{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T11:16:03Z","timestamp":1794050163327,"version":"4.8.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005722","name":"Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005722","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background and objectives<\/jats:title>\n                <jats:p>In 2020, a wide range of hygiene measures was implemented to mitigate infections caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In consequence, pulmonary infections due to other respiratory pathogens also decreased. Here, we evaluated the number of bacterial and viral meningitis and encephalitis cases during the coronavirus disease 2019 (COVID-19) pandemic.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In a multicentre retrospective analysis of data from January 2016 until December 2020, numbers of patients diagnosed with bacterial meningitis and other types of CNS infections (such as viral meningitis and encephalitis) at 26 German hospitals were studied. Furthermore, the number of common meningitis-preceding ear-nose-throat infections (sinusitis, mastoiditis and otitis media) was evaluated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Compared to the previous years, the total number of patients diagnosed with pneumococcal meningitis was reduced (<jats:italic>n<\/jats:italic>\u2009=\u200964 patients\/year in 2020 vs. <jats:italic>n<\/jats:italic>\u2009=\u200987 to 120 patients\/year between 2016 and 2019, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Additionally, the total number of patients diagnosed with otolaryngological infections was significantly lower (<jats:italic>n<\/jats:italic>\u2009=\u20091181 patients\/year in 2020 vs. <jats:italic>n<\/jats:italic>\u2009=\u20091525 to 1754 patients\/year between 2016 and 2019, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). We also observed a decline in viral meningitis and especially enterovirus meningitis (<jats:italic>n<\/jats:italic>\u2009=\u200925 patients\/year in 2020 vs. <jats:italic>n<\/jats:italic>\u2009=\u200997 to 181 patients\/year between 2016 and 2019, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>This multicentre retrospective analysis demonstrates a decline in the number of patients treated for viral and pneumococcal meningitis as well as otolaryngological infections in 2020 compared to previous years. Since the latter often precedes pneumococcal meningitis, this may point to the significance of the direct spread of pneumococci from an otolaryngological focus such as mastoiditis to the brain as one important pathophysiological route in the development of pneumococcal meningitis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-022-11034-w","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T10:03:07Z","timestamp":1647943387000},"page":"3389-3399","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Decline in the number of patients with meningitis in German hospitals during the COVID-19 pandemic"],"prefix":"10.1007","volume":"269","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6929-3831","authenticated-orcid":false,"given":"Stefanie","family":"V\u00f6lk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Pfirrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Koedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Walter","family":"Pfister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Scheibe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farid","family":"Salih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Herzig-Nichtweiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Zimmermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Alonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Wittstock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Totzeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Schirotzek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oezguer A.","family":"Onur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann Otto","family":"Pelz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Ottomeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Luger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Barlinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Binder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"W\u00f6bker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Reimann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Urbanek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Heckelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Lochner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Berghoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Sch\u00f6nenberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-Dirk","family":"Niesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dohmen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagen B.","family":"Huttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albrecht","family":"G\u00fcnther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"11034_CR1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1080\/14760584.2019.1557520","volume":"18","author":"R Acevedo","year":"2019","unstructured":"Acevedo R, Bai X, Borrow R, Caugant DA, Carlos J, Ceyhan M, Christensen H, Climent Y, De Wals P, Dinleyici EC, Echaniz-Aviles G, Hakawi A, Kamiya H, Karachaliou A, Lucidarme J, Meiring S, Mironov K, Safadi MAP, Shao Z, Smith V, Steffen R, Stenmark B, Taha MK, Trotter C, Vazquez JA, Zhu B (2019) The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations. Expert Rev Vaccines 18:15\u201330","journal-title":"Expert Rev Vaccines"},{"key":"11034_CR2","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1093\/cid\/ciaa1728","volume":"72","author":"Z Amin-Chowdhury","year":"2021","unstructured":"Amin-Chowdhury Z, Aiano F, Mensah A, Sheppard CL, Litt D, Fry NK, Andrews N, Ramsay ME, Ladhani SN (2021) Impact of the coronavirus disease 2019 (COVID-19) pandemic on invasive pneumococcal disease and risk of pneumococcal coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): prospective national cohort study, England. Clin Infect Dis 72:e65\u2013e75","journal-title":"Clin Infect Dis"},{"key":"11034_CR3","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.1136\/bmj.n1135","volume":"373","author":"J Bodilsen","year":"2021","unstructured":"Bodilsen J, Nielsen PB, Sogaard M, Dalager-Pedersen M, Speiser LOZ, Yndigegn T, Nielsen H, Larsen TB, Skjoth F (2021) Hospital admission and mortality rates for non-covid diseases in Denmark during covid-19 pandemic: nationwide population based cohort study. BMJ 373:1135","journal-title":"BMJ"},{"key":"11034_CR4","doi-asserted-by":"publisher","first-page":"e360","DOI":"10.1016\/S2589-7500(21)00077-7","volume":"3","author":"AB Brueggemann","year":"2021","unstructured":"Brueggemann AB, Jansen van Rensburg MJ, Shaw D, McCarthy ND, Jolley KA, Maiden MCJ, van der Linden MPG, Amin-Chowdhury Z, Bennett DE, Borrow R, Brandileone MC, Broughton K, Campbell R, Cao B, Casanova C, Choi EH, Chu YW, Clark SA, Claus H, Coelho J, Corcoran M, Cottrell S, Cunney RJ, Dalby T, Davies H, de Gouveia L, Deghmane AE, Demczuk W, Desmet S, Drew RJ, du Plessis M, Erlendsdottir H, Fry NK, Fuursted K, Gray SJ, Henriques-Normark B, Hale T, Hilty M, Hoffmann S, Humphreys H, Ip M, Jacobsson S, Johnston J, Kozakova J, Kristinsson KG, Krizova P, Kuch A, Ladhani SN, Lam TT, Lebedova V, Lindholm L, Litt DJ, Martin I, Martiny D, Mattheus W, McElligott M, Meehan M, Meiring S, Molling P, Morfeldt E, Morgan J, Mulhall RM, Munoz-Almagro C, Murdoch DR, Murphy J, Musilek M, Mzabi A, Perez-Arguello A, Perrin M, Perry M, Redin A, Roberts R, Roberts M, Rokney A, Ron M, Scott KJ, Sheppard CL, Siira L, Skoczynska A, Sloan M, Slotved HC, Smith AJ, Song JY, Taha MK, Toropainen M, Tsang D, Vainio A, van Sorge NM, Varon E, Vlach J, Vogel U, Vohrnova S, von Gottberg A, Zanella RC, Zhou F (2021) Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the invasive respiratory infection surveillance initiative: a prospective analysis of surveillance data. Lancet Digit Health 3:e360\u2013e370","journal-title":"Lancet Digit Health"},{"key":"11034_CR5","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1186\/s13054-016-1498-8","volume":"20","author":"G Buchholz","year":"2016","unstructured":"Buchholz G, Koedel U, Pfister HW, Kastenbauer S, Klein M (2016) Dramatic reduction of mortality in pneumococcal meningitis. Crit Care 20:312","journal-title":"Crit Care"},{"key":"11034_CR6","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/S1474-4422(18)30499-X","volume":"18","author":"GBDN Collaborators","year":"2019","unstructured":"Collaborators GBDN (2019) Global, regional, and national burden of neurological disorders, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 18:459\u2013480","journal-title":"Lancet Neurol"},{"key":"11034_CR7","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1080\/14787210.2021.1858799","volume":"19","author":"T Demirdal","year":"2021","unstructured":"Demirdal T, Sen P, Emir B (2021) Predictors of mortality in invasive pneumococcal disease: a meta-analysis. Expert Rev Anti Infect Ther 19:927\u2013944","journal-title":"Expert Rev Anti Infect Ther"},{"issue":"1","key":"11034_CR8","doi-asserted-by":"publisher","first-page":"53","DOI":"10.32614\/RJ-2010-008","volume":"2","author":"MP Fay","year":"2010","unstructured":"Fay MP (2010) Two-sided exact tests and matching confidence intervals for discrete data. R J 2(1):53\u201358","journal-title":"R J"},{"key":"11034_CR9","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.1111\/apa.15792","volume":"110","author":"R Gavish","year":"2021","unstructured":"Gavish R, Levinsky Y, Dizitzer Y, Bilavsky E, Livni G, Pirogovsky A, Scheuerman O, Krause I (2021) The COVID-19 pandemic dramatically reduced admissions of children with and without chronic conditions to general paediatric wards. Acta Paediatr 110:2212\u20132217","journal-title":"Acta Paediatr"},{"key":"11034_CR10","doi-asserted-by":"crossref","unstructured":"Hanada S, Takata M, Morozumi M, Iwata S, Fujishima S, Ubukata K (2021) Multiple comorbidities increase the risk of death from invasive pneumococcal disease under the age of 65 years. J Infect Chemother","DOI":"10.1016\/j.jiac.2021.04.018"},{"key":"11034_CR11","doi-asserted-by":"crossref","unstructured":"Kies KD, Thomas AS, Binnicker MJ, Bashynski KL, Patel R (2020) Decrease in enteroviral meningitis\u2014an unexpected benefit of COVID-19 mitigation? Clin Infect Dis","DOI":"10.1093\/cid\/ciaa1881"},{"key":"11034_CR12","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.cmi.2019.04.032","volume":"26","author":"DLH Koelman","year":"2020","unstructured":"Koelman DLH, Brouwer MC, van de Beek D (2020) Resurgence of pneumococcal meningitis in Europe and Northern America. Clin Microbiol Infect 26:199\u2013204","journal-title":"Clin Microbiol Infect"},{"key":"11034_CR13","doi-asserted-by":"crossref","unstructured":"Koelman DLH, van Kassel MN, Bijlsma MW, Brouwer MC, van de Beek D, van der Ende A (2020) Changing epidemiology of bacterial meningitis since introduction of conjugate vaccines: three decades of national meningitis surveillance in the Netherlands. Clin Infect Dis","DOI":"10.1093\/cid\/ciaa1774"},{"key":"11034_CR14","volume-title":"Testing statistical hypotheses","author":"EL Lehmann","year":"2005","unstructured":"Lehmann EL, Romano JP (2005) Testing statistical hypotheses, 3rd edn. New York, Springer","edition":"3"},{"key":"11034_CR15","doi-asserted-by":"publisher","first-page":"5163","DOI":"10.1002\/jmv.26893","volume":"93","author":"L Luciani","year":"2021","unstructured":"Luciani L, Morand A, Zandotti C, Piorkowski G, Boutin A, Mazenq J, Minodier P, Ninove L, Nougair\u00e8de A (2021) Circulation of enterovirus A71 during 2019\u20132020, Marseille, France. J Med Virol 93:5163\u20135166","journal-title":"J Med Virol"},{"key":"11034_CR16","doi-asserted-by":"crossref","unstructured":"Luciani L, Ninove L, Zandotti C, Nougairede A (2021) COVID-19 pandemic and its consequences disrupt epidemiology of enterovirus meningitis, South-East France. J Med Virol","DOI":"10.1002\/jmv.26785"},{"key":"11034_CR17","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1016\/j.vaccine.2020.12.080","volume":"39","author":"M Middeldorp","year":"2021","unstructured":"Middeldorp M, van Lier A, van der Maas N, Veldhuijzen I, Freudenburg W, van Sorge NM, Sanders EAM, Knol MJ, de Melker HE (2021) Short term impact of the COVID-19 pandemic on incidence of vaccine preventable diseases and participation in routine infant vaccinations in the Netherlands in the period March-September 2020. Vaccine 39:1039\u20131043","journal-title":"Vaccine"},{"key":"11034_CR18","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/path.4438","volume":"235","author":"A Muehlenbachs","year":"2015","unstructured":"Muehlenbachs A, Bhatnagar J, Zaki SR (2015) Tissue tropism, pathology and pathogenesis of enterovirus infection. J Pathol 235:217\u2013228","journal-title":"J Pathol"},{"key":"11034_CR19","doi-asserted-by":"publisher","first-page":"3681","DOI":"10.1111\/ajt.16381","volume":"20","author":"SJ Olsen","year":"2020","unstructured":"Olsen SJ, Azziz-Baumgartner E, Budd AP, Brammer L, Sullivan S, Pineda RF, Cohen C, Fry AM (2020) Decreased influenza activity during the COVID-19 pandemic-United States, Australia, Chile, and South Africa, 2020. Am J Transplant 20:3681\u20133685","journal-title":"Am J Transplant"},{"key":"11034_CR20","unstructured":"RKI (2020) Epidemiologisches Bulletin 47"},{"key":"11034_CR21","unstructured":"RKI (2021) Epidemiologisches Bulletin 1"},{"key":"11034_CR22","unstructured":"RKI (2020) Epidemiologisches Bulletin 3"},{"key":"11034_CR23","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1016\/S0140-6736(03)13693-8","volume":"361","author":"X Saez-Llorens","year":"2003","unstructured":"Saez-Llorens X, McCracken GH Jr (2003) Bacterial meningitis in children. Lancet 361:2139\u20132148","journal-title":"Lancet"},{"key":"11034_CR24","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1001\/jama.2020.6173","volume":"323","author":"H Sakamoto","year":"2020","unstructured":"Sakamoto H, Ishikane M, Ueda P (2020) Seasonal influenza activity during the SARS-CoV-2 outbreak in Japan. JAMA 323:1969\u20131971","journal-title":"JAMA"},{"key":"11034_CR25","first-page":"545","volume":"117","author":"A Slagman","year":"2020","unstructured":"Slagman A, Behringer W, Greiner F, Klein M, Weismann D, Erdmann B, Pigorsch M, M\u00f6ckel M (2020) Medical emergencies during the COVID-19 pandemic. Dtsch Arztebl Int 117:545\u2013552","journal-title":"Dtsch Arztebl Int"},{"key":"11034_CR26","doi-asserted-by":"publisher","first-page":"1933","DOI":"10.3201\/eid2608.201229","volume":"26","author":"RJJ Soo","year":"2020","unstructured":"Soo RJJ, Chiew CJ, Ma S, Pung R, Lee V (2020) Decreased influenza incidence under COVID-19 control measures, Singapore. Emerg Infect Dis 26:1933\u20131935","journal-title":"Emerg Infect Dis"},{"key":"11034_CR27","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1093\/ofid\/ofab115","volume":"8","author":"L Stoffel","year":"2021","unstructured":"Stoffel L, Agyeman PKA, Keitel K, Barbani MT, Duppenthaler A, Kopp MV, Aebi C (2021) Striking decrease of enteroviral meningitis in children during the COVID-19 pandemic. Open Forum Infect Dis 8:115","journal-title":"Open Forum Infect Dis"},{"key":"11034_CR28","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.jhin.2020.07.023","volume":"106","author":"JY Tan","year":"2020","unstructured":"Tan JY, Conceicao EP, Sim XYJ, Wee LEI, Aung MK, Venkatachalam I (2020) Public health measures during COVID-19 pandemic reduced hospital admissions for community respiratory viral infections. J Hosp Infect 106:387\u2013389","journal-title":"J Hosp Infect"},{"key":"11034_CR29","doi-asserted-by":"crossref","unstructured":"Tanislav C, Jacob L, Kostev K (2021) Consultations decline for stroke, transient ischemic attack, and myocardial infarction during the COVID-19 pandemic in Germany. Neuroepidemiology 1\u20138","DOI":"10.1159\/000513812"},{"key":"11034_CR30","doi-asserted-by":"publisher","first-page":"16074","DOI":"10.1038\/nrdp.2016.74","volume":"2","author":"D van de Beek","year":"2016","unstructured":"van de Beek D, Brouwer M, Hasbun R, Koedel U, Whitney CG, Wijdicks E (2016) Community-acquired bacterial meningitis. Nat Rev Dis Primers 2:16074","journal-title":"Nat Rev Dis Primers"},{"key":"11034_CR31","doi-asserted-by":"publisher","first-page":"1814","DOI":"10.1002\/jmv.26614","volume":"93","author":"HE Yun","year":"2021","unstructured":"Yun HE, Ryu BY, Choe YJ (2021) Impact of social distancing on incidence of vaccine-preventable diseases, South Korea. J Med Virol 93:1814\u20131816","journal-title":"J Med Virol"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-022-11034-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-022-11034-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-022-11034-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T04:38:44Z","timestamp":1655872724000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-022-11034-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,22]]},"references-count":31,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["11034"],"URL":"https:\/\/doi.org\/10.1007\/s00415-022-11034-w","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,22]]},"assertion":[{"value":"3 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 February 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 February 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no financial or non-financial conflicts of interest regarding the publication of this article. AG reports speaker\u2019s honoraria from Bayer Vital GmbH, Bristol Myer Squibb, Daichii Sankyo, and a research grant from IPSEN outside the submitted work. OAO received payments for a consultancy from Biogen outside the submitted work. MK received speaker fees from BioMerieux. SV, MP, UK, HWP, TL, FS, FS, JH, JZ, AA, MW, AT, PS, IS, JOP, CO, SL, KB, TB, GW, GR, CU, JH, PL, MB, SS, BN, WN, CD and HH report no disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was approved by the ethics committee of the Ludwig-Maximilians-University (LMU) Munich (project number 21-0104\u00a0KB) and all responsible local ethics committees of the participating hospitals. The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"This article does not include identifying information from individual participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}