• COVID‐19
• EAN
• SARS‐Cov‐2
• neurology
• pandemic

• Humans
• COVID-19/epidemiology
• Neurology
• Advisory Committees
• Europe/epidemiology
• Nervous System Diseases/therapy
• Pandemics
• SARS-CoV-2
• Academies and Institutes

• European Academy of Neurology
• brain health
• education
• founding process
• history
• organization
• research

• Humans
• Academies and Institutes/history
• Academies and Institutes/organization & administration
• Europe
• History, 20th Century
• History, 21st Century
• Neurology/history
• Neurology/organization & administration
• Societies, Medical/history
• Societies, Medical/organization & administration

• COVID‐19
• COVID‐19 vaccine
• Multiple Sclerosis
• disease‐modifying therapies
• immune response
• vaccine safety

• COVID‐19
• SARS‐CoV‐2
• immunomodulatory
• multiple sclerosis
• post‐COVID‐19 syndrome
• vaccine

• Humans
• COVID-19/prevention & control
• Nervous System Diseases/therapy
• Nervous System Diseases/etiology
• Pandemics
• SARS-CoV-2
• Neurology/standards
• Consensus
• Europe
• Pneumonia, Viral/complications
• Pneumonia, Viral/epidemiology
• Coronavirus Infections/complications
• Coronavirus Infections/therapy
• Betacoronavirus

• coronavirus-19
• immunosuppression
• myasthenia gravis
• neuromuscular junction disorders
• viral immunology

• Humans
• COVID-19/epidemiology
• COVID-19/complications
• Myasthenia Gravis
• Retrospective Studies
• Male
• Female
• Middle Aged
• China/epidemiology
• Adult
• Risk Factors
• SARS-CoV-2
• Aged
• Severity of Illness Index
• Comorbidity

Diagnosis of coronavirus disease 2019 (COVID-19)-related neurological events in the pediatric population is challenging. Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism, in addition to the frequency of asymptomatic COVID-19 cases, pose the main challenges for diagnosis. Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis (AIE) is reported.

A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE. Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal. Neither the immunological assessment, including viral serologies, antinuclear antibodies, autoimmune antibodies (NMDA, AMPA, CASPR2, LG11, GABARB, Hu, Yo, Ri, CV2, PNMA2, SOX1, Titin, amphiphysin, Recoverin), nor the metabolic assessment for lactate and pyruvate showed significant anomaly. Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE. A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veino-globulin and high dose of intravenous Corticosteroid.

Diagnostic biomarkers for AIE might aid effective treatment.

• Post-COVID-19
• Auto-immune encephalitis
• Diagnosis biomarkers
• Pediatric population
• Delta brush sign
• Autoimmune antibodies

• SARS-CoV-2
• clinical neuroscience
• neurologist
• neurology

• COVID-19
• Fatigue
• Long COVID
• Neurological deficits
• Neuropsychological assessment
• Post-COVID
• Somatization

• Antiseizure medications
• COVID-19
• Epilepsy
• SARS-CoV-2

Health risks associated with SARS‐CoV‐2 infection are undisputed. Moreover, the capability of vaccination to prevent symptomatic, severe, and fatal COVID‐19 is recognized. There is also early evidence that vaccination can reduce the chance for long COVID‐19. Nonetheless, the willingness to get vaccinated and receive booster shots remains subpar among people with neurologic disorders. Vaccine scepticism not only jeopardizes collective efforts to end the COVID‐19 pandemic but puts individual lives at risk, as some chronic neurologic diseases are associated with a higher risk for an unfavorable COVID‐19 course.

In this position paper, the NeuroCOVID‐19 Task Force of the European Academy of Neurology (EAN) summarizes the current knowledge on the prognosis of COVID‐19 among patients with neurologic disease, elucidates potential barriers to vaccination coverage, and formulates strategies to overcome vaccination hesitancy. A survey among the Task Force members on the phenomenon of vaccination hesitancy among people with neurologic disease supports the lines of argumentation.

The study revealed that people with multiple sclerosis and other nervous system autoimmune disorders are most skeptical of SARS‐CoV‐2 vaccination. The prevailing concerns included the chance of worsening the pre‐existing neurological condition, vaccination‐related adverse events, and drug interaction.

The EAN NeuroCOVID‐19 Task Force reinforces the key role of neurologists as advocates of COVID‐19 vaccination. Neurologists need to argue in the interest of their patients about the overwhelming individual and global benefits of COVID‐19 vaccination. Moreover, they need to keep on eye on this vulnerable patient group, its concerns, and the emergence of potential safety signals.

• COVID-19
• SARS-CoV-2
• advocacy
• disparity
• equitable global health
• neurology
• primary prevention

• COVID-19
• Humans
• Neurology
• Pandemics
• SARS-CoV-2
• Vaccination

Therapeutic plasma exchange (TPE) for neuroimmunological disorders has played an increasingly important role within the Southeast Asian (SEA) region. The South East Asian Therapeutic Plasma exchange Consortium (SEATPEC) was formed in 2018 to promote education and research on TPE within the region. The advent of the Covid‐19 pandemic has produced challenges for the development and expansion of this service.

A qualitative and semi‐quantitative questionnaire‐based survey was conducted by SEATPEC member countries from January to June 2020 (Phase 1) and then from July 2020 to January 2021 in (Phase 2) to assess the impact of Covid‐19 on regional TPE.

The study's main objectives were to explore the challenges experienced and adaptations/adjustments taken by SEATPEC countries in order to continue safe and efficient TPE during the Covid‐19 pandemic.

The pandemic was found to disrupt the delivery of TPE services in all SEATPEC countries. Contributing factors were multifactorial due to overstretched medical services, staff shortages, quarantines and redeployments, fear of acquiring Covid‐19, movement restriction orders, and patient's psychological fear of attending hospitals/testing for Covid‐19. All SEATPEC countries practiced careful stratification of cases for TPE (electives vs emergencies, Covid‐19 vs non‐Covid‐19 cases). SEATPEC countries had to modify TPE treatment protocols to include careful preprocedure screening of patient's for Covid‐19, use of personal protective equipment (PPE) and post‐TPE sanitization of machines and TPE suites.

Based on the responses of the survey, SEATPEC countries produced a consensus statement with five recommendations for safe and effective TPE within the region.

• Covid-19
• South East Asia
• impact
• therapeutic plasma exchange

(1) Background: The COVID-19 pandemic impacts healthcare utilization across all care settings and health conditions. The objective of this study was to determine changes in hospital admissions for neurodegenerative diseases (NDD) during the first COVID-19 wave in Germany; (2) Methods: This cross-sectional study used nationwide administrative claims data covering 1468 hospitals. The primary outcome was the year-to-year relative change in case numbers during a four-month study period (16 January–15 May 2020 vs. 2019) during the first pandemic wave. Secondary outcomes included year-to-year relative changes during a four-week peak phase (16 March–15 April) and changes between differential phases of the wave. The analyzed NDD comprised progressive supranuclear palsy (PSP), multiple system atrophy (MSA), Parkinson’s disease, amyotrophic lateral sclerosis (ALS) and Huntington’s disease; (3) Results: Hospital admissions for any reason decreased by 16.7% in 2020 during the study period and by 36.6% during the peak phase, whereas admissions for NDD decreased by 27.6% and 65.0%, respectively. PSP cases decreased during the study period (−34.7%) and the peak phase (−68.1%) and stayed reduced in a late phase with falling COVID-19 numbers. MSA and ALS cases increased strongest after the peak, with ALS cases being comparatively weakly reduced during the study period (−17.3%) and peak phase (−51.7%); (4) Conclusions: Inpatient care utilization for NDD changed differentially during the first wave of the COVID-19 pandemic in Germany and showed a greater reduction than overall and general neurological admissions. Mitigating long-term health deterioration of this vulnerable subgroup is important to reduce morbidity and mortality in the future.

• COVID-19
• Parkinson’s disease
• amyotrophic lateral sclerosis (ALS)
• multiple system atrophy (MSA)
• progressive supranuclear palsy (PSP)

• covid-19
• neurocovid
• pandemic
• neurological complications

• COVID-19
• Humans
• Nervous System Diseases/etiology
• Prognosis
• RNA, Viral
• SARS-CoV-2

• COVID-19
• chronic disorders
• medical care
• neurology
• people with neurological disease
• perspective
• survey

During acute coronavirus disease 2019 (COVID‐19) infection, neurological signs, symptoms and complications occur. We aimed to assess their clinical relevance by evaluating real‐world data from a multinational registry.

We analyzed COVID‐19 patients from 127 centers, diagnosed between January 2020 and February 2021, and registered in the European multinational LEOSS (Lean European Open Survey on SARS‐Infected Patients) registry. The effects of prior neurological diseases and the effect of neurological symptoms on outcome were studied using multivariate logistic regression.

A total of 6537 COVID‐19 patients (97.7% PCR‐confirmed) were analyzed, of whom 92.1% were hospitalized and 14.7% died. Commonly, excessive tiredness (28.0%), headache (18.5%), nausea/emesis (16.6%), muscular weakness (17.0%), impaired sense of smell (9.0%) and taste (12.8%), and delirium (6.7%) were reported. In patients with a complicated or critical disease course (53%) the most frequent neurological complications were ischemic stroke (1.0%) and intracerebral bleeding (ICB; 2.2%). ICB peaked in the critical disease phase (5%) and was associated with the administration of anticoagulation and extracorporeal membrane oxygenation (ECMO). Excessive tiredness (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.20–1.68) and prior neurodegenerative diseases (OR 1.32, 95% CI 1.07–1.63) were associated with an increased risk of an unfavorable outcome. Prior cerebrovascular and neuroimmunological diseases were not associated with an unfavorable short‐term outcome of COVID‐19.

Our data on mostly hospitalized COVID‐19 patients show that excessive tiredness or prior neurodegenerative disease at first presentation increase the risk of an unfavorable short‐term outcome. ICB in critical COVID‐19 was associated with therapeutic interventions, such as anticoagulation and ECMO, and thus may be an indirect complication of a life‐threatening systemic viral infection.

• COVID-19
• SARS-CoV-2
• neurological manifestations

• Angelman syndrome
• Puppet Children
• disability
• happy puppet syndrome
• physical and rehabilitation medicine
• physical therapy modalities
• rehabilitation

Myasthenia gravis (MG) patients could be a vulnerable group in the pandemic era of coronavirus 2019 (COVID‐19) mainly due to respiratory muscle weakness, older age and long‐term immunosuppressive treatment. We aimed to define factors predicting the severity of COVID‐19 in MG patients and risk of MG exacerbation during COVID‐19.

We evaluated clinical features and outcomes after COVID‐19 in 93 MG patients.

Thirty‐five patients (38%) had severe pneumonia and we recorded 10 deaths (11%) due to COVID‐19. Higher forced vital capacity (FVC) values tested before COVID‐19 were shown to be protective against severe infection (95% CI 0.934–0.98) as well as good control of MG measured by the quantified myasthenia gravis score (95% CI 1.047–1.232). Long‐term chronic corticosteroid treatment worsened the course of COVID‐19 in MG patients (95% CI 1.784–111.43) and this impact was positively associated with dosage (p = 0.005). Treatment using azathioprine (95% CI 0.448–2.935), mycophenolate mofetil (95% CI 0.91–12.515) and ciclosporin (95% CI 0.029–2.212) did not influence the course of COVID‐19. MG patients treated with rituximab had a high risk of death caused by COVID‐19 (95% CI 3.216–383.971). Exacerbation of MG during infection was relatively rare (15%) and was not caused by remdesivir, convalescent plasma or favipiravir (95% CI 0.885–10.87).

As the most important predictors of severe COVID‐19 in MG patients we identified unsatisfied condition of MG with lower FVC, previous long‐term corticosteroid treatment especially in higher doses, older age, the presence of cancer, and recent rituximab treatment.

• COVID-19
• corticosteroids
• immunosuppression
• myasthenia gravis
• rituximab

• COVID-19
• Health services administration
• Nervous system diseases
• Neurology
• Telemedicine

• accident & emergency medicine
• clinical trials
• neurology
• telemedicine

• COVID-19
• Emergency Service, Hospital
• Humans
• Pandemics
• Retrospective Studies
• SARS-CoV-2

Background: The clinical spectrum of coronavirus disease 2019 (COVID-19), due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, may be quite wide, including neurological symptoms. Among them, para-infectious or post-infectious neurological syndromes (PINS), caused by an inflammatory response against the central and/or peripheral nervous system, have been reported. The aim of this paper is to illustrate the functional and neurophysiological recovery in a series of subjects with COVID-19-related PINS who underwent intensive neurorehabilitation.

Materials and Methods: Five patients with PINS associated with COVID-19 were evaluated at baseline and followed up for 6 months. Three of them had polyradiculoneuropathy and two patients had myelitis. The onset of the neurological syndromes was temporally associated with the SARS-CoV-2 infection. After completing the acute neurological treatments in the intensive care unit, patients underwent a personalized multidisciplinary rehabilitation program. An in-depth clinical, functional, and electrophysiological assessment was carried out at baseline and at 3- and 6-month follow-ups.

Results: Among patients with polyradiculoneuropathy, the electrophysiological evaluation at baseline disclosed an acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in two patients and an acute motor and sensory axonal neuropathy (AMSAN) in the third patient. At follow-up, the electrophysiological features improved in one subject with AIDP and were stable in the remaining two cases. The functional assessment after neurorehabilitation showed global recovery and full independence in walking and in activities of daily life in one patient and mild improvement in the other two cases. Of the two subjects with myelitis, the baseline electrophysiological examination showed a prolonged central motor conduction time, which returned to normal in one patient, whereas it improved but remained pathological in the other patient at follow-up. The neurorehabilitation led to a substantial functional improvement in both subjects.

Discussion and Conclusions: This is the first study to describe clinical and electrophysiological aspects along with medium-term outcome in patients with COVID-19-related neurological manifestations who underwent an intensive rehabilitation program. The functional outcome following neurorehabilitation in patients with PINS related to SARS-CoV-2 infection is variable. In our small case series, subjects with polyradiculoneuropathy had a poorer recovery compared to patients with myelitis. The clinical course largely paralleled the follow-up electrophysiological findings.

• Guillain-Barrè syndrome
• SARS-CoV-2
• acute inflammatory demyelinating polyradiculoneuropathy
• acute motor sensory axonal neuropathy
• myelitis
• neurological rehabilitation

• Adult
• COVID-19/epidemiology
• Communicable Disease Control
• Female
• Health Personnel
• Humans
• Male
• Middle Aged
• Neurologists/psychology
• Norway/epidemiology
• Occupational Stress/etiology
• Occupational Stress/psychology
• Pandemics
• Patient Care
• Psychological Distress
• Surveys and Questionnaires
• Workforce

• CD20 depletion
• COVID-19
• SARS-CoV-2
• alemtuzumab
• cladribine
• disease-modifying drugs
• immune-depleting therapies
• multiple sclerosis
• vaccination

• ACE2
• COVID-19
• SARS-CoV-2
• coronavirus
• inflammation
• neurological complications