Neuro-Covid Registry

The EAN NEuro-covid ReGistrY (ENERGY) was established by the European Academy of Neurology in 2020 as an international registry to monitor and investigate neurological complications in patients with COVID-19.¹

The project brought together neurologists and centres from across Europe and beyond to collect systematic clinical data on patients with COVID-19 presenting neurological symptoms. The registry aimed to improve understanding of the frequency, characteristics and outcomes of neurological complications associated with COVID-19 and to identify factors associated with short- and long-term outcomes.¹

The ENERGY project was concluded in January 2026 following the completion of patient recruitment and data collection.

Over the course of the project, the ENERGY registry collected data from more than 4,000 patients, involving 152 investigators from 44 centres in 30 countries.
The resulting database enabled the ENERGY investigators to address several important questions concerning neurological complications of COVID-19, including their frequency, clinical characteristics, short- and long-term outcomes, and factors associated with recovery or persistent disability.
The project resulted in five peer-reviewed publications, contributing to the evidence based on neurological manifestations and outcomes of COVID-19.

The ENERGY publications provided important evidence on the neurological burden and consequences of COVID-19:

• Neurological manifestations were common among patients hospitalised with COVID-19. An international analysis combining the ENERGY and GCS-NeuroCOVID cohorts found neurological manifestations in approximately 80% of hospitalised patients, while clinically captured neurological signs and syndromes were associated with increased risk of in-hospital death.²
• Neurological complications were associated with substantial functional consequences. In an international cohort of 971 patients with neuro-COVID-19, more than half were discharged with a worse functional status than before COVID-19.³
• Persistent neurological symptoms were documented beyond the acute phase. At six-month follow-up, 31.5% of patients reported persistent neurological symptoms or signs, with fatigue and impaired memory or concentration among the most frequently reported.³
• Different neurological complications showed distinct clinical characteristics and outcomes. The registry provided comparative data on major neurological complications, including encephalopathy, stroke, seizures, movement disorders, ataxia, dysautonomia, sleep-wake disturbances and peripheral neuropathies.⁴
• The registry contributed to understanding post-COVID conditions and their predictors, helping identify clinical factors associated with persistent neurological symptoms following COVID-19.⁵

Together, these findings contributed to a better understanding of the neurological manifestations of COVID-19, their impact on patient outcomes, and the persistence of neurological symptoms beyond the acute infection.

1. S. Chou, E. Beghi, R. Helbok, et al., Global Incidence of Neurological Manifestations Among Patients Hospitalized With COVID-19—A Report for the GCS-NeuroCOVID Consortium and the ENERGY Consortium, JAMA Network Open, 4(5), e2112131, 2021.
2. E. Beghi, R. Helbok, M. Crean, et al., The European Academy of Neurology COVID-19 registry (ENERGY): an international instrument for surveillance of neurological complications in patients with COVID-19, European Journal of Neurology, vol. 28, issue 10, p. 3303-3323, 2021.
3. E. Beghi, R. Helbok, E. Bianchi, et al., Short- and long-term outcome and predictors in an international cohort of patients with neuro-COVID-19, European Journal of Neurology, vol. 29, issue 6, p. 1663-1684, 2022.
4. E. Beghi, E. Moro, M. Leone, et al., Comparative features and outcomes of major neurological complications of COVID-19, European Journal of Neurology, vol. 30, issue 2, p. 413-433, 2023.
5. M. Leone, R. Helbok, E. Bianchi, et al. Outcome predictors of post‑COVID conditions in the European Academy of Neurology COVID‑19 registry, Journal of Neurology, 2024.