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1.
Pediatr Infect Dis J ; 40(9): e340-e343, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1370831

ABSTRACT

AIM: To describe a term newborn with acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and multisystem involvement including seizures associated to ischemic lesions in the brain. BACKGROUND: Coronavirus disease 2019 (COVID-19) is predominantly a respiratory infection, but it may affect many other systems. Most pediatric COVID-19 cases range from asymptomatic to mild-moderate disease. There are no specific clinical signs described for neonatal COVID-19 infections. In children, severe central nervous system compromise has been rarely reported. CASE DESCRIPTION: We describe a 17-day-old newborn who acquired a SARS-CoV-2 infection in a family meeting that was admitted for fever, seizures and lethargy and in whom consumption coagulopathy, ischemic lesions in the brain and cardiac involvement were documented. CONCLUSIONS: SARS-CoV-2 neonatal infection can be associated with multi-organic involvement. In our patient, significant central nervous system compromise associated to ischemic lesions and laboratory findings of consumption coagulopathy were found. CLINICAL SIGNIFICANCE: Although neonatal SARS-CoV-2 infections are infrequent, they can be associated with multi-organic involvement. Neonatologists and pediatricians should be aware of this unusual way of presentation of COVID-19 in newborn infants.


Subject(s)
Brain Ischemia/virology , COVID-19/complications , Infant, Newborn, Diseases/virology , SARS-CoV-2/isolation & purification , Acyclovir/therapeutic use , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Brain/diagnostic imaging , Brain Ischemia/pathology , COVID-19/drug therapy , COVID-19/pathology , Ceftriaxone/therapeutic use , Fever , Frontal Lobe/blood supply , Frontal Lobe/diagnostic imaging , Frontal Lobe/pathology , Humans , Infant, Newborn , Infant, Newborn, Diseases/drug therapy , Infant, Newborn, Diseases/pathology , Lethargy , Magnetic Resonance Imaging , Male , Nasopharynx/virology , Seizures
3.
PLoS One ; 16(7): e0254045, 2021.
Article in English | MEDLINE | ID: covidwho-1295522

ABSTRACT

Intolerance of uncertainty (IU) can influence emotional predictions, constructed by the brain (generation stage) to prearrange action (implementation stage), and update internal models according to incoming stimuli (updating stage). However, neurocomputational mechanisms by which IU affects emotional predictions are unclear. This high-density EEG study investigated if IU predicted event-related potentials (ERPs) and brain sources activity developing along the stages of emotional predictions, as a function of contextual uncertainty. Thirty-six undergraduates underwent a S1-S2 paradigm, with emotional faces and pictures as S1s and S2s, respectively. Contextual uncertainty was manipulated across three blocks, each with 100%, 75%, or 50% S1-S2 emotional congruency. ERPs, brain sources and their relationship with IU scores were analyzed for each stage. IU did not affect prediction generation. During prediction implementation, higher IU predicted larger Contingent Negative Variation in the 75% block, and lower left anterior cingulate cortex and supplementary motor area activations. During prediction updating, as IU increased P2 to positive S2s decreased, along with P2 and Late Positive Potential in the 75% block, and right orbito-frontal cortex activity to emotional S2s. IU was therefore associated with altered uncertainty assessment and heightened attention deployment during implementation, and to uncertainty avoidance, reduced attention to safety cues and disrupted access to emotion regulation strategies during prediction updating.


Subject(s)
Brain/diagnostic imaging , Emotions/physiology , Fear/physiology , Frontal Lobe/diagnostic imaging , Adult , Behavior/physiology , Brain/pathology , Brain/physiology , Brain Mapping , Contingent Negative Variation/physiology , Electroencephalography , Evoked Potentials/physiology , Face/physiology , Fear/psychology , Female , Forecasting , Frontal Lobe/pathology , Frontal Lobe/physiology , Humans , Male , Uncertainty , Young Adult
4.
Am J Respir Cell Mol Biol ; 65(4): 403-412, 2021 10.
Article in English | MEDLINE | ID: covidwho-1237350

ABSTRACT

Mechanical ventilation is a known risk factor for delirium, a cognitive impairment characterized by dysfunction of the frontal cortex and hippocampus. Although IL-6 is upregulated in mechanical ventilation-induced lung injury (VILI) and may contribute to delirium, it is not known whether the inhibition of systemic IL-6 mitigates delirium-relevant neuropathology. To histologically define neuropathological effects of IL-6 inhibition in an experimental VILI model, VILI was simulated in anesthetized adult mice using a 35 cc/kg tidal volume mechanical ventilation model. There were two control groups, as follow: 1) spontaneously breathing or 2) anesthetized and mechanically ventilated with 10 cc/kg tidal volume to distinguish effects of anesthesia from VILI. Two hours before inducing VILI, mice were treated with either anti-IL-6 antibody, anti-IL-6 receptor antibody, or saline. Neuronal injury, stress, and inflammation were assessed using immunohistochemistry. CC3 (cleaved caspase-3), a neuronal apoptosis marker, was significantly increased in the frontal (P < 0.001) and hippocampal (P < 0.0001) brain regions and accompanied by significant increases in c-Fos and heat shock protein-90 in the frontal cortices of VILI mice compared with control mice (P < 0.001). These findings were not related to cerebral hypoxia, and there was no evidence of irreversible neuronal death. Frontal and hippocampal neuronal CC3 were significantly reduced with anti-IL-6 antibody (P < 0.01 and P < 0.0001, respectively) and anti-IL-6 receptor antibody (P < 0.05 and P < 0.0001, respectively) compared with saline VILI mice. In summary, VILI induces potentially reversible neuronal injury and inflammation in the frontal cortex and hippocampus, which is mitigated with systemic IL-6 inhibition. These data suggest a potentially novel neuroprotective role of systemic IL-6 inhibition that justifies further investigation.


Subject(s)
Antibodies/pharmacology , Apoptosis/drug effects , Delirium/metabolism , Interleukin-6/antagonists & inhibitors , Neurons/metabolism , Ventilator-Induced Lung Injury/metabolism , Animals , Delirium/drug therapy , Delirium/pathology , Disease Models, Animal , Female , Frontal Lobe/injuries , Frontal Lobe/metabolism , Frontal Lobe/pathology , HSP90 Heat-Shock Proteins/metabolism , Hippocampus/injuries , Hippocampus/metabolism , Hippocampus/pathology , Inflammation/drug therapy , Inflammation/metabolism , Inflammation/pathology , Interleukin-6/metabolism , Mice , Neurons/pathology , Proto-Oncogene Proteins c-fos/metabolism , Repressor Proteins/metabolism , Tumor Suppressor Proteins/metabolism , Ventilator-Induced Lung Injury/drug therapy , Ventilator-Induced Lung Injury/pathology
7.
Epilepsia ; 61(8): e90-e94, 2020 08.
Article in English | MEDLINE | ID: covidwho-615330

ABSTRACT

Neurological manifestations of coronavirus disease 19 (COVID-19) such as encephalitis and seizures have been reported increasingly, but our understanding of COVID-19-related brain injury is still limited. Herein we describe prefrontal involvement in a patient with COVID-19 who presented prior anosmia, raising the question of a potential trans-olfactory bulb brain invasion.


Subject(s)
Brain Diseases/pathology , Brain Diseases/virology , COVID-19/complications , Frontal Lobe/pathology , Status Epilepticus/virology , Aged , Brain Diseases/physiopathology , COVID-19/pathology , COVID-19/physiopathology , Frontal Lobe/physiopathology , Humans , Male , SARS-CoV-2 , Status Epilepticus/pathology , Status Epilepticus/physiopathology
8.
J Med Virol ; 92(7): 699-702, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-96729

ABSTRACT

Neurologic sequelae can be devastating complications of respiratory viral infections. We report the presence of virus in neural and capillary endothelial cells in frontal lobe tissue obtained at postmortem examination from a patient infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Our observations of virus in neural tissue, in conjunction with clinical correlates of worsening neurologic symptoms, pave the way to a closer understanding of the pathogenic mechanisms underlying central nervous system involvement by SARS-CoV-2.


Subject(s)
Ageusia/diagnosis , Ataxia/diagnosis , Betacoronavirus/pathogenicity , Coronavirus Infections/diagnosis , Olfaction Disorders/diagnosis , Pneumonia, Viral/diagnosis , Seizures/diagnosis , Aged , Ageusia/complications , Ageusia/physiopathology , Ageusia/virology , Ataxia/complications , Ataxia/physiopathology , Ataxia/virology , Betacoronavirus/genetics , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Endothelial Cells/pathology , Endothelial Cells/virology , Fatal Outcome , Frontal Lobe/blood supply , Frontal Lobe/pathology , Frontal Lobe/virology , Hospitalization , Humans , Lung/blood supply , Lung/pathology , Lung/virology , Male , Neurons/pathology , Neurons/virology , Olfaction Disorders/complications , Olfaction Disorders/physiopathology , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Seizures/complications , Seizures/physiopathology , Seizures/virology
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