Long-term neurological outcome after SARS-CoV-2 infection

Content of research project: Since the recognition of SARS-CoV-2 outbreak in 2019, there are now over 200 million COVID-19 cases worldwide with more than 4 million deaths. Neurological manifestations during the acute course of COVID-19 have been recognized (6-84%) and range from mild (headache, hyposmia, myalgia) to severe (i.e. strokes, seizures) diseases. We do not know much about long-term neurological outcomes of COVID-19 patients. Here, we propose a structured protocol to capture persistent and delayed neurological manifestations, neurocognitive deficits, and quality of life (QoL) impairments 3 and 12 months after COVID-19 diagnosis. Hypotheses: We hypothesize that neurological symptoms and neuropsychological/cognitive deficits substantially impact on patients QoL. Furthermore, we hypothesize, that some of these manifestations are associated with abnormal neuroimaging findings, which will be assessed by cerebral magnetic resonance imaging (MRI). Methods: We aim to enrol at least 225 patients with COVID-19 and we will compare these patients to 50 age- and sex matched controls hospitalized with pneumonia as well as 80 healthy controls for MRI-data. COVID-19 patients will include (1) outpatients, (2) in-patients admitted to the normal ward, and (3) patients admitted to the ICU. Our protocol includes (1) a structured neurological examination, (2) olfactory testing, (3) assessment of QoL, mental health and functional outcome at 3 and 12 months after COVID-19. Novelty of the project: With this study we will have data on the occurrence and natural history of of COVID-19 related neurological symptoms and manifestations. Our previous data already suggest that persistent neurological manifestations impact on mental health, cognition and QoL. We believe that our study results likely influence the long-term care of COVID-19 patients and help to identify those, who need further neuro-rehabilitative support. Primary researchers involved: Raimund Helbok, Verena Rass, Ronny Beer