bt9kzqr

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?:abstract	Objective: To systematically describe CNS and PNS complications in hospitalized COVID-19 patients. Methods: We conducted a prospective, consecutive, observational study of adult patients from a tertiary referral center with confirmed COVID-19. All patients were screened daily for neurological and neuropsychiatric symptoms during admission, at discharge and at 3-month follow-up. We classified complications as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related. Results: From April-September 2020, we enrolled 61 consecutively admitted COVID-19 patients, 35 (57%) of whom were referred to ICU for respiratory failure. Evaluation revealed a higher frequency of CNS/PNS symptoms in ICU patients compared to non-ICU patients. The most common CNS complication was encephalopathy (n=22, 36.1%), which was severe in 13 patients (GCS[≤]12), including 8 with akinetic mutism. Length of ICU admission was an independent predictor of encephalopathy (OR=1.23). Other CNS complications included ischemic stroke, a biopsy-proven acute necrotizing encephalitis, and transverse myelitis. The most common PNS complication was critical illness polyneuromyopathy (13.1%), with prolonged ICU stay as independent predictor (OR=1.14). Treatment-related PNS complications included meralgia paresthetica. Of 41 complications in total, 3 were classified as para/post-infectious. The remainder included cases secondary to critical illness or other causes (n=34) or without sufficient investigations (n=4). Cerebrospinal fluid was negative for SARS-CoV-2 RNA in all 5 patients investigated. Conclusions: CNS/PNS complications were common in hospitalized COVID-19 patients, particularly in ICU patients, and often attributable to critical illness. In cases with COVID-19 as the primary cause for neurological disease, there were no signs of viral neurotropism, but laboratory changes suggested autoimmune-mediated mechanisms.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C0009566> <https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C0027627> <https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C0035668> <https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C0422879> <https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C1518304> <https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C4285807> <https://research.tib.eu/covid-19/entity/6bt9kzqr_hasAnnotation_C5203676>
?:creator	<https://research.tib.eu/covid-19/entity/Nersesjan%2C_V.%3B_Amiri%2C_M.%3B_Lebech%2C_A.-M.%3B_Roed%2C_C.%3B_Mens%2C_H.%3B_Russell%2C_L.%3B_Fonsmark%2C_L.%3B_Berntsen%2C_M.%3B_Sigurdsson%2C_S._T.%3B_Carlsen%2C_J.%3B_Langkilde%2C_A.%3B_Martens%2C_P.%3B_Lund%2C_E._L.%3B_Hansen%2C_K.%3B_Jespersen%2C_B.%3B_Folke%2C_M._N.%3B_Meden%2C_P.%3B_Hejl%2C_A.-M.%3B_Warmberg%2C_C.%3B_Benros%2C_M.%3B_Kondziella%2C_D.>
?:doi	10.1101/2020.11.15.20231001
?:doi	<https://research.tib.eu/covid-19/entity/10.1101/2020.11.15.20231001>
?:license	medrxiv
?:pdf_json_files	document_parses/pdf_json/983c2c6fea94904dfa487719f9622fe0bc4ce972.json
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
?:sha_id	<https://research.tib.eu/covid-19/entity/983c2c6fea94904dfa487719f9622fe0bc4ce972>
?:source	MedRxiv; WHO
?:title	Central and peripheral nervous system complications of COVID-19: A prospective tertiary center cohort with 3-month follow-up
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-11-17

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Value

?:abstract

Objective: To systematically describe CNS and PNS complications in hospitalized COVID-19 patients. Methods: We conducted a prospective, consecutive, observational study of adult patients from a tertiary referral center with confirmed COVID-19. All patients were screened daily for neurological and neuropsychiatric symptoms during admission, at discharge and at 3-month follow-up. We classified complications as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related. Results: From April-September 2020, we enrolled 61 consecutively admitted COVID-19 patients, 35 (57%) of whom were referred to ICU for respiratory failure. Evaluation revealed a higher frequency of CNS/PNS symptoms in ICU patients compared to non-ICU patients. The most common CNS complication was encephalopathy (n=22, 36.1%), which was severe in 13 patients (GCS[≤]12), including 8 with akinetic mutism. Length of ICU admission was an independent predictor of encephalopathy (OR=1.23). Other CNS complications included ischemic stroke, a biopsy-proven acute necrotizing encephalitis, and transverse myelitis. The most common PNS complication was critical illness polyneuromyopathy (13.1%), with prolonged ICU stay as independent predictor (OR=1.14). Treatment-related PNS complications included meralgia paresthetica. Of 41 complications in total, 3 were classified as para/post-infectious. The remainder included cases secondary to critical illness or other causes (n=34) or without sufficient investigations (n=4). Cerebrospinal fluid was negative for SARS-CoV-2 RNA in all 5 patients investigated. Conclusions: CNS/PNS complications were common in hospitalized COVID-19 patients, particularly in ICU patients, and often attributable to critical illness. In cases with COVID-19 as the primary cause for neurological disease, there were no signs of viral neurotropism, but laboratory changes suggested autoimmune-mediated mechanisms.

is ?:annotates of