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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.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.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.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.

Background and purpose Tick-borne encephalitis (TBE) is a common viral disease in central Europe and Asia. Severe or even lethal neurological symptoms may ensue. With limited therapeutic options, active vaccination against the TBE virus (TBEV) is strongly recommended in endemic areas. A systematic analysis of the clinical picture and cerebral imaging findings associated with TBE was conducted with particular focus on patients who acquired TBE despite previous vaccination. Methods A cohort of 52 patients with serologically proven TBE treated at our centre in a 10-year period who received at least one cerebral magnetic resonance imaging (MRI) was retrospectively described. Extension of MRI changes was systematically assessed by an experienced neuroradiologist. Standard statistical procedures were performed. Results Fifty-two patients with a definite serological diagnosis of TBE were included. The most common presentation was encephalitis (67%). MRI showed TBE-associated parenchymal lesions in 33% of all patients. Sites of predilection included the periaqueductal grey, the thalamus and the brainstem. Ten patients had received at least one prior active or passive TBEV immunization. All of these had a maximal Rankin Scale score of at least 4. The median number of affected anatomical regions on MRI was significantly higher than in the non-vaccinated cohort. Conclusions To our knowledge, this is the first study systematically describing the peculiarities of MRI in patients vaccinated against TBE. In addition to a severe clinical course, they exhibit more extensive MRI lesions than a non-vaccinated cohort. Possible reasons for these findings include incomplete seroconversion, more virulent TBEV strains or antibody-dependent enhancement.

Despite the increasing number of reports on the spectrum of neurological manifestations of COVID-19 (neuro-COVID), few studies have assessed short- and long-term outcome of the disease.This is a cohort study enrolling adult patients with neuro-COVID seen in neurological consultation. Data were collected prospectively or retrospectively in the European Academy of Neurology NEuro-covid ReGistrY ((ENERGY). The outcome at discharge was measured using the modified Rankin Scale and defined as 'stable/improved' if the modified Rankin Scale score was equal to or lower than the pre-morbid score, 'worse' if the score was higher than the pre-morbid score. Status at 6 months was also recorded. Demographic and clinical variables were assessed as predictors of outcome at discharge and 6 months.From July 2020 to March 2021, 971 patients from 19 countries were included. 810 (83.4%) were hospitalized. 432 (53.3%) were discharged with worse functional status. Older age, stupor/coma, stroke and intensive care unit (ICU) admission were predictors of worse outcome at discharge. 132 (16.3%) died in hospital. Older age, cancer, cardiovascular complications, refractory shock, stupor/coma and ICU admission were associated with death. 262 were followed for 6 months. Acute stroke or ataxia, ICU admission and degree of functional impairment at discharge were predictors of worse outcome. 65/221 hospitalized patients (29.4%) and 10/32 non-hospitalized patients (24.4%) experienced persisting neurological symptoms/signs. 10/262 patients (3.8%) developed new neurological complaints during the 6 months of follow-up.Neuro-COVID is a severe disease associated with worse functional status at discharge, particularly in older subjects and those with comorbidities and acute complications of infection.

The type I interferons interferon alpha (IFNalpha) and IFNbeta are the first line of defense potently induced upon viral infection, and at the same time are immunomodulatory cytokines bridging innate and adaptive immunity. T cells secreting interleukin-17 (IL-17) have recently been identified to regulate neutrophil-mediated inflammation, and have been implicated in the pathogenesis of experimental colitis and human inflammatory bowel disease, and are considered to regulate the inflammatory response in these models. We therefore hypothesized that type I IFNs as sentinels of viral infection might counteract the development of Th17 cells. We studied the effects of IFNalpha on IL-17 mRNA and protein expression in human peripheral blood mononuclear cells (PBMC) and during differentiation of human and murine naïve T cells into Th17 cells. In patients with ulcerative colitis (UC) treated systemically with IFNalpha, we studied colonic expression of IL-17 before and 4 weeks after therapy. IFNalpha potently suppressed IL-17 production in PBMC both at the mRNA and protein level. Th17 differentiation of human and murine naïve T cells was markedly suppressed in the presence of IFNalpha. UC patients exhibited increased IL-17 expression in colonic tissue biopsies compared to healthy controls, which was down-regulated during IFNalpha therapy. IL-17 expression in colonic tissue correlated with clinical remission in these patients. Our data suggest that IFNalpha down-regulates IL-17 expression and Th17 differentiation in vitro and in vivo. As a corollary, these effects might play a role in the mode of action of type I IFNs in the treatment of various diseases.

1. Innerhalb der Carabidengattung Pterostichus finden sich verschiedene Typen der Jahresrhythmik. Untersucht wurden P. cupreus und P. coerulescens als Repr\:asentanten der Fr\:uhlingstiere mit Sommerlarven und Imaginal\:uberwinterung und P. vulgaris als Repr\:asentant der Herbsttiere mit Larval\:uberwinterung. 2. Die Weibchen der Fr\:uhlingstiere treten unabh\:angig von der Photoperiode in eine Dormanz ein, die durch aufeinanderfolgende Behandlung mit Kurztag und Langtag in Dauerw\:arme \:uberwunden wird (photoperiodische Parapause). Im Freiland bewirkt die steigende Tagesl\:ange die Aufhebung der Parapause. Der Prozentsatz reifer Weibchen hangt bei beiden Arten von der Dauer der Kurztag-Behandlung ab. Bei 4wochiger Kurztag-Behandlung erhalt man im folgenden Langtag die ersten reifen Weibchen. Nach 8 Wochen Kurztag steigt der Prozentsatz von Weibchen mit legereifen Eiern auf maximale Werte bis 100%. Durch erneute Behandlung mit zunachst Kurztag, dann Langtag konnen alte Weibchen zu einer zweiten Eireifung gebracht werden. Die Parapause der Weibchen kann auch bei konstanter Photoperiode (Dauer-Kurztag oder-Langtag) durch eine vorubergehende (4monatige) starke Temperatursenkung aufgehoben werden. Hierbei kommen aber weniger als 40% der Weibchen von P. coerulescens und weniger als 20% der Weibchen von P. cupreus zur Reife. Eine weitere Moglichkeit zur Uberwindung der Parapause bei Weibchen besteht in der Steigerung der Lichtintensitat bei konstantem Kurztag. Hier entwickelten sich aber nur 33% der Weibchen von P. coerulescens zur Reife. 3. Die M\:annchen der Fr\:uhlingstiere reifen in Dauerw\:arme bei Wechsel von Kurztag und langtag nur zu einem geringen Prozentsatz (maximal 25%). Sie kommen dagegen durch mit dem Kurztag verbundene K\:altebehandlung zur Reife. Dabei steigt der Prozentsatz reifer M\:annchen bei Verl\:angerung der K\:altekurztagwirkung von 2 auf 4 Monate und Senkung der Temperatur von +5\2−7\dg auf +2\2−3\dg steil an (auf \:uber 80%). Laborzuchtweibchen, die mit kaltekurztagbehandelten Mannchen gepaart werden, haben viel mehr Nachkommen als solche, die mit Mannchen gepaart werden, die in Warme mit Kurztag behandelt worden sind. Die Dormanz, in der die Mannchen von P. cupreus in Warme verharren, kann auch im Dauer-Langtag und Dauer-Kurztag durch zeitweilige Temperatursenkung zu einem hohen Prozentsatz uberwunden werden (thermische Parapause). Mannchen von P. coerulescens reifen durch Temperaturwechsel nur im Dauer-Kurztag zu einem geringen Prozentstatz, nicht im Langtag. 4. Die Entwicklung und Metamorphose l\:auft bei den untersuchten Fr\:uhlingstieren in W\:arme unter Kurztag und Langtag ab. Die Mortalit\:at ist unter beiden Photoperioden gleich. Langtag verl\:angert bei beiden Arten die Entwicklungsdauer. 5. Bei den Imagines des Herbsttieres P. vulgaris erfolgt die Reifung bei beiden Geschlechtern unabh\:angig von der Photoperiode. Eine Dormanz tritt nicht auf. 6. Die Larvalentwicklung von P. vulgaris verl\:auft unabh\:angig von der Photoperiode. Bei W\:arme verf\:allt das 2. oder 3. Larvenstadium in eine Dormanz, die als thermische Parapause der Larven bezeichnet werden soll, da sie durch zeitweilige K\:alteeinwirkung auf das 3. Stadium aufgehoben werden kann.