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1.
Vaccine ; 40(19): 2802-2809, 2022 04 26.
Article in English | MEDLINE | ID: covidwho-1783812

ABSTRACT

BACKGROUND: The CARD (Comfort Ask Relax Distract) system is a vaccine delivery framework that integrates evidence-based interventions to reduce stress-related responses and improve the vaccination experience for children undergoing vaccinations at school. In preliminary studies, CARD was acceptable and effective. The objective was to evaluate CARD in a large, pragmatic trial to confirm its effectiveness in real-world settings. METHODS: Hybrid effectiveness-implementation cluster randomized trial in schools receiving vaccination services from Wellington-Dufferin-Guelph Public Health. Forty schools with grade 7 students (12 years old) were randomized to CARD and control (n = 20/group). Nurses in CARD schools planned clinics with principals and educated students about CARD ahead of time. Principals disseminated information to staff and parents and sent reminders. Vaccination day processes minimized fear and facilitated student self-selected coping strategies. Nurses in control schools followed usual practices, which excluded principal meetings, education, reminders, and systematic integration of fear-reducing or child-selected coping strategies. Outcomes included stress-related symptoms (fear - primary outcome, pain, dizziness, fainting, post-vaccination reactions), use of coping interventions, vaccination uptake, attitudes and implementation outcomes (acceptability, appropriateness, feasibility, fidelity). RESULTS: Altogether, 1919 students were included. Fear and pain were lower in CARD schools: OR 0.65 (95% CI 0.47-0.90) and OR 0.62 (95% CI 0.50-0.77), respectively. No students fainted in CARD schools compared to 0.8% in control (p = 0.02). Dizziness and post-vaccination reactions did not differ. Student-led coping interventions were used more frequently in CARD schools. Vaccination uptake was 76.1% in CARD schools and 72.5% in control schools (OR 1.13 (95% CI 0.85-1.50)). Staff and students had positive attitudes about CARD and implementation outcomes; however, recommendations were made to improve fidelity. DISCUSSION: CARD reduced stress-related responses in students undergoing vaccinations at school and was positively received by students and public health staff. CARD is recommended to improve the quality of vaccination delivery services. TRIAL REGISTRATION: NCT03966300.


Subject(s)
Dizziness , Schools , Child , Humans , Pain , School Health Services , Students , Vaccination
2.
J Pak Med Assoc ; 72(2): 354-356, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1761742

ABSTRACT

In the present era of the coronavirus 2019 (COVID-19) pandemic, it has been observed that the severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2) infection does not only affect the respiratory tract, but also triggers various neurological symptoms in one-third of patients. The most prominent of such symptoms is anosmia, which is independent of rhinologic symptoms such as nasal obstruction, discharge, and pain that cannot be otherwise explained. Vestibular neuronitis ranks third among the causes of peripheral vestibular vertigo, characterized by nausea, vomiting, and dizziness that develops within minutes or hours. Although the etiopathogenesis remains poorly known, neuronitis is generally considered to be attributable to the viral or post-viral inflammation of the vestibular branch of the eighth cranial nerve. This report presents a case of vestibular neuronitis, which is likely to be a manifestation of acute vestibular neuronitis associated with COVID-19.


Subject(s)
COVID-19 , Vestibular Neuronitis , Adult , COVID-19/complications , Dizziness/etiology , Humans , Male , SARS-CoV-2 , Vertigo/diagnosis , Vertigo/etiology , Vestibular Neuronitis/complications , Vestibular Neuronitis/diagnosis
3.
Hum Vaccin Immunother ; 18(1): 2039017, 2022 12 31.
Article in English | MEDLINE | ID: covidwho-1730547

ABSTRACT

Assessment of safety of COVID-19 vaccines is an ongoing process. This study aims to explore long-term adverse events reported by physicians and dentists who received at least two COVID-19 vaccine doses. A group of physicians and dentists were invited to complete a validated questionnaire that was composed of items on: socio-demographics, medical history, administered vaccines, and long-term adverse events (LTAE). Data of a total of 498 practitioners were included. Age ranged from 22 to 71 years (mean age= 35.75 ± 11.74) with a female majority (N = 348, 69.9%). The most frequently administered vaccines were Pfizer-BioNtech, Sinopharm and AstraZeneca vaccines. A total of 80 (16.0%) participants reported LTAEs which were mainly fatigue, menstrual disturbances, myalgia, arthralgia, dizziness, and headache (N = 32, 15, 8, 6, 4, and 4, respectively). There was no statistically significant association between LTAEs and: age, gender, or medical history (P > .05). The collective symptoms of fatigue, myalgia, arthralgia, dizziness, and headache were significantly associated with Sinopharm vaccine (P = .04). This was further confirmed by general linear multivariate model analysis. Less than 20% of COVID-19 vaccine recipients may complain of LTAEs that are mostly fatigue-related. It seems that factors such as age, gender, and medical status play a negligible role in development of these AEs. On the other hand, Sinopharm vaccine showed the highest significant association with these AEs followed by AstraZeneca vaccine.


Subject(s)
COVID-19 , Physicians , Adult , Aged , Arthralgia/chemically induced , Arthralgia/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Dentists , Dizziness , Fatigue/chemically induced , Fatigue/epidemiology , Female , Headache/chemically induced , Headache/epidemiology , Humans , Jordan , Middle Aged , Myalgia/chemically induced , Myalgia/epidemiology , SARS-CoV-2 , Saudi Arabia , Young Adult
4.
Braz J Otorhinolaryngol ; 88(3): 287-288, 2022.
Article in English | MEDLINE | ID: covidwho-1703531
5.
Am J Emerg Med ; 54: 1-7, 2022 04.
Article in English | MEDLINE | ID: covidwho-1627843

ABSTRACT

Managing neurological emergencies is an essential element of emergency physicians' armamentarium, irrelevant of the specific nature of their practice. The combination of evolving literature and advances in imaging fuel the rapidly changing standards of care, especially in high-stakes diagnoses such as stroke. Navigating the emergency neurology literature to stay abreast of the current updates is becoming more challenging with the sheer volume of publications, combined with the recent dominance of COVID-19 on the literature and media attention. This review article summarizes emergency neurology literature updates that can help you improve your care of these high-risk presentations; articles covering stroke, dizziness, intracerebral hemorrhage, head trauma imaging, headache, seizures, and COVID-19 are reviewed.


Subject(s)
COVID-19 , Neurology , Dizziness/diagnosis , Dizziness/etiology , Headache , Humans , Vertigo
6.
Acta Otolaryngol ; 141(10): 921-924, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1493355

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic represented a stressful event. OBJECTIVES: The incidence of newly diagnosed Ménière's disease (MD) patients before and during COVID-19 at our Institution was calculated. MATERIALS AND METHODS: The period 2018-2020 was considered. Incidence was calculated as number of annual first MD diagnoses divided by the number of annual first audiological evaluations. RESULTS: One hundred and eighty-three patients were considered. Annual incidence of MD at our institution was 1.3% in 2018, 1.2% in 2019, and 3.2% in 2020, resulting in a significant increase during COVID-19 pandemic (2018 vs. 2020, p=.00001; 2019 vs. 2020, p=.00001). MD patients in 2020 presented a higher number of vertigo attacks (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.04) and higher Dizziness Handicap Inventory questionnaire (DHI) values (2018 vs. 2020, p=.02; 2019 vs. 2020, p=.03). During COVD-19 pandemic, MD patients reported significantly higher State-Trait Anxiety Inventory (STAI) - Y1 (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.03). CONCLUSIONS AND SIGNIFICANCE: A higher incidence of MD first diagnosis was calculated during COVID-19 pandemic; furthermore, MD patients presented with more vertigo attacks and higher DHI values. These could be associated with the higher state anxiety during COVID-19 pandemic.


Subject(s)
Meniere Disease/epidemiology , Anxiety/epidemiology , COVID-19 , Dizziness/epidemiology , Female , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Pandemics , Vertigo/epidemiology
7.
Clin Neurol Neurosurg ; 210: 106985, 2021 11.
Article in English | MEDLINE | ID: covidwho-1458745

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19), a global issue now, can have a variety of clinical manifestations. Hundreds of articles have discussed different aspects of this infectious disease, such as physiopathology, epidemiology, clinical manifestations and treatment protocols. Recently, neurological manifestations of the disease have been found to be pretty common among COVID-19 patients. Here, neurological symptoms of COVID-19 infection with a focus on non-cerebrovascular complications are discussed in a large study population. METHODS: Neurological symptoms of 891hospitalized COVID-19 patients from March to June 2020 in a major Hospital, Tehran, Iran, were reviewed. Demographic characteristics and neurological manifestations were analyzed. RESULTS: Among 891 hospitalized COVID-19 patients, the following symptoms were observed: headache (63.9%), sleeping problems (51.3%), hyposmia/anosmia (46%), dizziness (45.4%), hypogeusia (42.1%), memory issues (31.5%), auditory disturbances (17.5%), paralysis (3.7%) and seizures (1.7%). In 29.7% of the patients, a neurological symptom was the initiating symptoms of the infection. Females were more likely to show headache and dizziness compared to males (p value<0.05). Headache intensity was also higher in females compared to males (p value<0.05). Headache prevalence was lower in older patients (p value<0.05), while memory loss and impaired consciousness were higher by increasing age (p values=0.002 and 0.001, respectively). CONCLUSION: Neurological manifestations were common among COVID-19 patients under study. Headache, as the most common neurological symptom among COVID-19 patients, was the most prevalent and intense among the female population. Headache, dizziness, sleeping problems, hyposmia/anosmia and hypogeusia were common COVID-19 neurological manifestations, while memory issues, auditory disturbances, paralysis, and seizures were less common.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Hospitalization/trends , Nervous System Diseases/epidemiology , Nervous System Diseases/therapy , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , Child , Cross-Sectional Studies , Dizziness/diagnosis , Dizziness/epidemiology , Dizziness/therapy , Female , Headache/diagnosis , Headache/epidemiology , Headache/therapy , Humans , Iran/epidemiology , Male , Middle Aged , Nervous System Diseases/diagnosis , Retrospective Studies , Seizures/diagnosis , Seizures/epidemiology , Seizures/therapy , Young Adult
8.
Auris Nasus Larynx ; 49(2): 291-298, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1401171

ABSTRACT

OBJECTIVE: To answer the question whether balance related systems have been affected in adults who recovered from Covid-19 disease. This is the first case-control study to assess balance objectively and quantitatively in Covid-19 disease. METHODS: Thirty-seven patients who recovered from Covid-19 disease and 30 healthy controls were compared using Dizziness Handicap Inventory (DHI), Computerized Dynamic Posturography (CDP), Vestibular Evoked Myogenic Potentials(VEMP) and Video Head Impulse Test (v-HIT). RESULTS: On CDP, the composite and visual general scores of the patients were significantly lower than controls (p<0.01). The v-HIT gains of the patients significantly decreased in the vertical semicircular canals compared to controls (p<0.01).There was a significant difference between the patients and controls regarding the absence of o-VEMPs (p<0.01) while the amplitudes and latencies were similar between the groups (p>0.05). Decreased P1/N1 amplitudes and elongated N1 latencies were found on c-VEMP testing (p<0.05). Anosmia, taste disorder and gender were not associated with subjective and objective test results (p>0.05). CONCLUSION: The Covid-19 disease can cause dizziness rather that incapacitating vertigo. Dizziness can be seen in almost one-fifth of the adult covid19 out-patients, which may be due to involvement of vestibular and visual systems,ortheir central connections. The squeals created in the balance related systems may be irreversible as they have persisted after the recovery of the patients. It is also plausible to anticipate more severe condition in the older patients who were treated in the intensive care units. In the long term follow up of the survivors, the need for balance rehabilitation programs should be remembered in order to minimize risks of falling down.


Subject(s)
COVID-19 , Vestibular Evoked Myogenic Potentials , Adult , Case-Control Studies , Dizziness/etiology , Humans , Postural Balance/physiology , Vertigo/etiology , Vestibular Evoked Myogenic Potentials/physiology
9.
Rev. gaúch. enferm ; 42(spe): e20200205, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1243891

ABSTRACT

ABSTRACT Objective To identify symptoms of COVID-19 in adults in the scientific literature. Method Systematic review of studies published from December 1, 2019 to April 21, 2020 from the Scopus, Web of Science and PubMed databases, in order to answer the following research question: "What are the symptoms caused by COVID-19 in adults?" using the keywords "Symptoms", "Clinical Manifestations", "Coronavirus", "COVID-19". Results Of the total 105 references, 13 references that addressed the symptoms of COVID-19 were selected. Fever and normal or dry cough were symptoms present in all studies. Conclusion The symptoms identified in adult patients were fever, normal or dry cough, headache, pharyngalgia, dyspnea, diarrhea, myalgia, vomiting, sputum or expectoration, anxiety or chest pain, fatigue, nausea, anorexia, abdominal pain, rhinorrhea, runny nose or nasal congestion, dizziness, chills, systemic pain, mental confusion, hemoptysis, asthma, taste disorder, smell disorder, belching and tachycardia.


RESUMEN Objetivo Verificar en la literatura científica las manifestaciones sintomáticas de COVID-19 en adultos. Método Una revisión sistemática realizada en las bases de datos Scopus, Web of Science y PubMed con estudios publicados del 1 de diciembre de 2019 al 21 de abril de 2020, con el fin de responder a la pregunta orientadora: "¿Cuáles son las manifestaciones sintomáticas causada por COVID-19 en adultos?" utilizando las palabras clave: "Síntomas", "Manifestaciones clínicas", "Coronavirus", "COVID-19". Resultados Del total de 105 referencias, se seleccionaron 13 que abordaron las manifestaciones sintomáticas de COVID-19, con fiebre y tos normal o seca presente en todos los estudios. Conclusión Las manifestaciones sintomáticas identificadas en pacientes adultos fueron: fiebre, tos normal o seca, dolor de cabeza, faringalgia, disnea, diarrea, mialgia, vómitos, esputo o expectoración, angustia o dolor en el pecho, fatiga, náuseas, anorexia, dolor abdominal, rinorrea, secreción nasal o congestión nasal, mareos, escalofríos, dolor sistémico, confusión mental, hemoptisis, asma, alteración del gusto, alteración del olfato, eructos y taquicardia.


RESUMO Objetivo Verificar na literatura científica as manifestações sintomáticas da COVID-19 em pessoas adultas. Método Revisão sistemática utilizando as bases Scopus, Web of Science e PubMed com estudos publicados de 1 de dezembro de 2019 a 21 de abril de 2020, a fim de responder à questão norteadora: "Quais as manifestações sintomáticas causada pela COVID-19 em pessoas adultas?" utilizando-se as palavras-chave: "Symptoms", "Clinical Manifestations", "Coronavirus", "COVID-19". Resultados Do total de 105 referências, foram selecionadas 13 que abordaram as manifestações sintomáticas da COVID-19, estando a febre e a tosse normal ou seca presente em todos os estudos. Conclusão As manifestações sintomáticas identificadas nos pacientes adultos foram: febre, tosse normal ou seca, cefaleia, faringalgia, dispneia, diarreia, mialgia, vômito, escarro ou expectoração, angústia ou dor no peito, fadiga, náusea, anorexia, dor abdominal, rinorreia, coriza ou congestão nasal, tontura, calafrios, dor sistêmica, confusão mental, hemoptise, asma, comprometimento do paladar, comprometimento do olfato, arroto e taquicardia.


Subject(s)
Humans , Male , Female , Adult , General Symptoms , SARS-CoV-2 , COVID-19 , Asthma , Vomiting , Anorexia , Databases, Bibliographic , Cough , Ageusia , Diarrhea , Dizziness , Fatigue , Fever , Olfaction Disorders
10.
Clin Auton Res ; 31(3): 385-394, 2021 06.
Article in English | MEDLINE | ID: covidwho-1188108

ABSTRACT

PURPOSE: Post-COVID-19 syndrome is a poorly understood aspect of the current pandemic, with clinical features that overlap with symptoms of autonomic/small fiber dysfunction. An early systematic analysis of autonomic dysfunction following COVID-19 is lacking and may provide initial insights into the spectrum of this condition. METHODS: We conducted a retrospective review of all patients with confirmed history of COVID-19 infection referred for autonomic testing for symptoms concerning for para-/postinfectious autonomic dysfunction at Mayo Clinic Rochester or Jacksonville between March 2020 and January 2021. RESULTS: We identified 27 patients fulfilling the search criteria. Symptoms developed between 0 and 122 days following the acute infection and included lightheadedness (93%), orthostatic headache (22%), syncope (11%), hyperhidrosis (11%), and burning pain (11%). Sudomotor function was abnormal in 36%, cardiovagal function in 27%, and cardiovascular adrenergic function in 7%. The most common clinical scenario was orthostatic symptoms without tachycardia or hypotension (41%); 22% of patients fulfilled the criteria for postural tachycardia syndrome (POTS), and 11% had borderline findings to support orthostatic intolerance. One patient each was diagnosed with autoimmune autonomic ganglionopathy, inappropriate sinus tachycardia, vasodepressor syncope, cough/vasovagal syncope, exacerbation of preexisting orthostatic hypotension, exacerbation of sensory and autonomic neuropathy, and exacerbation of small fiber neuropathy. CONCLUSION: Abnormalities on autonomic testing were seen in the majority of patients but were mild in most cases. The most common finding was orthostatic intolerance, often without objective hemodynamic abnormalities on testing. Unmasking/exacerbation of preexisting conditions was seen. The temporal association between infection and autonomic symptoms implies a causal relationship, which however cannot be proven by this study.


Subject(s)
Autonomic Nervous System Diseases/etiology , COVID-19/complications , Adult , Aged , Autonomic Dysreflexia/etiology , Autonomic Fibers, Postganglionic/pathology , Autonomic Nervous System Diseases/diagnosis , Autonomic Nervous System Diseases/physiopathology , Dizziness , Female , Hemodynamics , Humans , Male , Middle Aged , Neurologic Examination , Orthostatic Intolerance/diagnosis , Postural Orthostatic Tachycardia Syndrome/etiology , Retrospective Studies , Shy-Drager Syndrome/etiology , Young Adult
11.
Can J Neurol Sci ; 49(2): 184-195, 2022 03.
Article in English | MEDLINE | ID: covidwho-1177041

ABSTRACT

OBJECTIVES: Extensive studies indicate that severe acute respiratory syndrome coronavirus (SARS-CoV-2) involves human sensory systems. A lack of discussion, however, exists given the auditory-vestibular system involvement in CoV disease 2019 (COVID-19). The present systematic review and meta-analysis were performed to determine the event rate (ER) of hearing loss, tinnitus, and dizziness caused by SARS-CoV-2. METHODS: Databases (PubMed, ScienceDirect, Wiley) and World Health Organization updates were searched using combined keywords: 'COVID-19,' 'SARS-CoV-2,' 'pandemic,' 'auditory dysfunction,' 'hearing loss,' 'tinnitus,' 'vestibular dysfunction,' 'dizziness,' 'vertigo,' and 'otologic symptoms.' RESULTS: Twelve papers met the eligibility criteria and were included in the study. These papers were single group prospective, cross-sectional, or retrospective studies on otolaryngologic, neurologic, or general clinical symptoms of COVID-19 and had used subjective assessments for data collection (case histories/medical records). The results of the meta-analysis demonstrate that the ER of hearing loss (3.1%, CIs: 0.01-0.09), tinnitus (4.5%, CIs: 0.012-0.153), and dizziness (12.2%, CIs: 0.070-0.204) is statistically significant in patients with COVID-19 (Z ≤ -4.469, p ≤ 0.001). CONCLUSIONS: COVID-19 can cause hearing loss, tinnitus, and dizziness. These findings, however, should be interpreted with caution given insufficient evidence and heterogeneity among studies. Well-designed studies and follow-up assessments on otologic symptoms of SARS-CoV-2 using standard objective tests are recommended.


Subject(s)
COVID-19 , Hearing Loss , Tinnitus , COVID-19/complications , Cross-Sectional Studies , Dizziness/epidemiology , Dizziness/etiology , Hearing Loss/complications , Humans , Prospective Studies , Retrospective Studies , SARS-CoV-2 , Tinnitus/epidemiology , Tinnitus/etiology , Vertigo/diagnosis
12.
Curr Neuropharmacol ; 19(1): 92-96, 2021.
Article in English | MEDLINE | ID: covidwho-1154160

ABSTRACT

The pandemic novel coronavirus disease (COVID-19) has become a global concern in which the respiratory system is not the only one involved. Previous researches have presented the common clinical manifestations including respiratory symptoms (i.e., fever and cough), fatigue and myalgia. However, there is limited evidence for neurological and psychological influences of SARS-CoV-2. In this review, we discuss the common neurological manifestations of COVID-19 including acute cerebrovascular disease (i.e., cerebral hemorrhage) and muscle ache. Possible viral transmission to the nervous system may occur via circulation, an upper nasal transcribrial route and/or conjunctival route. Moreover, we cannot ignore the psychological influence on the public, medical staff and confirmed patients. Dealing with public psychological barriers and performing psychological crisis intervention are an important part of public health interventions.


Subject(s)
COVID-19/physiopathology , Central Nervous System Viral Diseases/physiopathology , Cerebrovascular Disorders/physiopathology , Myalgia/physiopathology , Nervous System Diseases/physiopathology , Blood-Brain Barrier , COVID-19/psychology , COVID-19/transmission , Central Nervous System Viral Diseases/psychology , Central Nervous System Viral Diseases/transmission , Cerebral Hemorrhage/physiopathology , Conjunctiva , Dizziness/physiopathology , Ethmoid Bone , Headache/physiopathology , Health Personnel/psychology , Humans , Nervous System Diseases/psychology , SARS-CoV-2
13.
J Clin Neurophysiol ; 38(2): e5-e10, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1150060

ABSTRACT

SUMMARY: Neurological manifestations of coronavirus disease 2019 most commonly present in severe cases and range from mild complications, such as headache and dizziness, to severe complications, such as encephalopathy and acute cerebrovascular disease. Seizures, however, are an underreported neurological manifestation of this disease. We present three critically ill coronavirus disease 2019 patients with EEG monitoring who developed new-onset seizures and encephalopathy up to three-and-a-half weeks after symptom onset. There are several speculated etiologies for the development of new-onset seizures; however, the pathogenic mechanism remains unknown. Testing of coronavirus disease 2019 in the cerebrospinal fluid in addition to extensive research on neurological manifestations is warranted.


Subject(s)
Brain Diseases/virology , COVID-19/complications , Dizziness/virology , Headache/virology , Seizures/virology , Adult , Aged , Female , Humans , Male , Middle Aged , SARS-CoV-2
14.
J Child Neurol ; 36(10): 853-866, 2021 09.
Article in English | MEDLINE | ID: covidwho-1109882

ABSTRACT

INTRODUCTION: Although multiple neurologic manifestations associated with SARS-CoV-2 infection have been described in adults, there is little information about those presented in children. Here, we described neurologic manifestations associated with COVID-19 in the pediatric population. METHODS: Retrospective case series report. We included patients younger than 18 years, admitted with confirmed SARS-CoV-2 infection and neurologic manifestations at our hospital in Santiago, Chile. Demographics, clinical presentations, laboratory results, radiologic and neurophysiological studies, treatment, and outcome features were described. Cases were described based on whether they presented with predominantly central or peripheral neurologic involvement. RESULTS: Thirteen of 90 (14.4%) patients admitted with confirmed infection presented with new-onset neurologic symptoms and 4 patients showed epilepsy exacerbation. Neurologic manifestations ranged from mild (headache, muscle weakness, anosmia, ageusia), to severe (status epilepticus, Guillain-Barré syndrome, encephalopathy, demyelinating events). CONCLUSIONS: We found a wide range of neurologic manifestations in children with confirmed SARS-CoV-2 infection. In general, neurologic symptoms were resolved as the systemic presentation subsided. It is essential to recognize and report the main neurologic manifestations related to this new infectious disease in the pediatric population. More evidence is needed to establish the specific causality of nervous system involvement.


Subject(s)
COVID-19/complications , Dizziness/etiology , Encephalitis/etiology , Headache/etiology , Myalgia/etiology , Adolescent , Child , Child, Preschool , Female , Humans , Male , Retrospective Studies
15.
Int Arch Occup Environ Health ; 94(7): 1627-1636, 2021 10.
Article in English | MEDLINE | ID: covidwho-1107813

ABSTRACT

OBJECTIVES: During the COVID-19 pandemic, healthcare professionals are recommended to use PPE to prevent the transmission of disease. Healthcare workers who use N95 FFR, which has an important place, experience complaints such as headache and dizziness. In this study, we plan to find the cause of these complaints and aim to clarify whether they are associated with the use of N95 mask. METHOD: Healthcare workers first put on a surgical mask for at least 1 h and a maximum of 4 h, this process was then repeated on another day with the same workers wearing N95 masks. After removing the mask, capillary blood gases were taken and a questionnaire was given. RESULTS: Thirty-four participants over the age of 18 were included in the study; 19 participants were female (56%) and 15 male (44%). The results of the capillary blood gas analysis after the use of surgical mask and N95 mask, respectively: pH: 7.43 ± 0.03; 7.48 ± 0.04 (p < 0.001); pCO2: 37.33 ± 8.81; 28.46 ± 7.77 mmHg (p < 0.001); HCO3: 24.92 ± 2.86; 23.73 ± 3.29 mmol/L (p = 0.131); Base excess (BE): 1.40 (- 3.90-3.10); - 2.68 (- 4.50-1.20) [median (Q1-Q3)] (p = 0.039); lactate: 1.74 ± 0.68; 1.91 ± 0.61 (p = 0314). Headache, attention deficit and difficulty in concentrating were significantly higher after using N95 mask. CONCLUSION: Respiratory alkalosis and hypocarbia were detected after the use of N95. Acute respiratory alkalosis can cause headache, anxiety, tremor, muscle cramps. In this study, it was quantitatively shown that the participants' symptoms were due to respiratory alkalosis and hypocarbia.


Subject(s)
COVID-19/epidemiology , Dizziness/etiology , Headache/etiology , N95 Respirators/adverse effects , Adult , Age Factors , Blood Gas Analysis , COVID-19/prevention & control , Female , Health Personnel , Hospitals, University , Humans , Hydrogen-Ion Concentration , Male , Masks/adverse effects , Pandemics , SARS-CoV-2 , Sex Factors , Socioeconomic Factors
16.
Postgrad Med ; 133(5): 548-551, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1082103

ABSTRACT

Objective: Hypoglycemia is a serious adverse effect of hydroxychloroquine (HCQ) which is very rare in non-diabetic patients. This case report describes a non-diabetic patient without any other chronic diseases, who experienced mild hypoglycemia related to HCQ used for COVID-19 treatment.Methods: All etiologies causing hypoglycemia were investigated and a 72-hour fast test was performed.Results: A 34-year-old male patient was admitted to our hospital with a high fever, cough, and chest pain. The result of his COVID-19 PCR test was positive. He received HCQ for 10 days for the treatment of COVID-19 infection. He experienced fatigue, dizziness, severe headache, weakness and feeling of hunger after discontinuation of HCQ during his isolation at home. Before COVID-19 infection, he never experienced hypoglycemia symptoms. He did not have a history of chronic diseases, drug use, alcohol consumption, or smoking. A 72-hour fasting test was performed. He complained about headache and weakness during the 72-hour test period. The PG level was determined as 49 mg/dl during these symptoms. Concurrent insulin and C-peptide levels were <2 mU/mL and 0.553 ng/mL, respectively. ACTH, cortisol, growth hormones, liver and kidney function tests were normal. HbA1c level was 4.7% (28 mmol/mol) (Normal Range %4,5-5,7).Conclusion: Hypoglycemia may be observed as an adverse effect of HCQ used for COVID-19 infection even in patients without chronic diseases and comorbidities. We must be careful while using HCQ for these patients and must warn them about this effect. The warning about hypoglycemia effect of HCQ must be added to COVID-19 treatment guidelines.


Subject(s)
Antiviral Agents/adverse effects , COVID-19/drug therapy , Hydroxychloroquine/adverse effects , Hypoglycemia/chemically induced , Hypoglycemia/diagnosis , Adult , Antiviral Agents/therapeutic use , Dizziness/chemically induced , Fatigue/chemically induced , Humans , Hydroxychloroquine/therapeutic use , Male , Treatment Outcome
17.
J Laryngol Otol ; 134(12): 1120-1122, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1043356

ABSTRACT

BACKGROUND: Coronavirus disease 2019 and other factors have driven interest in conducting remote consultations, but there has been little research on this topic in neuro-otology. With suitable preparation, neuro-otology patients with dizziness can have remote assessments that include elements of neuro-otological physical examination, with tailored management and onward pathways arranged. METHODS: This paper reports experience with remote consultation in over 700 neuro-otology patient consultations and suggests a systematic approach, illustrated by a clinical case report and data on 100 consultations. CONCLUSION: Remote consultations can play a role in neuro-otology clinics. Further research is needed to establish patient acceptability, diagnostic accuracy, safety and efficiency of remote models of care for this patient group.


Subject(s)
COVID-19/epidemiology , Dizziness/therapy , Neurotology/methods , Remote Consultation/instrumentation , COVID-19/diagnosis , COVID-19/virology , Dizziness/diagnosis , Dizziness/etiology , Female , Humans , Middle Aged , Neurotology/trends , Patient Care Management/methods , Patient Care Management/trends , Patient Satisfaction , Remote Consultation/methods , SARS-CoV-2/genetics , Telemedicine/methods , Telemedicine/trends , Vestibular Function Tests/methods
18.
Gac. méd. Méx ; 156(4): 313-316, Jul.-Aug. 2020.
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1041610

ABSTRACT

Abstract Coronavirus disease 2019 (COVID-19), an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently hitting the world in the form of a pandemic. Given that some reports suggest that this infection can also occur with neurologic manifestations, this narrative review addresses the basic and clinical aspects concerning the nervous system involvement associated with this disease. More than one third of patients hospitalized for COVID-19 can present with both central and peripheral neurological manifestations. The former includes dizziness and headache, while the latter includes taste and smell disturbances. Other reported neurological manifestations are cerebrovascular disease and epileptic seizures. According to published reports, neurological disorders are not uncommon in COVID-19 and can sometimes represent the first manifestation of the disease; therefore, neurologists should consider this diagnostic possibility in their daily practice. Since maybe not all COVID-19 neurological manifestations are due to SARS-CoV-2 direct effects, it is important to monitor the rest of the clinical parameters such as, for example, oxygen saturation. Similarly, follow-up of patients is advisable, since whether neurological complications may develop lately is thus far unknown.


Resumen La enfermedad del coronavirus 2019 (COVID-19), infección causada por el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2), actualmente afecta al mundo en forma de una pandemia. Debido a que algunos reportes apuntan a que esta infección puede cursar también con manifestaciones neurológicas, en esta revisión narrativa se abordan los aspectos básicos y clínicos concernientes a la afectación del sistema nervioso por esta enfermedad. Más de un tercio de los pacientes hospitalizados por COVID-19 pueden presentar manifestaciones neurológicas, tanto centrales como periféricas. Entre las primeras se encuentran el mareo y la cefalea; y entre las segundas, las alteraciones del gusto y el olfato. Otras manifestaciones neurológicas reportadas son la enfermedad vascular cerebral y las crisis epilépticas. Según los informes publicados, los padecimientos neurológicos no son infrecuentes en COVID-19 y en ocasiones pueden representar la primera manifestación de la enfermedad, de modo que los neurólogos deberán considerar esta posibilidad diagnóstica en su práctica cotidiana. Dado que no todas las manifestaciones neurológicas de COVID-19 pudieran deberse a efectos directos de SARS-CoV-2, es importante monitorear el resto de los parámetros clínicos, por ejemplo, la oxigenación. De igual forma, es recomendable el seguimiento de los pacientes, ya que hasta el momento se ignora si las complicaciones neurológicas pueden desarrollarse tardíamente.


Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Betacoronavirus/isolation & purification , Nervous System Diseases/virology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Taste Disorders/virology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Clinical Laboratory Techniques , Dizziness/virology , Pandemics , COVID-19 Testing , SARS-CoV-2 , COVID-19 , Headache/virology , Olfaction Disorders/virology , Nervous System Diseases/diagnosis
19.
Brain Behav ; 11(5): e02025, 2021 05.
Article in English | MEDLINE | ID: covidwho-1014008

ABSTRACT

BACKGROUND: At the end of December 2019, a novel respiratory infection, initially reported in China, known as COVID-19 initially reported in China, and later known as COVID-19, led to a global pandemic. Despite many studies reporting respiratory infections as the primary manifestations of this illness, an increasing number of investigations have focused on the central nervous system (CNS) manifestations in COVID-19. In this study, we aimed to evaluate the CNS presentations in COVID-19 patients in an attempt to identify the common CNS features and provide a better overview to tackle this new pandemic. METHODS: In this systematic review and meta-analysis, we searched PubMed, Web of Science, Ovid, EMBASE, Scopus, and Google Scholar. Included studies were publications that reported the CNS features between 1 January 2020 and 20 April 2020. The data of selected studies were screened and extracted independently by four reviewers. Extracted data analyzed by using STATA statistical software. The study protocol registered with PROSPERO (CRD42020184456). RESULTS: Of 2,353 retrieved studies, we selected 64 studies with 11,687 patients after screening. Most of the studies were conducted in China (58 studies). The most common CNS symptom of COVID-19 was headache (8.69%, 95%CI: 6.76%-10.82%), dizziness (5.94%, 95%CI: 3.66%-8.22%), and impaired consciousness (1.90%, 95%CI: 1.0%-2.79%). CONCLUSIONS: The growing number of studies has reported COVID-19, CNS presentations as remarkable manifestations that happen. Hence, understanding the CNS characteristics of COVID-19 can help us for better diagnosis and ultimately prevention of worse outcomes.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Central Nervous System Diseases/complications , Central Nervous System Diseases/physiopathology , COVID-19/virology , Central Nervous System Diseases/virology , China/epidemiology , Dizziness/complications , Headache/complications , Humans , SARS-CoV-2/pathogenicity
20.
J Zhejiang Univ Sci B ; 21(12): 940-947, 2020.
Article in English | MEDLINE | ID: covidwho-999887

ABSTRACT

BACKGROUND: The proportion of recurrences after discharge among patients with coronavirus disease 2019 (COVID-19) was reported to be between 9.1% and 31.0%. Little is known about this issue, however, so we performed a meta-analysis to summarize the demographical, clinical, and laboratorial characteristics of non-recurrence and recurrence groups. METHODS: Comprehensive searches were conducted using eight electronic databases. Data regarding the demographic, clinical, and laboratorial characteristics of both recurrence and non-recurrence groups were extracted, and quantitative and qualitative analyses were conducted. RESULTS: Ten studies involving 2071 COVID-19 cases were included in this analysis. The proportion of recurrence cases involving patients with COVID-19 was 17.65% (between 12.38% and 25.16%) while older patients were more likely to experience recurrence (weighted mean difference (WMD)=1.67, range between 0.08 and 3.26). The time from discharge to recurrence was 13.38 d (between 12.08 and 14.69 d). Patients were categorized as having moderate severity (odds ratio (OR)=2.69, range between 1.30 and 5.58), while those with clinical symptoms including cough (OR=5.52, range between 3.18 and 9.60), sputum production (OR=5.10, range between 2.60 and 9.97), headache (OR=3.57, range between 1.36 and 9.35), and dizziness (OR=3.17, range between 1.12 and 8.96) were more likely to be associated with recurrence. Patients presenting with bilateral pulmonary infiltration and decreased leucocyte, platelet, and CD4+ T counts were at risk of COVID-19 recurrence (OR=1.71, range between 1.07 and 2.75; WMD=-1.06, range between -1.55 and -0.57, WMD=-40.39, range between -80.20 and -0.48, and WMD=-55.26, range between -105.92 and -4.60, respectively). CONCLUSIONS: The main factors associated with the recurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after hospital discharge were older age, moderate severity, bilateral pulmonary infiltration, laboratory findings including decreased leucocytes, platelets, and CD4+ T counts, and clinical symptoms including cough, sputum production, headache, and dizziness. These factors can be considered warning indicators for the recurrence of SARS-CoV-2 and might help the development of specific management strategies.


Subject(s)
COVID-19/diagnosis , Recurrence , Age Factors , Blood Cell Count , CD4 Lymphocyte Count , COVID-19/pathology , Cough , Dizziness , Headache , Humans , Patient Discharge , Risk Factors
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