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1.
Frontiers in Psychology ; 13:923316, 2022.
Article in English | MEDLINE | ID: covidwho-1974676

ABSTRACT

People with dementia have an increased risk of contracting severe forms of COVID-19. Although in worldwide vaccination programs priority has been given to older people, having taken the vaccine does not totally eliminate the risk of contracting COVID-19 when one is in close contact with unvaccinated people. Thus, family caregivers' choices to remain unvaccinated against COVID-19 could have potentially lethal consequences for their relatives. To our knowledge, this study represents the first attempt within the international literature to analyze COVID-19 vaccine uptake among family caregivers of people with dementia and to identify some of the psychological factors, related to COVID-19 and vaccination behavior, that could facilitate or hinder vaccine uptake. Contact information for family caregivers was obtained from five different centers and associations throughout the Italian territory. Data were collected from 179 respondents during July-September 2021 using a cross-sectional web-based survey design. More than 75% of the respondents indicated that had been vaccinated against COVID-19 and reported receiving vaccine information mainly from print or electronic newspapers (86%), followed by TV (81%) and families (64.2%). In multivariable logistic regression analyses, worries about unforeseen future effects was significantly related to COVID-19 vaccine uptake, indicating that family caregivers concerned about potential side effects of vaccines were less likely to have been vaccinated against COVID-19 (OR = 0.60, CI = 0.40-0.89). Openness to experience was also related to COVID-19 vaccine uptake, with family caregivers higher on this trait being less likely to have been vaccinated against COVID-19 (OR = 0.83, CI = 0.71-0.98). Implications for targeting of vaccine-related messages are discussed.

2.
Milano University Press. Chapter ; 16:02, 2021.
Article in English | MEDLINE | ID: covidwho-1836687
4.
Journal of the Neurological Sciences ; 429, 2021.
Article in English | EMBASE | ID: covidwho-1466657

ABSTRACT

Background and aims: The number of cases of encephalitis in COVID-19 pandemic is increasing. We describe characteristics and outcome of encephalitis in COVID-19 (COV-ENC) patients in one of the most affected regions by COVID-19 of the world, Lombardia, during the first pandemic wave. Methods: A multi-center observational study on neurological complications in COVID-19 patients was conducted by the Italian society of Hospital Neuroscience (SNO). Adult patients admitted to 20 Neurological Departments in Lombardia between February-April 2020 with COV-ENC have been included. Results: 30 COV-ENC patients had a mean age of 66.5 years and male frequency of 56.6%. Altered consciousness was characterized by confusion in 86%, coma in 30%, delirium in 37.9% and alteration of personality traits in 27.6%. Epileptic seizures occurred in 74% of cases. One third of cases had hyperproteinorrachia, one third pleocytosis/hyperproteinorrachia, and remaining third had a normal CSF. PCR for SARS-CoV-2 was negative in all tested patients. EEG was altered in 82.7% of patients. Brain CT and MRI were normal in 9 patients, and among abnormal findings 9 patients had mesial temporal lesions, one of which confirmed with PET imaging. The course was favorable in 39.2% of patients, sequelae were few in 26.6% and moderate in 19.2%, while 20% of patients died. Conclusions: The outcome tends to be worse in male patients. PCR negativity seems to confirm an autoimmune etiology more than a direct invasion of the virus. However, a temporal lobe involvement, detected in 30% of patients with COV-ENC, suggests usual sites of encephalitis due to herpes virus.

5.
European Journal of Neurology ; 28(SUPPL 1):768, 2021.
Article in English | EMBASE | ID: covidwho-1307812

ABSTRACT

Background and aims: Recent reports have linked SARSCoV- 2 infection with para- and post-infectious autoimmune encephalitis, suggesting cytokine storm as a possible pathogenesis. Methods: We describe a patient who developed acute encephalitis three weeks after resolution of SARS-CoV-2 infection symptoms, coincident with a rise in serum anti- SARS-CoV-2 antibodies. Results: A 29 year-old man presented with fluent aphasia and ideo-motor apraxia since awakening in the morning, mimicking a stroke. His brain CT, angio-CT and perfusion CT were all negative;an urgent brain MRI revealed nonspecific FLAIR hyperintensities. After a lumbar puncture, showing 150 lymphocytes and elevated proteins, his symptoms suddenly started improving, with complete resolution two hours later. An urgent EEG showed left temporal slow waves. A SARS-CoV-2 swab turned negative, and he was admitted to the Neurology department with antiviral and antibiotic treatment. His wife had PCRconfirmed Covid-19 infection a month before, and he experienced fever and hyposmia the following week. Over the course of a month he experienced another aphasic episode, resolved with diazepam. Serum SARS-CoV-2 antibodies title increased and decreased over three weeks;notably, serial EEG showed worsening of epileptic activity along with the rise in SARS-CoV-2 antibodies title, despite anti-epileptic treatment. A brain PET was non-significant, and his CSF parameters slowly improved only after a five days cycle of methylprednisolone. Serum anti-surface antigens antibodies and CSF SARS-CoV-2 IgG were negative. Conclusion: The patient was discharged with double antiepileptic therapy after exclusion of known causes of encephalitis (infectious, paraneoplastic, autoimmune);therefore, in our opinion, the most probable diagnosis was SARS-CoV-2-related post-infectious encephalitis. (Figure Presented).

6.
European Journal of Neurology ; 28(SUPPL 1):103, 2021.
Article in English | EMBASE | ID: covidwho-1307709

ABSTRACT

Background and aims: Several studies reported increased incidence of Guillain-Barre' Syndrome (GBS) after Zika epidemic, SARS-CoV and MERS, and more recently SARS-CoV-2 infection. We estimate incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients in one of the most affected regions by COVID-19 of the world, Lombardia. Methods: A multi-center observational study on neurological complications in COVID-19 patients was conducted in 20 Neurology Units by the Italian society of Hospital Neuroscience (SNO). Adult patients admitted to Neurological units between February-April 2020 with COVID19-GBS were included. Results: 38 COVID19-GBS patients had mean age of 60.7 years and male frequency of 86.8%. Mean interval between COVID-19 onset and GBS onset was 15.1 days. CSF albuminocytologic dissociation was detected in 71.4% of cases, PCR for SARS-CoV-2 negative in all 15 tested patients, and anti-ganglioside antibodies positive in 43.7%. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP diagnosis, 12.1% AMSAN and 6% AMAN. 29 patients have been treated with intravenous Immunoglobulin (IVIg), two with plasma exchange (PE), two with PE followed by IVIg and five untreated. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.1% worsened, of which three died. The estimated occurrence rate in Lombardia is 0.5 GBS cases per 1000 COVID-19 infections. Conclusion: We detected an increased incidence of GBS in COVID-19 patients which can reflect higher risk of GBS in COVID-19 patients or be secondary to an increase of prevalence of prior infection in that period.

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