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1.
BMJ Case Rep ; 15(3)2022 Mar 08.
Article in English | MEDLINE | ID: covidwho-1736042

ABSTRACT

Although neurological manifestations such as headache and myalgias have been observed with COVID-19, presentation with more serious neurological illness is uncommon and rare. We report a case of a middle-aged woman who presented to the emergency department of a tertiary care hospital. Her clinical presentation was primarily neurological rather than the more common presentation with respiratory manifestations. She presented with generalised tonic-clonic seizures, along with history of undocumented low-grade fever and generalised body aches. The positive SARS-CoV-2 RT-PCR nasal swab, the cerebrospinal fluid analysis (lymphocytic pleocytosis) and electroencephalogram were consistent with viral encephalitis; brain imaging was unremarkable. This case highlights the variable presenting features of COVID-19 infection as patients can primarily present with neurological manifestations in the absence of significant respiratory symptoms. We believe it is important to recognise neurological disease associated with SARS-CoV-2 in patients with asymptomatic respiratory infection.


Subject(s)
Brain Diseases , COVID-19 , Status Epilepticus , Brain Diseases/complications , COVID-19/complications , Female , Humans , Middle Aged , SARS-CoV-2 , Seizures/etiology , Status Epilepticus/complications
2.
Br J Clin Pharmacol ; 88(6): 2969-2972, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1672996

ABSTRACT

Mild encephalopathy with a reversible splenial lesion syndrome (MERS) is a rare clinico-radiological entity. Rituximab (RTX)-induced MERS has never been described before. Herein, we report the case of a 33-year-old patient diagnosed since 2017, with an IgG4-related disease (IgG4-RD). This diagnosis was retained in the face of a prolonged fever, sicca syndrome, hepatic damage and renal pseudotumour associated to a high level of IGg4 at 2.8 g/L with suggestive renal histology. The patient was treated with corticosteroid therapy with persistence of renal impairment and nephrotic syndrome indicating RTX therapy. The patient received his first dose of RTX and presented neurological and respiratory impairments a few hours afterwards. An infectious investigation comprising a SARS CoV-2 PCR and viral PCRs (VZV, herpes and CMV) on cerebrospinal fluid (CSF) were negative. The HBV, HCV, HIV, Parvo B19, CMV, EBV, herpes, mycoplasma and syphilis serologies as well as Legionella antigenuria were also negative. The patient had received intravenous immunoglobulins (IVIG) and methylprednisone, associated with sodium valproate with favourable outcome. The diagnosis of MERS induced by RTX was retained in our patient according to clinical and radiological features. We herein report the first case of MERS following RTX in a patient treated for IgG4-RD.


Subject(s)
Brain Diseases , COVID-19 , Cytomegalovirus Infections , Drug-Related Side Effects and Adverse Reactions , Encephalitis , Immunoglobulin G4-Related Disease , Adult , Brain Diseases/chemically induced , Brain Diseases/complications , Brain Diseases/diagnosis , Corpus Callosum/diagnostic imaging , Corpus Callosum/pathology , Encephalitis/complications , Encephalitis/diagnosis , Encephalitis/pathology , Humans , Immunoglobulin G4-Related Disease/complications , Immunoglobulin G4-Related Disease/pathology , Magnetic Resonance Imaging , Rituximab/adverse effects
3.
Indian J Pharmacol ; 53(6): 499-510, 2021.
Article in English | MEDLINE | ID: covidwho-1603884

ABSTRACT

BACKGROUND: Till now, no meta-analysis is available to address the clinical profile, risk factors, different interventions, and outcomes among COVID-19-associated rhino-orbito-cerebral mucormycosis (C-ROCM) cases. MATERIALS AND METHODS: Eight literature databases were screened using appropriate keywords from November 1, 2019, to June 30, 2021. The objectives were to analyze the clinical and microbiological profile, risk factor/comorbidity, intervention, and outcome. "R-metafor package" was used for analysis. RESULTS: A total of 23 studies were included. The mean age of presentation of C-ROCM was 54.6 years. The most common presentation was ptosis (72.7%), lid edema (60.6%), proptosis (60.6%), ophthalmoplegia (57.3%), loss of vision (53.7%), facial edema (34.7%), and nasal-blockage (11.8%). Evidence of intracranial spread was seen in 42.8% of cases. Rhizopus was the most common fungus (57.1%) isolated in fungal culture. Among C-ROCM patients, diabetes was the commonest comorbid condition, and the use of corticosteroids related to COVID-19 treatment was the most common risk factor (85.75%). Compared to controlled diabetics, C-ROCM was significantly higher among uncontrolled diabetics (odds ratio [OR] 0.15, 95% confidence interval [C.I.] 0.041-0.544, P = 0.0010). However, no significant association was seen between C-ROCM and COVID-19 severity (OR 0.930, 95% C.I. 0.212-4.087, P = 0.923). For treatment, amphotericin-B was the most common antifungal drug used which was followed by surgical options. However, mortality was high (prevalence 0.344, 95% C.I. 0.205-0.403) despite treatment. CONCLUSION: Although local rhino-orbito symptoms were the first to appear, rapid intracranial extension was seen in a significant number of C-ROCM cases. Uncontrolled diabetes and excessive use of corticosteroid were the most common risk factors present among the C-ROCM cases. High index clinical suspicion is imperative (specifically among COVID-19 patients with diabetes), and routine screening may be helpful.


Subject(s)
Brain Diseases/complications , COVID-19/complications , Mucormycosis/complications , Nose Diseases/complications , Orbital Diseases/complications , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Brain Diseases/drug therapy , COVID-19/virology , Humans , Mucormycosis/drug therapy , Nose Diseases/drug therapy , Orbital Diseases/drug therapy , Regression Analysis , Risk Factors , SARS-CoV-2/isolation & purification
4.
J Neurovirol ; 27(6): 966-967, 2021 12.
Article in English | MEDLINE | ID: covidwho-1499533

ABSTRACT

The involvement of the nervous system may occur in 36.4% of patients with COVID-19. Cases have been described of cerebrovascular diseases, encephalitis, encephalopathies, and changes in smell and taste. Two months after being discharged from hospital with COVID-19, a 63-year-old male patient presented with a predominantly demyelinating multiple sensory and motor mononeuropathy. A diagnostic possibility of multiple sensory and motor demyelinating mononeuropathy (Lewis-Sumner syndrome) was made. Treatment with human immunoglobulin was initiated. COVID-19 may be associated with multiple demyelinating sensory and motor mononeuropathy.


Subject(s)
Brain Diseases , COVID-19 , Cerebrovascular Disorders , Mononeuropathies , Brain Diseases/complications , COVID-19/complications , Cerebrovascular Disorders/etiology , Humans , Male , Middle Aged , Mononeuropathies/complications
5.
J Pediatr Endocrinol Metab ; 34(12): 1611-1614, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1405353

ABSTRACT

OBJECTIVES: The impact of coronavirus disease-19 (COVID-19) on metabolic outcome in patients with inborn errors of metabolism has rarely been discussed. Herein, we report a case with an acute encephalopathic crisis at the course of COVID-19 disease as the first sign of glutaric aciduria type 1 (GA-1). CASE PRESENTATION: A 9-month-old patient was admitted with encephalopathy and acute loss of acquired motor skills during the course of COVID-19 disease. She had lethargy, hypotonia, and choreoathetoid movements. In terms of COVID-19 encephalopathy, the reverse transcription-polymerase chain reaction assay test for COVID-19 was negative in cerebral spinal fluid. Brain imaging showed frontotemporal atrophy, bilateral subcortical and periventricular white matter, basal ganglia, and thalamic involvement. Elevated glutarylcarnitine in plasma and urinary excretion of glutaric and 3-OH-glutaric acids was noted. A homozygote mutation in the glutaryl-CoA dehydrogenase gene led to the diagnosis of GA-1. CONCLUSIONS: With this report, neurological damage associated with COVID-19 has been reported in GA-1 patients for the first time in literature.


Subject(s)
Amino Acid Metabolism, Inborn Errors/complications , Brain Diseases, Metabolic/complications , Brain Diseases/etiology , COVID-19/complications , Glutaryl-CoA Dehydrogenase/deficiency , Amino Acid Metabolism, Inborn Errors/diagnostic imaging , Amino Acid Metabolism, Inborn Errors/genetics , Brain/diagnostic imaging , Brain Diseases/complications , Brain Diseases/diagnostic imaging , Brain Diseases, Metabolic/diagnostic imaging , Brain Diseases, Metabolic/genetics , COVID-19/diagnosis , COVID-19/diagnostic imaging , COVID-19 Testing , Carnitine/analogs & derivatives , Carnitine/blood , Carnitine/urine , Female , Genetic Testing , Glutarates/blood , Glutarates/urine , Glutaryl-CoA Dehydrogenase/genetics , Humans , Infant , Magnetic Resonance Imaging , Motor Skills , Movement Disorders/etiology , Muscle Hypotonia/etiology
7.
AJR Am J Roentgenol ; 217(4): 959-974, 2021 10.
Article in English | MEDLINE | ID: covidwho-1365501

ABSTRACT

Neurologic involvement is well-recognized in COVID-19. This article reviews the neuroimaging manifestations of COVID-19 on CT and MRI, presenting cases from the New York City metropolitan region encountered by the authors during the first surge of the pandemic. The most common neuroimaging manifestations are acute infarcts with large clot burden and intracranial hemorrhage, including microhemorrhages. However, a wide range of additional imaging patterns occur, including leukoencephalopathy, global hypoxic injury, acute disseminated encephalomyelitis, cytotoxic lesions of the corpus callosum, olfactory bulb involvement, cranial nerve enhancement, and Guillain-Barré syndrome. The described CNS abnormalities largely represent secondary involvement from immune activation that leads to a prothrombotic state and cytokine storm; evidence for direct neuroinvasion is scant. Comorbidities such as hypertension, complications of prolonged illness and hospitalization, and associated supportive treatments also contribute to the CNS involvement in COVID-19. Routine long-term neurologic follow-up may be warranted, given emerging evidence of long-term microstructural and functional changes on brain imaging after COVID-19 recovery.


Subject(s)
Brain Diseases/complications , Brain Diseases/diagnostic imaging , COVID-19/complications , Magnetic Resonance Imaging/methods , Neuroimaging/methods , Tomography, X-Ray Computed/methods , Adult , Brain/diagnostic imaging , Humans , Pandemics , SARS-CoV-2
8.
Br J Radiol ; 94(1127): 20210149, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1207615

ABSTRACT

OBJECTIVE: We reviewed the literature to describe outcomes associated with abnormal neuroimaging findings among adult COVID-19 patients. METHODS: We performed a systematic literature review using PubMed and Embase databases. We included all studies reporting abnormal neuroimaging findings among hospitalized patients with confirmed COVID-19 and outcomes. Data elements including patient demographics, neuroimaging findings, acuity of neurological symptoms and/or imaging findings relative to COVID-19 onset (acute, subacute, chronic), and patient outcomes were recorded and summarized. RESULTS: After review of 775 unique articles, a total of 39 studies comprising 884 COVID-19 patients ≥ 18 years of age with abnormal neuroimaging findings and reported outcomes were included in our analysis. Ischemic stroke was the most common neuroimaging finding reported (49.3%, 436/884) among patients with mortality outcomes data. Patients with intracranial hemorrhage (ICH) had the highest all-cause mortality (49.7%, 71/143), followed by patients with imaging features consistent with leukoencephalopathy (38.5%, 5/13), and ischemic stroke (30%, 131/436). There was no mortality reported among COVID-19 patients with acute disseminated encephalomyelitis without necrosis (0%, 0/8) and leptomeningeal enhancement alone (0%, 0/12). Stroke was a common acute or subacute neuroimaging finding, while leukoencephalopathy was a common chronic finding. CONCLUSION: Among hospitalized COVID-19 patients with abnormal neuroimaging findings, those with ICH had the highest all-cause mortality; however, high mortality rates were also seen among COVID-19 patients with ischemic stroke in the acute/subacute period and leukoencephalopathy in the chronic period. ADVANCES IN KNOWLEDGE: Specific abnormal neuroimaging findings may portend differential mortality outcomes, providing a potential prognostic marker for hospitalized COVID-19 patients.


Subject(s)
Advisory Committees , Brain Diseases/complications , Brain Diseases/diagnostic imaging , COVID-19/complications , Diagnostic Imaging/methods , Inpatients , Neuroimaging/methods , Brain/diagnostic imaging , Humans , North America , SARS-CoV-2 , Societies, Medical
9.
J Med Virol ; 93(1): 206-222, 2021 01.
Article in English | MEDLINE | ID: covidwho-1206776

ABSTRACT

Encephalopathy and encephalitis are major and devastating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus-associated central nervous system complications. Hypoxic/metabolic changes produced by intense inflammatory response against the virus triggers cytokine storm and subsequently acute respiratory distress syndrome and multiple organ failure. Hypoxic/metabolic changes result in encephalopathy. The presence of comorbidities predisposes to hypoxic/metabolic changes responsible for encephalopathy. Altered consciousness, ranging from mild confusion, delirium, to deep coma, is hallmark clinical features. Cortical and subcortical T2/FLAIR signal changes are common neuroimaging abnormalities. In a few isolated case reports of SARS-CoV-2 encephalitis, the virus has been demonstrated in cerebrospinal fluid. The presence of anosmia and ageusia can help in differentiation from other encephalopathies. We analyzed published reports on coronavirus disease 2019-associated encephalopathy. Encephalopathy is common in older patients, the majority are more than 50 years of age. The patients having encephalopathy/encephalitis are either severely or critically ill. Many patients were already on mechanical ventilation. Lung abnormalities are noted in almost all of the patients, presenting with encephalopathy. Encephalopathy is always preceded by commoner clinical features, like, fever, cough, dyspnoea, and headache. In majority, patients are already in the intensive care unit, when encephalopathy develops.


Subject(s)
Brain Diseases/diagnosis , Brain Diseases/virology , COVID-19/complications , Age Factors , Ageusia , Brain Diseases/complications , Critical Care , Critical Illness , Headache , Humans
10.
BMC Neurol ; 21(1): 138, 2021 Mar 30.
Article in English | MEDLINE | ID: covidwho-1161068

ABSTRACT

BACKGROUND: The spectrum of neurological involvement in COVID-19 is not thoroughly understood. To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between severe and non-severe cases has been published. The aim of this study is to assess the frequency of neurological manifestations and complications, identify the neurodiagnostic findings, and compare these aspects between severe and non-severe COVID-19 cases. METHODS: A systematic search of PubMed, Scopus, EBSCO, Web of Science, and Google Scholar databases was conducted for studies published between the 1st of January 2020 and 22nd of April 2020. In addition, we scanned the bibliography of included studies to identify other potentially eligible studies. The criteria for eligibility included studies published in English language (or translated to English), those involving patients with COVID-19 of all age groups, and reporting neurological findings. Data were extracted from eligible studies. Meta-analyses were conducted using comprehensive meta-analysis software. Random-effects model was used to calculate the pooled percentages and means with their 95% confidence intervals (CIs). Sensitivity analysis was performed to assess the effect of individual studies on the summary estimate. A subgroup analysis was conducted according to severity. The main outcomes of the study were to identify the frequency and nature of neurological manifestations and complications, and the neuro-diagnostic findings in COVID-19 patients. RESULTS: 44 articles were included with a pooled sample size of 13,480 patients. The mean age was 50.3 years and 53% were males. The most common neurological manifestations were: Myalgia (22.2, 95% CI, 17.2 to 28.1%), taste impairment (19.6, 95% CI, 3.8 to 60.1%), smell impairment (18.3, 95% CI, 15.4 to 76.2%), headache (12.1, 95% CI, 9.1 to 15.8%), dizziness (11.3, 95% CI, 8.5 to 15.0%), and encephalopathy (9.4, 95% CI, 2.8 to 26.6%). Nearly 2.5% (95% CI, 1 to 6.1%) of patients had acute cerebrovascular diseases (CVD). Myalgia, elevated CK and LDH, and acute CVD were significantly more common in severe cases. Moreover, 20 case reports were assessed qualitatively, and their data presented separately. CONCLUSIONS: Neurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.


Subject(s)
Brain Diseases/complications , COVID-19 , SARS-CoV-2 , Humans
11.
Mol Psychiatry ; 26(4): 1044-1059, 2021 04.
Article in English | MEDLINE | ID: covidwho-983662

ABSTRACT

Scientists and health professionals are exhaustively trying to contain the coronavirus disease 2019 (COVID-19) pandemic by elucidating viral invasion mechanisms, possible drugs to prevent viral infection/replication, and health cares to minimize individual exposure. Although neurological symptoms are being reported worldwide, neural acute and long-term consequences of SARS-CoV-2 are still unknown. COVID-19 complications are associated with exacerbated immunoinflammatory responses to SARS-CoV-2 invasion. In this scenario, pro-inflammatory factors are intensely released into the bloodstream, causing the so-called "cytokine storm". Both pro-inflammatory factors and viruses may cross the blood-brain barrier and enter the central nervous system, activating neuroinflammatory responses accompanied by hemorrhagic lesions and neuronal impairment, which are largely described processes in psychiatric disorders and neurodegenerative diseases. Therefore, SARS-CoV-2 infection could trigger and/or worse brain diseases. Moreover, patients with central nervous system disorders associated to neuroimmune activation (e.g. depression, Parkinson's and Alzheimer's disease) may present increased susceptibility to SARS-CoV-2 infection and/or achieve severe conditions. Elevated levels of extracellular ATP induced by SARS-CoV-2 infection may trigger hyperactivation of P2X7 receptors leading to NLRP3 inflammasome stimulation as a key mediator of neuroinvasion and consequent neuroinflammatory processes, as observed in psychiatric disorders and neurodegenerative diseases. In this context, P2X7 receptor antagonism could be a promising strategy to prevent or treat neurological complications in COVID-19 patients.


Subject(s)
Brain Diseases/complications , Brain Diseases/pathology , COVID-19/complications , COVID-19/pathology , Neuroimmunomodulation , Receptors, Purinergic P2X7/metabolism , SARS-CoV-2/pathogenicity , Brain Diseases/drug therapy , Brain Diseases/metabolism , COVID-19/immunology , COVID-19/metabolism , Humans , Inflammasomes/immunology , Inflammasomes/metabolism , Pandemics , SARS-CoV-2/immunology
14.
J Neurovirol ; 26(5): 631-641, 2020 10.
Article in English | MEDLINE | ID: covidwho-739689

ABSTRACT

A subset of patients with coronavirus 2 disease (COVID-19) experience neurological complications. These complications include loss of sense of taste and smell, stroke, delirium, and neuromuscular signs and symptoms. The etiological agent of COVID-19 is SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), an RNA virus with a glycoprotein-studded viral envelope that uses ACE2 (angiotensin-converting enzyme 2) as a functional receptor for infecting the host cells. Thus, the interaction of the envelope spike proteins with ACE2 on host cells determines the tropism and virulence of SARS-CoV-2. Loss of sense of taste and smell is an initial symptom of COVID-19 because the virus enters the nasal and oral cavities first and the epithelial cells are the receptors for these senses. Stroke in COVID-19 patients is likely a consequence of coagulopathy and injury to cerebral vascular endothelial cells that cause thrombo-embolism and stroke. Delirium and encephalopathy in acute and post COVID-19 patients are likely multifactorial and secondary to hypoxia, metabolic abnormalities, and immunological abnormalities. Thus far, there is no clear evidence that coronaviruses cause inflammatory neuromuscular diseases via direct invasion of peripheral nerves or muscles or via molecular mimicry. It appears that most of neurologic complications in COVID-19 patients are indirect and as a result of a bystander injury to neurons.


Subject(s)
Betacoronavirus/pathogenicity , Brain Diseases/complications , Coronavirus Infections/complications , Olfaction Disorders/complications , Pneumonia, Viral/complications , Pulmonary Embolism/complications , Stroke/complications , Angiotensin-Converting Enzyme 2 , Brain/blood supply , Brain/pathology , Brain/virology , Brain Diseases/immunology , Brain Diseases/pathology , Brain Diseases/virology , Bystander Effect , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Coronavirus Infections/virology , Epithelial Cells/pathology , Epithelial Cells/virology , Gene Expression Regulation , Host-Pathogen Interactions/genetics , Host-Pathogen Interactions/immunology , Humans , Lung/blood supply , Lung/pathology , Lung/virology , Neurons/pathology , Neurons/virology , Olfaction Disorders/immunology , Olfaction Disorders/pathology , Olfaction Disorders/virology , Pandemics , Peptidyl-Dipeptidase A/genetics , Peptidyl-Dipeptidase A/immunology , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Pulmonary Embolism/immunology , Pulmonary Embolism/pathology , Pulmonary Embolism/virology , SARS-CoV-2 , Signal Transduction/genetics , Signal Transduction/immunology , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/immunology , Stroke/immunology , Stroke/pathology , Stroke/virology
15.
Int J Mol Sci ; 21(15)2020 Jul 31.
Article in English | MEDLINE | ID: covidwho-693402

ABSTRACT

Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called "cytokine storm"), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.


Subject(s)
Betacoronavirus/physiology , Central Nervous System/virology , Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Angiotensin-Converting Enzyme 2 , Animals , Betacoronavirus/isolation & purification , Blood-Brain Barrier/metabolism , Blood-Brain Barrier/virology , Brain Diseases/complications , Brain Diseases/pathology , COVID-19 , Central Nervous System/metabolism , Coronavirus Infections/virology , Encephalitis/complications , Encephalitis/pathology , Humans , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/virology , SARS-CoV-2
16.
J Child Neurol ; 35(13): 934-939, 2020 11.
Article in English | MEDLINE | ID: covidwho-651500

ABSTRACT

Children are susceptible to infection with the novel coronavirus SARS-CoV-2. In this time of uncertainty, this review attempts to compile information that may be helpful to pediatric neurologists. This review consolidates current data on the disease associated with SARS-CoV-2, called COVID-19, and information from past coronavirus epidemics, to discuss diseases of pediatric neurology including Guillain-Barre syndrome (acute inflammatory demyelinating polyradiculoneuropathy); central demyelinating diseases like multiple sclerosis and acute disseminated encephalomyelitis; infantile spasms; febrile seizures; and maternal-fetal transmission of virus.


Subject(s)
Betacoronavirus , Brain Diseases/complications , Brain Diseases/therapy , Coronavirus Infections/complications , Coronavirus Infections/therapy , Infectious Disease Transmission, Vertical/prevention & control , Neurology/methods , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , COVID-19 , Child , Coronavirus Infections/diagnosis , Humans , Neurologists , Pandemics , Pediatricians , Pediatrics/methods , Pneumonia, Viral/diagnosis , SARS-CoV-2
17.
J Neurovirol ; 26(5): 785-789, 2020 10.
Article in English | MEDLINE | ID: covidwho-647060

ABSTRACT

Over the course of the pandemic due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), multiple new clinical manifestations, as the consequence of the tropism of the virus, have been recognized. That includes now the neurological manifestations and conditions, such as headache, encephalitis, as well as olfactory and taste disorders. We present a series of ten cases of RT-PCR-confirmed SARS-CoV-2-infected patients diagnosed with viral-associated olfactory and taste loss from four different countries.


Subject(s)
Ageusia/complications , Betacoronavirus/pathogenicity , Brain Diseases/complications , Coronavirus Infections/complications , Headache/complications , Olfaction Disorders/complications , Pneumonia, Viral/complications , Adult , Aged , Aged, 80 and over , Ageusia/immunology , Ageusia/pathology , Ageusia/virology , Brain/pathology , Brain/virology , Brain Diseases/immunology , Brain Diseases/pathology , Brain Diseases/virology , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Coronavirus Infections/virology , Europe , Female , Headache/immunology , Headache/pathology , Headache/virology , Humans , Male , Middle Aged , North America , Olfaction Disorders/immunology , Olfaction Disorders/pathology , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , SARS-CoV-2 , South America , Time Factors
18.
Arq. neuropsiquiatr ; 78(5): 290-300, May 2020. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-539324

ABSTRACT

ABSTRACT Background: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. Objective: To review the literature on neurological complications of SARS-CoV-2 infection. Methods: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. Results: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. Conclusion: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.


RESUMO Introdução: À medida que a pandemia da COVID-19 se desenvolve em todo o mundo, diferentes tipos de publicações descreveram suas manifestações neurológicas. Objetivo: Revisar a literatura sobre complicações neurológicas da infecção por SARS-CoV-2. Métodos: A pesquisa bibliográfica foi realizada seguindo diretrizes de revisões sistemáticas, usando palavras-chave específicas baseadas nas complicações neurológicas da COVID-19 descritas até 10 de maio de 2020. Resultados: Foram selecionados 43 artigos, incluindo descrições que variam de sintomas comuns e inespecíficos, como hiposmia e mialgia, a condições mais complexas e com risco de vida, como doenças cerebrovasculares, encefalopatias e síndrome de Guillain-Barré. Conclusão: O reconhecimento das manifestações neurológicas da SARS-CoV-2 deve ser enfatizado apesar dos óbvios desafios enfrentados pelos clínicos que cuidam de pacientes críticos, muitas vezes sedados e apresentando outras complicações sistêmicas concomitantes.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Nervous System Diseases/complications , Brain Diseases/complications , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/physiopathology , Coronavirus Infections , Guillain-Barre Syndrome/complications , Ageusia/complications , Pandemics , Myalgia/complications , Olfaction Disorders/complications , Nervous System Diseases/physiopathology
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