Case series of neurological complications in patients with COVID-19 infection in a tertiary care hospital

Objective: To report the clinical course, neurological complications and outcomes of thirty one patients admitted with diagnosis of COVID-19 in a tertiary care hospital. Background: There have been several case reports of various neurological manifestations of COVID-19. Patients can present with focal and or generalized neurological deficits including stroke, seizures, encephalopathy and meningitis. Design/Methods: Electronic medical records of patients who presented with or developed neurological symptoms and were diagnosed with COVID-19 were reviewed. Results: Charts of 31 patients were reviewed. Majority of the patients were male with only 7 female patients. The presenting age group varied between 35-80 years with majority of patients above the age of 60. About 50% of the patients were African American. The most common presenting neurological symptoms were acute change in mental status, followed by focal deficits including right or left hemiparesis, speech impairment (aphasia), headache and loss of sense of taste. During admission, 18 patients were diagnosed with acute stroke, 1 patient suffered from intracerebral and intraventricular hemorrhage, 2 were diagnosed with encephalitis and the rest were diagnosed with acute encephalopathy. Two patients developed seizures during their hospital course and another two patients were diagnosed with status epilepticus. All patients were treated with hydroxychloroquine, broad spectrum antibiotics, vitamins but only 50% were treated with prednisone. Two patients underwent thrombectomy, 2 received Intravenous alteplase and 2 patients received Intravenous Immunoglobulin. 20 patients required Intensive Care Unit stay and suffered from systemic complications - sepsis, respiratory failure, hypoxia and kidney failure. Majority of the patients were discharged to subacute rehabilitation, 6 were discharged home and 10 patients died. Length of stay varied between 2-45 days. Conclusions: COVID-19 can manifest with acute focal and or generalized neurological symptoms. In our experience, a third of patients presenting with/developing neurological symptoms passed away and two-thirds of patients recovered though most required rehabilitation.

A novel methodology for epidemic risk assessment of COVID-19 outbreak.

We propose a novel data-driven framework for assessing the a-priori epidemic risk of a geographical area and for identifying high-risk areas within a country. Our risk index is evaluated as a function of three different components: the hazard of the disease, the exposure of the area and the vulnerability of its inhabitants. As an application, we discuss the case of COVID-19 outbreak in Italy. We characterize each of the twenty Italian regions by using available historical data on air pollution, human mobility, winter temperature, housing concentration, health care density, population size and age. We find that the epidemic risk is higher in some of the Northern regions with respect to Central and Southern Italy. The corresponding risk index shows correlations with the available official data on the number of infected individuals, patients in intensive care and deceased patients, and can help explaining why regions such as Lombardia, Emilia-Romagna, Piemonte and Veneto have suffered much more than the rest of the country. Although the COVID-19 outbreak started in both North (Lombardia) and Central Italy (Lazio) almost at the same time, when the first cases were officially certified at the beginning of 2020, the disease has spread faster and with heavier consequences in regions with higher epidemic risk. Our framework can be extended and tested on other epidemic data, such as those on seasonal flu, and applied to other countries. We also present a policy model connected with our methodology, which might help policy-makers to take informed decisions.

Terahertz Spectroscopy Applied to Diagnostics in Public Health: A Review

Terahertz (THz) spectroscopy is an emerging technology that is that is bringing a number of technical breakthroughs in several scientific applications. This review aimed to describe potential applications of THz spectroscopy at the biochemistry and molecules detection for food industry, environment monitoring and diagnostics, and present the importance of such technological platform in disease control and Public Health.