Possible autoimmune pediatric encephalitis following COVID-19 infection with focal cerebral dysfunction in a young female: A case report

Introduction: Post-COVID-19 autoimmune encephalitis is a rare manifestation following COVID-19. Most cases have not demonstrated solid evidence regarding their pathogenesis. Some believe it to be an immune process. Case presentation: In this case report, we present a case of a young female who presented to our emergency department with visual, auditory, and olfactory hallucinations after successfully treating COVID-19 two weeks prior to this visit. On examination, her vital signs were stable, but she was agitated, distressed, and hallucinating. Neurological examinations were normal. Laboratory investigations, including autoimmune profiles, were all negative. Magnetic resonance imaging of the brain showed non-specific changes in the bilateral frontal area. Electroencephalography (EEG) showed lateralized rhythmic delta activity (LRDA) arising more from the right occipital lobes. Autoimmune psychosis was suspected due to psychosis, abnormal imaging, and abnormal EEG findings. She was given corticosteroids and antipsychotic medication. Her symptoms improved within ten days. On follow-up, she remained well without any return of psychosis. Conclusion(s): Possible autoimmune pediatric encephalitis following COVID-19 is a rare entity that has scarcely been reported. The majority of the cases were reported to have been related to stress following the infection. To establish the correct diagnosis, an extensive workup, including an autoimmune profile, lumbar puncture, magnetic resonance imaging, and electroencephalography, is recommended.Copyright © 2022 The Author(s)

Examining implicit neural bias against vaccine hesitancy.

COVID-19 pandemic has changed the world in many ways. At the societal level, disparities in attitudes toward the COVID-19 vaccines have led to polarization and intense animosity. In this study, we use a novel paradoxical thinking intervention that was found to be effective in difficult and violent intergroup contexts, and measure its effectiveness in a novel unobtrusive way in an important and timely context, namely prejudice against vaccine hesitancy. In the midst of a vaccination campaign, 36 young Finnish adults either went through the intervention or through a control condition. Magnetoencephalography then measured a neural response that is thought to reflect intergroup bias and possibly implicit prejudice. This neural response was reduced among the participants receiving the intervention, compared to the control group, thereby suggesting a potential mechanism of intergroup bias that is affected by a psychological intervention even during a campaign that castigates aggressively vaccine-hesitant individuals. The findings reported here contribute to the recent accumulating evidence of the potential of neuroimaging to reveal covert mental effects by psychological interventions. They may also have societal implications for moderating the polarized attitudes in a new era of pandemics.

Clusters of SARS-CoV-2 infection across six schools for children with intellectual and developmental disabilities

Background. In-person learning is important for children with intellectual and developmental disabilities (IDD) because of the additional health, vocational, and functional services for students at these schools. It may be difficult to reduce SARS-CoV-2 transmission in IDD schools because students require assistance with activities of daily living such as eating, during which social distancing and masking cannot occur. Surveillance testing and cluster tracking in schools for children with IDD, which may be considered high-risk environments for transmissions, could have benefits for mitigating transmission and keeping students in schools. The objective of this study was to identify SARS-CoV-2 clusters in IDD specific schools to compare viral transmission in delta and BA.1 variant waves. Methods. A saliva-based PCR test was offered to students and staff for weekly SARS-CoV-2 screening at six Special School District (SSD) schools dedicated to children with IDD. Clusters, which are considered 2 or more positives cases in the same classroom having an epidemiological link, were then recorded. All weekly testing took place between November 23, 2020 and May 27, 2022. Clusters were recorded from November 15, 2021 to January 28, 2022. A Fisher's exact test was used to compare categorical variables. Results. 545 (90%) and 113 (16%) students participated in weekly testing. 160 participants tested positive throughout the study, 23 (14%) during the delta variant wave and 115 (72%) during the BA.1 variant wave. There was no significant variation in age, race, ethnicity, gender, or vaccination status between positive cases recorded from alpha, delta, and BA.1 variant waves (Table 1). Notably, the vaccination rate of positive participants was lower than the vaccination rate of participants who did not test positive. 42 clusters were recorded, 3 (7%) during the delta variant wave and 39 (93%) during the BA.1 variant wave (Fig. 1). Conclusion. The highly transmissible BA.1 variant resulted in an increase in clusters observed in IDD specific schools. Mitigation strategies for less transmissible alpha and delta waves were not as effective in reducing transmission during the BA.1 wave.

Impact of Kevzara on the Survival and the Need for Renal Replacement Therapy (RRT) in the Alpha-Wave of COVID-19 Patients: Retrospective Cohort Study

Background: The alpha wave of COVID-19 brought death and dismay to patients and to providers respectively. Remdesivir nor plasma was available. We studied this cohort to evaluate the need for mechanical ventilation (MV) and Renal replacement therapy and the outcome of hospital discharge. Is well known that the covid-19 causes Cytokine Release Syndrome (CRS), therefore, producing dysregulation and an increase in the immune response, interleukine 6, plays and central role in triggering the (CRS) and stimulating other inflammatory markers. Method(s): A retrospective-observational study. We reviewed the patients admitted to the intensive care unit of a metropolitan hospital in the Los Angeles area from February 17th, 2020, till March 14th, 2020. There was 24 patient who was in the ICU. At the time, Remdesivir was not available at the hospital Results: Eight of the 24 patients received Kevzara. Of the 8 patients, 2 required RRT while of the 16 patients who did not receive Kevzara, 6 required RRT. All 8 patients who received RRT also had MV for varying number of days and all were alive at 28 days. Among the 16 patients who did not receive Kevzara, 11 required mechanical ventilation, and 6 got RRT. 5 patients got both MV and RRT. The number of days of RRT was required was 12 in the Kevzara group and 4.25 in the none-Kevzara group. Chi Square value of 5.3706 p value = <0.5 Conclusion(s): Kevzara reduced 28-d mortality in the alpha wave of covid-19. There is incremental value in the use of Kevzara and Organ support technologies such as MV and RRT in the ICU. As the patient's life is prolonged in critical care units, there is increased demand for renal replacement therapy resources.

A validation study for a consumer-grade auditory-visual stimulation device

Self-care and improving one’s well-being has been growing rapidly in recent years for manifold reasons (e.g. higher workload, corona pandemic). Consumer-grade noninvasive stimulation devices are therefore on the rise to counteract the occurrence of mood disorders and burn-out symptoms. Here, we aim at investigating the impact of dynamically varying auditory-visual stimulation patterns on neural entrainment patterns and resonance phenomena. Twenty-two healthy volunteers (11 female, 25.4±5.1 years, one dropout, seven in control group) participated in the study. EEG data (64 channel;equidistant layout) were acquired pre- and during stimulation for each volunteer. Visual and auditory stimuli were presented via a headset (ATUM, NeuroBright;https://www.neurobright.co.uk/). Presentation patterns (frequency, intensity, spatial distribution) varied within a presentation session but were kept constant across all volunteers. Stimulus intensity was adjusted to individual comfort levels. Individual alpha peak frequencies (iAPF) were calculated via the power spectral density with 50% overlapping 10s epochs from pre-stimulation segments. For both, the study and the control group, a time-frequency representation was calculated for the pre- and during-stimulation segments. From this, power values were determined for different frequency-bands (iAPF, stimulation frequencies and second harmonics of the latter). Statistical analyses focused on contrasting the power values between pre- and during stimulation. Mean iAPF values were 10.25±0.99Hz for the study and 10.63±1.21Hz for the control group respectively. Both, power values at the stimulation frequencies and their second harmonics differed significantly between pre- and during stimulation (pstim=0.001;pharm=0.001) in the study group. No such difference was found for the control group (pstim=0.352;pharm=0.237). Further, neither the study nor the control group showed significant iAPF power differences (pstudy=0.035;pcontrol=0.352;alpha*=0.008). Our results suggest that lightweight, portable auditory-visual presentation devices represent an effective tool for generating entrainment and resonance effects at home. Further analyses will focus on the investigation of individual differences driving such modulatory effects. © 2022 The Author(s), published by De Gruyter.