Comparative features and outcomes of major neurological complications of COVID‐19

Abstract

Background and purpose

The aim of this study was to assess the neurological complications of SARS‐CoV‐2 infection and compare phenotypes and outcomes in infected patients with and without selected neurological manifestations.

Methods

The data source was a registry established by the European Academy of Neurology during the first wave of the COVID‐19 pandemic. Neurologists collected data on patients with COVID‐19 seen as in‐ and outpatients and in emergency rooms in 23 European and seven non‐European countries. Prospective and retrospective data included patient demographics, lifestyle habits, comorbidities, main COVID‐19 complications, hospital and intensive care unit admissions, diagnostic tests, and outcome. Acute/subacute selected neurological manifestations in patients with COVID‐19 were analysed, comparing individuals with and without each condition for several risk factors.

Results

By July 31, 2021, 1523 patients (758 men, 756 women, and nine intersex/unknown, aged 16–101 years) were registered. Neurological manifestations were diagnosed in 1213 infected patients (79.6%). At study entry, 978 patients (64.2%) had one or more chronic general or neurological comorbidities. Predominant acute/subacute neurological manifestations were cognitive dysfunction ( N = 449, 29.5%), stroke ( N = 392, 25.7%), sleep–wake disturbances ( N = 250, 16.4%), dysautonomia ( N = 224, 14.7%), peripheral neuropathy ( N = 145, 9.5%), movement disorders ( N = 142, 9.3%), ataxia ( N = 134, 8.8%), and seizures ( N = 126, 8.3%). These manifestations tended to differ with regard to age, general and neurological comorbidities, infection severity and non‐neurological manifestations, extent of association with other acute/subacute neurological manifestations, and outcome.

Conclusions

Patients with COVID‐19 and neurological manifestations present with distinct phenotypes. Differences in age, general and neurological comorbidities, and infection severity characterize the various neurological manifestations of COVID‐19.