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

URN to cite this document:: urn:nbn:de:bvb:355-epub-566609
DOI to cite this document:: 10.5283/epub.56660

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

License: Creative Commons Attribution Non-commercial No Derivatives 4.0
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Date of publication of this fulltext: 29 Feb 2024 12:35

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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.

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