Senility and COVID-19 as two possible risk factors for loss of consciousness: A rare case report.

Introduction: and Importance: More than two years after the start of the COVID-19 pandemic, the world is still grappling with this dilemma. COVID-19 covers a wide range of symptoms. Loss of consciousness (LOC) is a very rare symptom that can threaten a patient's life and blur the prognosis of recovery. Case presentation: An 89-year-old woman was presented to the emergency department with LOC (Glasgow Coma Scale (GCS) score = 3) without any history of the underlying disease and was immediately admitted to the intensive care unit. In brain imaging, severe small vessel disease was diagnosed by observing partial dilatation of the ventricles, sulcus, and hypodense areas in the periventricular area. Lung imaging propounded COVID-19 by detecting the ground glass pattern with 50%-75% involvement. After detecting severe acute respiratory syndrome coronavirus 2 nucleic acid by reverse transcription-polymerase chain reaction, COVID-19 treatment was performed according to the national protocol. Finally, she was discharged after 26 days of hospitalization with partial recovery. Clinical discussion: COVID-19-induced cytokine storm along with old age appears to increase LOC risk. It can be claimed that COVID-19-induced LOC can be considered as one of the symptoms of COVID-19 in the elderly population. Therefore, more attention should be paid to this population, which is more at risk. Conclusion: Few reports illustrate the LOC as a COVID-19 presentation. This report highlights the fact that older people are more at risk for COVID-19-induced LOC than other age groups and should be given more care.

Neurological Manifestations in Critically Ill COVID-19 Patients

Patients with COVID-19 frequently experience neurological symptoms. Headaches and dizziness are common but non-specific symptoms. Both peripheral and central nervous systems can be impacted in severe stages. We focused on the neurological manifestations of COVID-19 patients in critical care. A cohort study evaluated the acute neurological manifestations in 204 patients admitted to intensive care units (ICU) tertiary Imam Khomeini hospital complex, Tehran, Iran. Patients with positive COVID-19 tests and severe clinical symptoms in both sexes, older than 16 years, were included in the study. Two groups of patients with positive or negative neurologic complications were compared by chi-square or Fisher exact test for categorical variables. The differences in continuous variables between the two groups were investigated using an independent sample t-test. The Kolmogorov-Simonov test was used to verify the normality assumption. A P less than 0.05 was considered statistically significant. The study included 204 individuals (130 males and 74 females) out of 270 ICU patients. Ninety (44.1%) patients were discharged, while 114 (55.9%) died. Overall, 17 (8.3%) patients had neurological complications, while 187 (91%) did not (P=0.005). The two groups did not have significantly different mean age (P=0.325) and sex (P=.793). The ventilation support was significantly different in the two groups (P=0.002). The death group had a higher incidence of loss of consciousness (P=0.003). COVID-19 causes neurological symptoms, especially during the inflammatory phase, and clinicians should be alert for neurological issues. [ FROM AUTHOR] Copyright of Acta Medica Iranica is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Classification and detection of covid-19 in human respiratory lungs using convolutional neural network architectures

The covid-19 was discovered for the first time in the Wuhan region of China. It was on December 31, 2019, that it all started. The speed of propagation of this germ has grown exponentially and on a planetary scale. This disease caused panic among specialists because the virus caused a high fever with cough in the patient and loss of consciousness. The worst part of all of this was that the coronavirus was virulent and contagious. The doctors did not know how to fight this new disease. Researchers in medical imaging opted for the tool of artificial intelligence, more particularly the technology of deep learning with its architectures of convolutional neural networks. The goal is the classification and detection of coronavirus disease. In our paper, we propose to study coronavirus disease. First, we will classify x-ray pictures into three main classes (viral pneumonia, normal, and covid-19). Then, we will use deep learning technology with convolutional neural network architectures. The architecture used is VGG, InceptionV3, DenseNet, MobileNet, ResNet, and Xception. The test results are satisfactory, with an accuracy of 95.83% for MobileNetV1 and 98.95% for ResNet101. © 2021 IEEE.

SAFETY OF PROPOFOL FOR SEDATION IN PATIENTS WITH COVID-19 ACUTE RESPIRATORY DISTRESS SYNDROME

B Introduction: b Patients with acute respiratory distress syndrome (ARDS) require deep sedation and neuromuscular blockade to facilitate ventilator synchrony. B Conclusion: b In patients receiving continuous propofol infusions for sedation in ARDS, this study found that patients with C-ARDS had a higher rate of hypertriglyceridemia compared to non-C-ARDS. It has been observed that patients with COVID-19 ARDS (C-ARDS) often have higher sedation requirements. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

SUCCESSFUL MANAGEMENT OF PROPOFOL DEPENDENCE WITH PHENOBARBITAL IN AN ADULT PATIENT WITH COVID-19

B Discussion: b Extended courses of deep sedation are often required in mechanically ventilated COVID-19 patients and may result in withdrawal phenomena not previously seen with standard sedation practices. B Introduction: b Coronavirus Disease 2019 (COVID-19) brought unique challenges to the management of pain and agitation in mechanically ventilated patients. Over the next 36 hours, the patient received 5 more doses of phenobarbital 130 mg at 8 to 12 hour intervals until propofol was discontinued. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

SARS-CoV-2 Infection in the Central and Peripheral Nervous System-Associated Morbidities and Their Potential Mechanism.

The recent outbreak of SARS-CoV-2 infections that causes coronavirus-induced disease of 2019 (COVID-19) is the defining and unprecedented global health crisis of our time in both the scale and magnitude. Although the respiratory tract is the primary target of SARS-CoV-2, accumulating evidence suggests that the virus may also invade both the central nervous system (CNS) and the peripheral nervous system (PNS) leading to numerous neurological issues including some serious complications such as seizures, encephalitis, and loss of consciousness. Here, we present a comprehensive review of the currently known role of SARS-CoV-2 and identify all the neurological problems reported among the COVID-19 case reports throughout the world. The virus might gain entry into the CNS either through the trans-synaptic route via the olfactory neurons or through the damaged endothelium in the brain microvasculature using the ACE2 receptor potentiated by neuropilin-1 (NRP-1). The most critical of all symptoms appear to be the spontaneous loss of breathing in some COVID-19 patients. This might be indicative of a dysfunction within the cardiopulmonary regulatory centers in the brainstem. These pioneering studies, thus, lay a strong foundation for more in-depth basic and clinical research required to confirm the role of SARS-CoV-2 infection in neurodegeneration of critical brain regulatory centers.