Outcome predictors of post-COVID conditions in the European Academy of Neurology COVID-19 registry.

Leone, Maurizio Angelo; Helbok, Raimund; Bianchi, Elisa; Yasuda, Clarissa Lin; Konti, Maria; Ramankulov, Dauren; Lolich, Maria; Lovrencic-Huzjan, Arijana; Kovács, Tibor; Armon, Carmel; Cotelli, Maria Sofia; Cavallieri, Francesco; Grosu, Oxana; Kiteva-Trenchevska, Gordana; Rodriguez-Leyva, Ildefonso; Boldingh, Marion; Brola, Waldemar; Maia, Luís F; de Seabra, Mafalda Maria Laracho; Davidescu, Eugenia Irene; ... (2024). Outcome predictors of post-COVID conditions in the European Academy of Neurology COVID-19 registry. Journal of neurology, 271(6), pp. 3153-3168. Springer 10.1007/s00415-024-12212-8

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Several neurological manifestations are part of the post-COVID condition. We aimed to: (1) evaluate the 6-month outcome in the cohort of patients with neurological manifestations during the COVID-19 acute phase and surviving the infection, and find outcome predictors; (2) define the prevalence and type of neurological symptoms persistent at six months after the infection. Data source was an international registry of patients with COVID-19 infection and neurological symptoms, signs or diagnoses established by the European Academy of Neurology. Functional status at six-month follow-up was measured with the modified Rankin scale (mRS), and defined as: "stable/improved" if the mRS at six months was equal as or lower than the baseline score; "worse" if it was higher than the baseline score. By October 30, 2022, 1,003 lab-confirmed COVID-19 patients were followed up for a median of 6.5 months. Compared to their pre-morbid status, 522 patients (52%) were stable/improved, whereas 465 (46%) were worse (functional status missing for 16). Age, hospitalization, several pre-COVID-19 comorbidities, and COVID-19 general complications were predictors of a worse status. Amongst neurological manifestations, stroke carried the highest risk for worse outcome (OR 5.96), followed by hyperactive delirium (2.8), and peripheral neuropathies (2.37). On the other hand, hyposmia/hypogeusia (0.38), headache (0.40), myalgia (0.45), and COVID-19 vaccination (0.52) were predictors of a favourable prognosis. Persisting neurological symptoms or signs were reported by 316/1003 patients (31.5%), the commonest being fatigue (n = 133), and impaired memory or concentration (n = 103). Our study identified significant long-term prognostic predictors in patients with COVID-19 and neurological manifestations.

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