
Phenotypes
Prospective Studies
Retrospective Studies
Risk analysis
Risk factors
SARS-CoV-2
Seizures
Seizures - complications
Severe acute respiratory syndrome coronavirus 2
Sleep and wakefulness
Viral diseases
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Summary:Background and purpose The aim of this study was to assess the neurological complications of SARS‐CoV‐2 infection and compare phenotypes and outcomes in infected patients with and without selected neurological manifestations. Methods The data source was a registry established by the European Academy of Neurology during the first wave of the COVID‐19 pandemic. Neurologists collected data on patients with COVID‐19 seen as in‐ and outpatients and in emergency rooms in 23 European and seven non‐European countries. Prospective and retrospective data included patient demographics, lifestyle habits, comorbidities, main COVID‐19 complications, hospital and intensive care unit admissions, diagnostic tests, and outcome. Acute/subacute selected neurological manifestations in patients with COVID‐19 were analysed, comparing individuals with and without each condition for several risk factors. Results By July 31, 2021, 1523 patients (758 men, 756 women, and nine intersex/unknown, aged 16–101 years) were registered. Neurological manifestations were diagnosed in 1213 infected patients (79.6%). At study entry, 978 patients (64.2%) had one or more chronic general or neurological comorbidities. Predominant acute/subacute neurological manifestations were cognitive dysfunction (N = 449, 29.5%), stroke (N = 392, 25.7%), sleep–wake disturbances (N = 250, 16.4%), dysautonomia (N = 224, 14.7%), peripheral neuropathy (N = 145, 9.5%), movement disorders (N = 142, 9.3%), ataxia (N = 134, 8.8%), and seizures (N = 126, 8.3%). These manifestations tended to differ with regard to age, general and neurological comorbidities, infection severity and non‐neurological manifestations, extent of association with other acute/subacute neurological manifestations, and outcome. Conclusions Patients with COVID‐19 and neurological manifestations present with distinct phenotypes. Differences in age, general and neurological comorbidities, and infection severity characterize the various neurological manifestations of COVID‐19.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.15617