Neurological Complications of COVID-19

20 April 2020

Neurological Complications of COVID-19: 

Reporting of patients for national/international data registries

It is becoming increasingly apparent that the COVID-19 pandemic will leave in its wake a substantial burden of neurological disease. This will occur in many forms from the common (critical illness polyneuropathy and myopathy, hypoxic encephalopathy, stroke, delirium etc.), to those that are less common (Guillain-Barré syndrome, acute disseminated encephalomyelitis), and possibly, SARS-CoV-2 encephalitis. Such neurological disorders have substantial implications on subsequent healthcare, often including prolonged intensive care stays and inpatient rehabilitation. Delineating the true frequency of such complications is therefore important for planning the ongoing provision of such services as the pandemic progresses.

Despite much discussion over the potential for these neurological sequelae, there are, as yet, very few rigorous reports confirming these concerns. Therefore, internationally, neurological associations are seeking to collect highly aligned datasets in order to contribute to the understanding of the nature and frequency of these conditions. In the UK, this registry is being co-ordinated by the CoroNerve Studies Group with representation from adult and paediatric neurology, infectious disease, stroke medicine, psychiatry and intensive care. It is being executed in close collaboration with the Association of British Neurologists (ABN), the British Association of Stroke Physicians, the Royal College of Psychiatrists, the British Paediatric Neurology Association, the Intensive Care Society (ICS), the Faculty of Intensive Care Medicine (FICM), and the Neuroanaesthesia and Critical Care Society (NACCS). 

The CoroNerve Studies Group aim to use the channels provided by the ICS, FICM and NACCS to address this issue. Initiatives based on the impact of these complications on care, course and outcome specifically in the ICU will emerge over the next week or so. 

However, in order to have an integrated picture of all patients diagnosed with an acute neurological disorder in the context of SARS-CoV-2 infection, we encourage reporting to the ABN registry. This notification takes a minute to complete, and can be done directly by ICU staff, or through the neurology teams to whom referrals are made. 

The CoroNerve Studies Group also strongly encourage that these patients are recruited to the UK ISARIC-CCP study which will allow these patients to be framed within the context of COVID-19 more broadly. The information required for reporting is kept intentionally brief and anonymous to encourage participation. 

The CoroNerveStudies Group would like to encourage all intensivists to have a low threshold for involving their local neurology service and reporting using the links above, when patients with COVID-19 display symptoms of neurological disturbance, so that patients may be reported to this registry where appropriate. By contributing a case you will be considered part of the CoroNerve Study Group for the purposes of outputs relating to notification.