Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up

• DOI: 10.1007/s00415-020-10380-x
• Publication Date: 2021-01-13T23:36:37Z
• Authors: Vardan Nersesjan; Moshgan Amiri; Anne-Mette Lebech; Casper Roed; Helene Mens; Lene Russell; Lise Fonsmark; Marianne Berntsen; Sigurdur Thor Sig...; Jonathan Carlsen; Annika Reynberg L...; Pernille Martens; Eva Løbner Lund; Klaus Hansen; Bo Jespersen; Marie Norsker Folke; Per Meden; Anne-Mette Hejl; Christian Wamberg; Michael E. Benros; Daniel Kondziella
• Keywords: Adult; Original Communication; SARS-CoV-2; Clinical Neurology; COVID-19; 3. Good health; Stroke; 03 medical and health sciences; 0302 clinical medicine; Neurology; Peripheral Nervous System; Humans; RNA, Viral; Prospective Studies; Follow-Up Studies

To systematically describe central (CNS) and peripheral (PNS) nervous system complications in hospitalized COVID-19 patients.We conducted a prospective, consecutive, observational study of adult patients from tertiary referral center with confirmed COVID-19. All were screened daily for neurological neuropsychiatric symptoms during admission discharge. Three-month follow-up data collected using electronic health records. We classified as caused by SARS-CoV-2 neurotropism, immune-mediated or critical illness-related.From April to September 2020, we enrolled 61 consecutively admitted patients, 35 (57%) whom required intensive care (ICU) management respiratory failure. Forty-one CNS/PNS identified 28 (45.9%) more frequent ICU compared non-ICU patients. The most common CNS complication was encephalopathy (n = 19, 31.1%), which severe 13 (GCS ≤ 12), including 8 akinetic mutism. Length independently associated (OR 1.22). Other included ischemic stroke, biopsy-proven acute necrotizing encephalitis, transverse myelitis. PNS illness polyneuromyopathy (13.1%), prolonged stay independent predictor 1.14). Treatment-related meralgia paresthetica. Of 41 total, 3 para/post-infectious, 34 secondary other causes, 4 remained unresolved. Cerebrospinal fluid negative RNA all 5 investigated.CNS particularly the ICU, often attributable illness. When primary cause disease, no signs viral neurotropism detected, but laboratory changes suggested autoimmune-mediated mechanisms.