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1.
Neurol Sci ; 41(9): 2345-2351, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-705416

ABSTRACT

BACKGROUND: During COVID-19 lockdown, non-urgent medical procedures were suspended. Grade of urgency of electroencephalography (EEG) may vary according to the clinical indication, setting, and status of infection of SARS-CoV-2 virus. "Italian Society of Clinical Neurophysiology" (SINC), "Italian League Against Epilepsy" (LICE), and the "Italian Association of Neurophysiology Technologists" (AITN) aimed to provide clinical and technical recommendation for EEG indications and recording standards in this pandemic era. METHODS: Presidents of SINC, LICE, and AITN endorsed three members per each society to formulate recommendations: classification of the degree of urgency of EEG clinical indications, management and behavior of physicians and neurophysiology technologists, hygiene and personal protection standards, and use of technical equipment. RESULTS: Scientific societies endorsed a paper conveying the recommendation for EEG execution in accordance with clinical urgency, setting (inpatients/outpatients), status of SARS-CoV-2 virus infection (positive, negative and uncertain), and phase of governmental restrictions (phase 1 and 2). Briefly, in phase 1, EEG was recommended only for those acute/subacute neurological symptoms where EEG is necessary for diagnosis, prognosis, or therapy. Outpatient examinations should be avoided in phase 1, while they should be recommended in urgent cases in phase 2 when they could prevent an emergency room access. Reduction of staff contacts must be encouraged through rescheduling job shifts. The use of disposable electrodes and dedicated EEG devices for COVID-19-positive patients are recommended. CONCLUSIONS: During the different phases of COVID-19 pandemic, the EEG should be reserved for patients really benefiting from its execution in terms of diagnosis, treatment, prognosis, and avoidance of emergency room access.


Subject(s)
Betacoronavirus , Coronavirus Infections/physiopathology , Electroencephalography/standards , Epilepsy/physiopathology , Pneumonia, Viral/physiopathology , Practice Guidelines as Topic/standards , Societies, Medical/standards , Advisory Committees/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Disease Outbreaks/prevention & control , Epilepsy/diagnosis , Epilepsy/epidemiology , Humans , Italy/epidemiology , Medical Laboratory Personnel/standards , Neurophysiology/methods , Neurophysiology/standards , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology
2.
Neurol Sci ; 41(9): 2345-2351, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-659243

ABSTRACT

BACKGROUND: During COVID-19 lockdown, non-urgent medical procedures were suspended. Grade of urgency of electroencephalography (EEG) may vary according to the clinical indication, setting, and status of infection of SARS-CoV-2 virus. "Italian Society of Clinical Neurophysiology" (SINC), "Italian League Against Epilepsy" (LICE), and the "Italian Association of Neurophysiology Technologists" (AITN) aimed to provide clinical and technical recommendation for EEG indications and recording standards in this pandemic era. METHODS: Presidents of SINC, LICE, and AITN endorsed three members per each society to formulate recommendations: classification of the degree of urgency of EEG clinical indications, management and behavior of physicians and neurophysiology technologists, hygiene and personal protection standards, and use of technical equipment. RESULTS: Scientific societies endorsed a paper conveying the recommendation for EEG execution in accordance with clinical urgency, setting (inpatients/outpatients), status of SARS-CoV-2 virus infection (positive, negative and uncertain), and phase of governmental restrictions (phase 1 and 2). Briefly, in phase 1, EEG was recommended only for those acute/subacute neurological symptoms where EEG is necessary for diagnosis, prognosis, or therapy. Outpatient examinations should be avoided in phase 1, while they should be recommended in urgent cases in phase 2 when they could prevent an emergency room access. Reduction of staff contacts must be encouraged through rescheduling job shifts. The use of disposable electrodes and dedicated EEG devices for COVID-19-positive patients are recommended. CONCLUSIONS: During the different phases of COVID-19 pandemic, the EEG should be reserved for patients really benefiting from its execution in terms of diagnosis, treatment, prognosis, and avoidance of emergency room access.


Subject(s)
Betacoronavirus , Coronavirus Infections/physiopathology , Electroencephalography/standards , Epilepsy/physiopathology , Pneumonia, Viral/physiopathology , Practice Guidelines as Topic/standards , Societies, Medical/standards , Advisory Committees/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Disease Outbreaks/prevention & control , Epilepsy/diagnosis , Epilepsy/epidemiology , Humans , Italy/epidemiology , Medical Laboratory Personnel/standards , Neurophysiology/methods , Neurophysiology/standards , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology
4.
J Neurovirol ; 26(3): 324-329, 2020 06.
Article in English | MEDLINE | ID: covidwho-276266

ABSTRACT

Coronavirus disease 2019 (COVID-19) was reported at the end of 2019 in China for the first time and has rapidly spread throughout the world as a pandemic. Since COVID-19 causes mild to severe acute respiratory syndrome, most studies in this field have only focused on different aspects of pathogenesis in the respiratory system. However, evidence suggests that COVID-19 may affect the central nervous system (CNS). Given the outbreak of COVID-19, it seems necessary to perform investigations on the possible neurological complications in patients who suffered from COVID-19. Here, we reviewed the evidence of the neuroinvasive potential of coronaviruses and discussed the possible pathogenic processes in CNS infection by COVID-19 to provide a precise insight for future studies.


Subject(s)
Ataxia/epidemiology , Brain Edema/epidemiology , Coronavirus Infections/epidemiology , Encephalitis, Viral/epidemiology , Epilepsy/epidemiology , Multiple Sclerosis/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Ataxia/complications , Ataxia/diagnosis , Ataxia/virology , Betacoronavirus/drug effects , Betacoronavirus/immunology , Betacoronavirus/pathogenicity , Blood-Brain Barrier/pathology , Blood-Brain Barrier/virology , Brain Edema/complications , Brain Edema/diagnosis , Brain Edema/virology , Central Nervous System/pathology , Central Nervous System/virology , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Encephalitis, Viral/complications , Encephalitis, Viral/diagnosis , Encephalitis, Viral/virology , Epilepsy/complications , Epilepsy/diagnosis , Epilepsy/virology , Humans , Multiple Sclerosis/complications , Multiple Sclerosis/diagnosis , Multiple Sclerosis/virology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Prevalence , Severe Acute Respiratory Syndrome/complications , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/transmission
5.
Neurology ; 95(2): 77-84, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-146855

ABSTRACT

OBJECTIVE: The emergence of coronavirus disease 2019 (COVID-19) presents a challenge for neurologists caring for patients with preexisting neurologic conditions hospitalized for COVID-19 or for evaluation of patients who have neurologic complications during COVID-19 infection. We conducted a scoping review of the available literature on COVID-19 to assess the potential effect on neurologists in terms of prevalent comorbidities and incidence of new neurologic events in patients hospitalized with COVID-19. METHODS: We searched MEDLINE/PubMed, CINAHL (EBSCO), and Scopus databases for adult patients with preexisting neurologic disease who were diagnosed and hospitalized for COVID-19 or reported incidence of secondary neurologic events following diagnosis of COVID-19. Pooled descriptive statistics of clinical data and comorbidities were examined. RESULTS: Among screened articles, 322 of 4,014 (8.0%) of hospitalized patients diagnosed and treated for COVID-19 had a preexisting neurologic illness. Four retrospective studies demonstrated an increased risk of secondary neurologic complications in hospitalized patients with COVID-19 (incidence of 6%, 20%, and 36.4%, respectively). Inconsistent reporting and limited statistical analysis among these studies did not allow for assessment of comparative outcomes. CONCLUSION: Emerging literature suggests a daunting clinical relationship between COVID-19 and neurologic illness. Neurologists need to be prepared to reorganize their consultative practices to serve the neurologic needs of patients during this pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Hospitalization , Nervous System Diseases/epidemiology , Pneumonia, Viral/epidemiology , Respiratory Distress Syndrome, Adult/epidemiology , Betacoronavirus , Cerebrovascular Disorders/epidemiology , Comorbidity , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Dementia/epidemiology , Epilepsy/epidemiology , Guillain-Barre Syndrome/epidemiology , Guillain-Barre Syndrome/etiology , Humans , Hypoxia-Ischemia, Brain/epidemiology , Hypoxia-Ischemia, Brain/etiology , Intensive Care Units , Leukoencephalitis, Acute Hemorrhagic/epidemiology , Leukoencephalitis, Acute Hemorrhagic/etiology , Pandemics , Parkinson Disease/epidemiology , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Stroke/epidemiology , Stroke/etiology
6.
Epilepsia ; 61(6): 1166-1173, 2020 06.
Article in English | MEDLINE | ID: covidwho-143876

ABSTRACT

OBJECTIVE: To compare the severity of psychological distress between patients with epilepsy and healthy controls during the COVID-19 outbreak in southwest China, as well as identify potential risk factors of severe psychological distress among patients with epilepsy. METHODS: This cross-sectional case-control study examined a consecutive sample of patients older than 15 years treated at the epilepsy center of West China Hospital between February 1 and February 29, 2020. As controls, sex- and age-matched healthy visitors of inpatients (unrelated to the patients) were also enrolled during the same period. Data on demographics and attention paid to COVID-19 were collected by online questionnaire, data on epilepsy features were collected from electronic medical records, and psychological distress was evaluated using the 6-item Kessler Psychological Distress Scale (K-6). Potential risk factors of severe psychological distress were identified using multivariate logistic regression. RESULTS: The 252 patients and 252 controls in this study were similar along all demographic variables except family income. Patients with epilepsy showed significantly higher K-6 scores than healthy controls and spent significantly more time following the COVID-19 outbreak (both P < .001). Univariate analyses associated both diagnosis of drug-resistant epilepsy and time spent paying attention to COVID-19 with severe psychological distress (defined as K-6 score >12; both P ≤ .001). Multivariate logistic regression identified two independent predictors of severe psychological distress: time spent paying attention to COVID-19 (odds ratio [OR] = 1.172, 95% confidence interval [CI] = 1.073-1.280) and diagnosis of drug-resistant epilepsy (OR = 0.283, 95% CI = 0.128-0.623). SIGNIFICANCE: During public health outbreaks, clinicians and caregivers should focus not only on seizure control but also on mental health of patients with epilepsy, especially those with drug-resistant epilepsy. K-6 scores > 12 indicate severe psychological distress. This may mean, for example, encouraging patients to engage in other activities instead of excessively following media coverage of the outbreak.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections , Depression/epidemiology , Epilepsy/epidemiology , Pandemics , Pneumonia, Viral , Psychological Distress , Adolescent , Adult , Anxiety/psychology , Attention , Betacoronavirus , Case-Control Studies , China/epidemiology , Cross-Sectional Studies , Depression/psychology , Disease Outbreaks , Drug Resistant Epilepsy/epidemiology , Female , Humans , Male , Severity of Illness Index , Time Factors , Young Adult
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