nt5kvh02

Property	Value
?:abstract	OBJECTIVE: To systematically describe central (CNS) and peripheral (PNS) nervous system 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 and discharge. Three-month follow-up data were collected using electronic health records. We classified complications as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related. RESULTS: From April to September 2020, we enrolled 61 consecutively admitted COVID-19 patients, 35 (57%) of whom required intensive care (ICU) management for respiratory failure. Forty-one CNS/PNS complications were identified in 28 of 61 (45.9%) patients and were more frequent in ICU compared to non-ICU patients. The most common CNS complication was encephalopathy (n = 19, 31.1%), which was severe in 13 patients (GCS ≤ 12), including 8 with akinetic mutism. Length of ICU admission was independently associated with encephalopathy (OR = 1.22). 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 para/post-infectious, 34 were secondary to critical illness or other causes, and 4 remained unresolved. Cerebrospinal fluid was negative for SARS-CoV-2 RNA in all 5 patients investigated. CONCLUSION: CNS and PNS complications were common in hospitalized COVID-19 patients, particularly in the ICU, and often attributable to critical illness. When COVID-19 was the primary cause for neurological disease, no signs of viral neurotropism were detected, but laboratory changes suggested autoimmune-mediated mechanisms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-020-10380-x.
?:creator	<https://research.tib.eu/covid-19/entity/Nersesjan%2C_Vardan%3B_Amiri%2C_Moshgan%3B_Lebech%2C_Anne-Mette%3B_Roed%2C_Casper%3B_Mens%2C_Helene%3B_Russell%2C_Lene%3B_Fonsmark%2C_Lise%3B_Berntsen%2C_Marianne%3B_Sigurdsson%2C_Sigurdur_Thor%3B_Carlsen%2C_Jonathan%3B_Langkilde%2C_Annika_Reynberg%3B_Martens%2C_Pernille%3B_Lund%2C_Eva_L%C3%B8bner%3B_Hansen%2C_Klaus%3B_Jespersen%2C_Bo%3B_Folke%2C_Marie_Norsker%3B_Meden%2C_Per%3B_Hejl%2C_Anne-Mette%3B_Wamberg%2C_Christian%3B_Benros%2C_Michael_E.%3B_Kondziella%2C_Daniel>
?:doi	<https://research.tib.eu/covid-19/entity/10.1007/s00415-020-10380-x>
?:doi	10.1007/s00415-020-10380-x
?:journal	J_Neurol
?:license	cc-by
?:pdf_json_files	document_parses/pdf_json/9a352a4d938ba9bcec32de97a1c0201ea0cf6748.json
?:pmc_json_files	document_parses/pmc_json/PMC7803470.xml.json
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7803470>
?:pmid	<https://research.tib.eu/covid-19/entity/33438076.0>
?:pmid	33438076.0
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
?:sha_id	<https://research.tib.eu/covid-19/entity/9a352a4d938ba9bcec32de97a1c0201ea0cf6748>
?:source	Medline; PMC
?: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	2021-01-13

Property

Value

?:abstract

OBJECTIVE: To systematically describe central (CNS) and peripheral (PNS) nervous system 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 and discharge. Three-month follow-up data were collected using electronic health records. We classified complications as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related. RESULTS: From April to September 2020, we enrolled 61 consecutively admitted COVID-19 patients, 35 (57%) of whom required intensive care (ICU) management for respiratory failure. Forty-one CNS/PNS complications were identified in 28 of 61 (45.9%) patients and were more frequent in ICU compared to non-ICU patients. The most common CNS complication was encephalopathy (n = 19, 31.1%), which was severe in 13 patients (GCS ≤ 12), including 8 with akinetic mutism. Length of ICU admission was independently associated with encephalopathy (OR = 1.22). 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 para/post-infectious, 34 were secondary to critical illness or other causes, and 4 remained unresolved. Cerebrospinal fluid was negative for SARS-CoV-2 RNA in all 5 patients investigated. CONCLUSION: CNS and PNS complications were common in hospitalized COVID-19 patients, particularly in the ICU, and often attributable to critical illness. When COVID-19 was the primary cause for neurological disease, no signs of viral neurotropism were detected, but laboratory changes suggested autoimmune-mediated mechanisms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-020-10380-x.

?:creator