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

被引：24

作者：

Kleineberg, Nina N. ^{[1
,2
,3
]}

Knauss, Samuel ^{[4
,5
,6
,7
]}

Guelke, Eileen ^{[8
]}

Pinnschmidt, Hans O. ^{[9
]}

Jakob, Carolin E. M. ^{[10
,11
,12
]}

Lingor, Paul ^{[13
]}

Hellwig, Kerstin ^{[14
]}

Berthele, Achim ^{[13
]}

Hoeglinger, Guenter ^{[15
,16
]}

Fink, Gereon R. ^{[1
,2
,3
]}

Endres, Matthias ^{[4
,5
,6
,17
,18
,19
,20
]}

Gerloff, Christian ^{[8
]}

Klein, Christine ^{[21
,22
]}

Stecher, Melanie ^{[10
,11
,12
]}

Classen, Annika Y. ^{[10
,11
,12
]}

Rieg, Siegbert ^{[23
]}

Borgmann, Stefan ^{[24
]}

Hanses, Frank ^{[25
,26
]}

Ruethrich, Maria M. ^{[27
,28
]}

Hower, Martin ^{[29
]}

Tometten, Lukas ^{[10
,11
]}

Haselberger, Martina ^{[30
]}

Piepel, Christiane ^{[31
]}

Merle, Uta ^{[32
]}

Dolff, Sebastian ^{[33
]}

Degenhardt, Christian ^{[34
]}

Jensen, Bjoern-Erik O. ^{[35
]}

Vehreschild, Maria J. G. T. ^{[36
]}

Erber, Johanna ^{[37
]}

Franke, Christiana ^{[4
,5
,6
]}

Warnke, Clemens ^{[1
,2
]}

机构：

[1] Univ Cologne, Fac Med, Dept Neurol, Cologne, Germany

[2] Univ Cologne, Cologne, Germany

[3] Res Ctr Julich, Inst Neurosci & Med INM 3, Cognit Neurosci, Julich, Germany

[4] Charite Univ Med Berlin, Dept Neurol Expt Neurol, Berlin, Germany

[5] Free Univ Berlin, Berlin, Germany

[6] Humboldt Univ, Berlin, Germany

[7] DZHK German Ctr Cardiovasc Res, Partner Site, Berlin, Germany

[8] Univ Med Ctr Hamburg Eppendorf, Dept Neurol, Hamburg, Germany

[9] Epidemiol Univ Med Ctr Hamburg Eppendorf, Inst Med Biometry, Hamburg, Germany

[10] Univ Cologne, Fac Med, Dept Internal Med 1, Cologne, Germany

[11] Univ Cologne, Univ Hosp Cologne, Cologne, Germany

[12] German Ctr Infect Res DZIF, Partner Site Cologne Bonn, Cologne, Germany

[13] Tech Univ Munich, Sch Med, Dept Neurol, Klinikum Rechts Isar, Munich, Germany

[14] Klinikum Ruhr Univ, Katholisches Klinikum Bochum, Dept Neurol, Bochum, Germany

[15] Hannover Med Sch, Dept Neurol Clin Neurophysiol, Hannover, Germany

[16] German Ctr Neurodegenerat Dis DZNE, Munich, Germany

[17] Ctr Stroke Res Berlin, Berlin, Germany

[18] ExcellenceCluster NeuroCure, Berlin, Germany

[19] German Ctr Neurodegenerat Dis DZNE, Partner Site Berlin, Berlin, Germany

[20] German Ctr Cardiovasc Res DZHK, Partner Site Berlin, Berlin, Germany

[21] Univ Lubeck, Inst Neurogenet, Campus Luebeck, Lubeck, Germany

[22] Univ Hosp Schleswig Holstein, Campus Luebeck, Lubeck, Germany

[23] Univ Freiburg, Fac Med, Med Ctr, Dept Med 2, Freiburg, Germany

[24] Ingolstadt Hosp, Dept Infect Dis & Infect Control, Ingolstadt, Germany

[25] Univ Hosp Regensburg, Emergency Dept, Regensburg, Germany

[26] Univ Hosp Regensburg, Dept Infect Dis & Infect Control, Regensburg, Germany

[27] Univ Hosp Jena, Dept Internal Med Hematol & Med Oncol 2, Jena, Germany

[28] Hans Knoell Inst, Leibniz Inst Nat Prod Res & Infect Biol, Jena, Germany

[29] Klinikum Dortmund, Dept Internal Med, Dortmund, Germany

[30] Passau Hosp, Dept Internal Med 1, Passau, Germany

[31] Hosp Bremen Cent, Dept Internal Med 1, Bremen, Germany

[32] Univ Hosp Heidelberg, Dept Internal Med 4, Heidelberg, Germany

[33] Univ Duisburg Essen, Univ Hosp Essen, West German Ctr Infect Dis, Dept Infect Dis, Essen, Germany

[34] Stadtisches Klinikum, Dept Pharm, Karlsruhe, Germany

[35] Univ Hosp Dusseldorf, Dept Gastroenterol Hepatol & Infect Dis, Dusseldorf, Germany

[36] Goethe Univ Frankfurt, Univ Hosp Frankfurt, Infect Dis, Dept Internal Med, Frankfurt, Germany

[37] Tech Univ Munich, Univ Hosp Rechts Isar, Sch Med, Dept Internal Med 2, Munich, Germany

来源：

EUROPEAN JOURNAL OF NEUROLOGY | 2021年 / 28卷 / 12期

关键词：

COVID-19; neurological manifestations; SARS-CoV-2; CORONAVIRUS DISEASE 2019; CLINICAL CHARACTERISTICS; MANIFESTATIONS;

D O I：

10.1111/ene.15072

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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.

引用

页码：3925 / 3937

页数：13

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