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

Autor: Kleineberg NN; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany., Knauss S; Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.; DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany., Gülke E; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Pinnschmidt HO; Institute of Medical Biometry, Epidemiology University Medical Centre Hamburg-Eppendorf, Hamburg, Germany., Jakob CEM; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.; German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany., Lingor P; Department of Neurology, Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Munich, Germany., Hellwig K; Department of Neurology, Katholisches Klinikum Bochum, Klinikum der Ruhr Universität, Bochum, Germany., Berthele A; Department of Neurology, Technical University of Munich, School of Medicine, Klinikum Rechts der Isar, Munich, Germany., Höglinger G; Department of Neurology with Clinical Neurophysiology, Hannover Medical School, Hannover, Germany.; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany., Fink GR; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany., Endres M; Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.; Center for Stroke Research Berlin, Berlin, Germany.; ExcellenceCluster NeuroCure, Berlin, Germany.; German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany.; German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany., Gerloff C; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Klein C; Institute of Neurogenetics, University of Luebeck and University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany., Stecher M; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.; German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany., Classen AY; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.; German Center for Infection Research (DZIF), Partner-Site Cologne-Bonn, Cologne, Germany., Rieg S; Division of Infectious Diseases, Department of Medicine II, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany., Borgmann S; Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany., Hanses F; Emergency Department, University Hospital Regensburg, Regensburg, Germany.; Department of Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany., Rüthrich MM; Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Jena, Germany.; Leibniz Institute for Natural Product Research and Infection Biology, Hans-Knöll Institute, Jena, Germany., Hower M; Department of Internal Medicine, Klinikum Dortmund, Dortmund, Germany., Tometten L; Department I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany., Haselberger M; Department of Internal Medicine I, Passau Hospital, Passau, Germany., Piepel C; Department of Internal Medicine I, Hospital Bremen Central, Bremen, Germany., Merle U; Department of Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany., Dolff S; Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Degenhardt C; Department of Pharmacy, Städtisches Klinikum, Karlsruhe, Germany., Jensen BO; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Düsseldorf, Germany., Vehreschild MJGT; Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany., Erber J; Department of Internal Medicine II, Technical University of Munich, School of Medicine, University Hospital Rechts der Isar, Munich, Germany., Franke C; Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany., Warnke C; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2021 Dec; Vol. 28 (12), pp. 3925-3937. Date of Electronic Publication: 2021 Sep 03.
DOI: 10.1111/ene.15072
Abstrakt: 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.
(© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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