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Neurological Sciences ; 43(Supplement 1):S334-S335, 2022.
Article in English | EMBASE | ID: covidwho-2174374


Objective: Cranial nerves are frequently affected in patients with COVID-19, indeed smell and taste disturbances are some of the most frequent self-reported neurological symptoms. Previous studies suggested a concomitant impairment of the trigeminal nerve in patients with olfactory disturbances, however it has never been confirmed with objective measurements techniques. The aim of this study was to assess the trigeminal function with electrophysiological tests and its correlation with clinical data. Materials: The study involved 16 patients with mild course COVID-19 infection and smell disturbances and 14 healthy controls (HCs). Olfactory and gustatory symptoms were assessed with self-reported questionnaires, whereas the trigeminal impairment was assessed by electrophysiological tests. Method(s): At the time of enrollment (T0), all participants underwent a baseline interview, assessing general demographic and clinical variables, a neurological and ear-nose-throat physical examination. A clinical follow-up was performed after one month (T1) in all patients and after 20 months (T2) in a subgroup of seven patients. Electrophysiological evaluations of Masseter Inhibitory Reflex (MIR) and Blink Reflex (BR) were assessed at T0 and at T2 in a subgroup of seven patients. Result(s): At T0 MIR revealed a significant increase in the latency of the ipsilateral and contralateral early Silent Period (SP1) compared to HCs. Differences in SP1 and SP2 duration between patients and HCs were not significant;however, a subgroup of patients showed an increase of SP1 duration compared to HCs. The analysis of BR revealed a significant increase of R1 amplitude compared to HCs. At T2 the number of alterations at MIR examination was reduced and the amplitude of R1 normalized at follow-up in most of the patients. Discussion(s): The increase in the latency of ipsilateral and contralateral SP1 in the patients' group suggests a peripheral involvement of the mandibular branch rather than the ophthalmic division of the trigeminal nerve. The increased amplitude of R1 at BR examination and the prolonged SP1 duration at MIR might be explained as a compensatory upregulation of trigeminal function as consequence of the olfactory damage. Conclusion(s): Patients with COVID-19 and smell impairment show a subclinical trigeminal nerve impairment. Trigeminal alterations seem to mainly involve the oligosynaptic pathway, as result of either direct viral damage or secondary neuroinflammation of the peripheral trigeminal fibers, whereas the polysynaptic ponto-medullary circuits seem to be spared.

Neurological Sciences ; 43(Supplement 1):S219, 2022.
Article in English | EMBASE | ID: covidwho-2174296


Objectives: We performed a multicenter, prospective and retrospective, observational study, to evaluate the risk of disease relapse after COVID-19 vaccination in patients with chronic inflammatory neuropathies and the safety and tolerability of COVID-19 vaccines in these patients. Materials: Study subjects were chosen from among patients with CIDP or MMN included in the Italian CIDP and MMN databases. Method(s):We invited to participate CIDP and MMN patients fulfilling the EFNS/PNS criteria for probable/definite diagnosis who had been in a stable maintenance treatment or in remission without ongoing active treatment in the three months prior to the commencement of the study. We assessed the relative risk (RR) of relapse associated with COVID-19 vaccination by comparing patients who underwent or did not undergo vaccination. We also compared the frequency of relapse in CIDP and MMN patients undergoing vaccination for COVID-19 in the three months prior and after vaccination and evaluated safety and tolerability of the COVID-19 vaccines. Subjects were evaluated using objective outcome measures and a specific questionnaire. Result(s): A total of 336 patients were included (278 CIDP;58MMN). 307 (91%) patients underwent COVID-19 vaccination, including 269 (88%) with Pfizer/BioNTech, 28 (9%) with Moderna, and 10 (3%) with AstraZeneca. Twenty-nine patients (9%) did not undergo vaccination. Clinical relapse was observed in 16 (5.2%) patients (13 CIDP;3 MMN) who underwent COVID-19 vaccination and in none of the patients who did not undergo vaccination (RR= 3.21, 95% confidence interval [CI] 0.19-52.25). Compared to the 3-month control period preceding baseline, during which 4 (1.3%) of the 307 vaccinated patients had a disease relapse, the relative risk of relapse was increased. (RR: 4.00;95% CI, 1.35 to 11.82). The specific RR for Pfizer/BioNTech was 2.77 (95% CI, 0.16 - 45.74), and for Moderna was 9.31 (95% CI, 0.52 -165.33). None of the 10 patients who received the Astrazeneca vaccine had a relapse. The specific RR of relapse associated with COVID-19 vaccination in CIDP patients was 1.96 (95% CI, 0.12 to 31.81), while inMMN patients was 1.75 (95% CI, 0.09 - 31.64). The safety profile of the COVID-19 vaccines was similar to that observed in the general population. There were no serious adverse events. Discussion(s): Vaccination for COVID-19 in patients with CIDP and MMN seems to be associated with a small increased risk of disease relapse, and with an acceptable short-term safety profile. Conclusion(s): The benefits of COVID-19 vaccination in CIDP and MMN patients outweigh the risk of disease relapse.

Journal of African Media Studies ; 13(2):207-220, 2021.
Article in English | Web of Science | ID: covidwho-1266556


The article discusses the freedom of expression crisis that characterized the authoritarian response of the Egyptian government to the COVID-19 pandemic. Through the case study of the expulsion of the foreign correspondent for The Guardian over contested outbreak data, the article argues that authorities in Egypt exploited the pandemic for political ends by silencing critics and by manipulating the public opinion.