Trigeminal neuralgia of COVID-19: meta-analysis

Introduction: trigeminal nerve is fifth cranial nerve carrying face sensation and dividing into ophthalmic, maxillary and mandibular divisions. Trigeminal neuralgia is clinical condition can be presenting in Covid19 patients. The current study reviews the clinical cases of trigeminal neuralgia of covid19 and explains the anatomical mechanism of pain and its radiation as present with associated symptoms. On current studies reviews entire cases covid19 since 2019 up to 2022 presenting with Trigeminal pain. It found to be a very rare reason comparing to the previous reasons such as infection, tumor, thrombosis, vasculitis, autoimmune disease leading to direct or indirect effects on trigeminal nerve demyelination. Knowing the case presentation of covid19 patient presenting with trigeminal neuralgia may lead to prevent further complications and saving patients life. Learning new clinical issues based on understanding the basic medical sciences prepare good safe physicians to raise their level of education resulting in good medical services in future. Pediatricians, internist, radiologist, ophthalmologist, Otorhinolaryngologists and surgeons has to be aware of this clinical presentation to be able to take more precaution and avid outbreak of corvid 19 infection between medical staffs in different regions of hospital such as clinics, wards, emergency rooms and operations.

Neurological manifestations in patients with COVID-19

Introduction: COVID-19 pandemic represents a challenge for healthcare systems, due to the impact on different systems, such as respiratory, cardiovascular and nervous systems. Background: to describe the neurological manifestations in patients with COVID-19. Methods: a search for information was carried out in the PubMed/Medline, SciELO, EBSCO, Lilacs and Scopus databases. A search strategy was applied by combining terms and using Boolean operators. Thirty references were chosen. Results: olfactory nerves and invasion of peripheral nerve terminals are suggested as routes of entry;the presence of severe neural symptoms associated with lesions of other organs and cytokine storm is also described. Headache was the most common neurological manifestation in patients with COVID-19, and rhabdomyolysis, acute hemorrhagic necrotizing encephalopathy, Guillain Barre syndrome, meningitis and encephalitis are rare neurological entities. In Guillain Barre syndrome, the literature suggests both a post infectious and para-infectious pattern. Conclusions: COVID-19 is associated with different neurological manifestations, including headache, dizziness, vertigo, vomiting, and alterations of consciousness, stroke and others not so frequent. These symptoms as a whole should be evaluated by healthcare personnel, with a view to their rapid detection and management, in order to guarantee the disappearance of sequelae that reduce the quality of life of patients, as well as to reduce the associated mortality records.

Clinical-epidemiological behavior of post-COVID-19 syndrome in patients at Andres Ortiz Polyclinic, 2021

Introduction: post-COVID-19 syndrome is the set of signs and symptoms that develop during or after an infection compatible with COVID-19, that persist for more than 12 weeks and are not explained by an alternative diagnosis. Background: to characterize the clinical-epidemiological behavior of the post-COVID-19 syndrome in patients at the Andres Ortiz Polyclinic. Method: a descriptive and cross-sectional observational study was carried out from October to December 2021, in a population of 51 subjects that was studied in its entirety. The analysis was descriptive. Results: patients with 50-59 years (n = 20;39.2%), female (n = 32;62.7%) predominated. The most frequently affected organ system was the respiratory (n = 19;37.2%), while the symptoms were: chronic fatigue (n = 15;29.4%), shortness of breath (n = 11;21.5%) and cough (n = 8, 15.6%). Among the patients with respiratory (n = 30), cardiovascular (n = 24) and neurological (n = 10) diseases, the most frequent were, respectively: pulmonary fibrosis (n = 17;56.7%), cardiac arrhythmias (n = 11;45.8%) and peripheral neuropathies (n = 5;50%). Conclusions: post-COVID-19 syndrome occurred mainly between the ages of 50 and 59, in female patients, with symptoms of chronic fatigue, shortness of breath and cough, as well as pulmonary fibrosis, cardiac arrhythmias and peripheral neuropathies as main comorbidities.

COVID-19 entry

This editorial provides a brief information on how the coronavirus initially enters into the central nervous system (CNS) via the synaptic route followed by first capturing the Peripheral nerves, where trans-synaptic transfer in avian bronchitis and HEV67 virus. It has been observed in the study that SARS-CoV possess ananalogous potential with SARS-CoV-2, and both are highly similar. The mechanism about the entry of coronavirus into the nose, invade in CNS through olfactory bulb while nasal infection which leads to cause demyelination and inflammation, Further it reaches to the whole brain via Barrier of Blood-Brain and CSF via Blood-CSF barrier within 7 days which leads to respiratory disease due to the inability of air into the lungs as the defects in respiration controlled by the nervous systemand patients show symptoms like neurologic signs. According to theepidemiology study, the first symptom is dyspnoea which shows within 5 days, followed by admission in hospital at 7 days and intensive care at 8 days for SARS-CoV-2 and this latency period is sufficient for the virus to enter into CNS and destroy the medullary neurons which further causes respiratory problems.

SARS-CoV-2 Dissemination Through Peripheral Nerves Explains Multiple Organ Injury.

Coronavirus disease (CoVID-19), caused by recently identified severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), is characterized by inconsistent clinical presentations. While many infected individuals remain asymptomatic or show mild respiratory symptoms, others develop severe pneumonia or even respiratory distress syndrome. SARS-CoV-2 is reported to be able to infect the lungs, the intestines, blood vessels, the bile ducts, the conjunctiva, macrophages, T lymphocytes, the heart, liver, kidneys, and brain. More than a third of cases displayed neurological involvement, and many severely ill patients developed multiple organ infection and injury. However, less than 1% of patients had a detectable level of SARS-CoV-2 in the blood, raising a question of how the virus spreads throughout the body. We propose that nerve terminals in the orofacial mucosa, eyes, and olfactory neuroepithelium act as entry points for the brain invasion, allowing SARS-CoV-2 to infect the brainstem. By exploiting the subcellular membrane compartments of infected cells, a feature common to all coronaviruses, SARS-CoV-2 is capable to disseminate from the brain to periphery via vesicular axonal transport and passive diffusion through axonal endoplasmic reticula, causing multiple organ injury independently of an underlying respiratory infection. The proposed model clarifies a wide range of clinically observed phenomena in CoVID-19 patients, such as neurological symptoms unassociated with lung pathology, protracted presence of the virus in samples obtained from recovered patients, exaggerated immune response, and multiple organ failure in severe cases with variable course and dynamics of the disease. We believe that this model can provide novel insights into CoVID-19 and its long-term sequelae, and establish a framework for further research.