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1.
Crit Care Clin ; 38(3): 553-570, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1878086

ABSTRACT

Neurologic complications can be seen in mild to severe COVID-19 with a higher risk in patients with severe COVID-19. These can occur as a direct consequence of viral infection or consequences of treatments. The spectrum ranges from non-life-threatening, like headache, fatigue, malaise, anosmia, dysgeusia, to life-threatening complications, like stroke, encephalitis, coma, Guillain-Barre syndrome. A high index of suspicion can aid in early recognition and treatment. Outcomes depend on severity of underlying COVID-19, patient age, comorbidities, and severity of the complication. Postacute sequelae of COVID-19 range from fatigue, headache, dysosmia, brain fog, anxiety, depression to an overlap with postintensive care syndrome.


Subject(s)
COVID-19 , Nervous System Diseases , Stroke , COVID-19/complications , Disease Progression , Fatigue/complications , Headache/complications , Humans , Nervous System Diseases/etiology , Nervous System Diseases/therapy
2.
Mikrobiyol Bul ; 56(2): 365-370, 2022 Apr.
Article in Turkish | MEDLINE | ID: covidwho-1818597

ABSTRACT

The coronavirus disease-2019 (COVID-19) pandemic, which affects millions of people around the world, has been affecting our country since March 2020. The fact that the symptoms such as fever, myalgia, headache, joint pain which are common in COVID-19 patients are quite similar to the symptoms of diseases such as Crimean-Congo hemorrhagic fever (CCHF) and Brucellosis. This may cause a diagnostic confusion in regions where these diseases are seen as endemic. In this report, a patient hospitalized with a pre-diagnosis of COVID-19 and diagnosed with acute Brucellosis, CCHF and COVID-19 during followup was presented. A 31-year-old female patient living in a rural area admitted to the emergency service with complaints of fever, weakness, headache, and body/joint pain. Physical examination revealed a temperature of 38.3°C, a pulse rate of 102/minute, and a peripheral capillary oxygen saturation of 97% in room air. The system examination was normal. In the laboratory findings, an increase in liver enzymes and acute phase reactants was observed and the platelet count was at the lower limit of the normal range. In terms of COVID-19, no involvement compatible with COVID-19 was detected in the thorax computed tomography (CT) of the patient whose nasopharyngeal and oropharyngeal mixed swab samples were taken.The patient was transferred to our infectious diseases service with a pre-diagnosis of COVID-19 and CCHF. Serum samples were sent to the Public Health Agency Microbiology Reference Laboratory Department (PHA-MRLD) for CCHF diagnostic tests and supportive treatment was started. Brucella Rose Bengal and Coombs' immuncapture (1/1280 titer) tests were found as positive in the patient, who was examined for brucellosis because of living in a rural area and having a history of consuming fresh dairy products. In the tests performed at PHA-MRLD, CCHF-specific IgM positivity and the presence of viral RNA were detected. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) test was negative. For Brucellosis, doxycycline and rifampicin were added to the treatment of the patient whom was given supportive therapy for CCHF. In the followup, the patient's fever was persisting and loss of taste and smell complaint developed. In this context, COVID-19 test was repeated and resulted as positive. Upon this, hydroxychloroquine sulfate treatment was started due to the recommendation of the current Ministry of Health Scientific Committee Guide. No new infiltration was detected in the chest radiography of the patient. The patient's fever subsided during follow-up and laboratory findings improved. The treatment of brucellosis was completed to eight weeks at the outpatient clinic. No problems were detected in the follow-up. This report was prepared because of a case with simultaneous brucellosis, CCHF and COVID-19 infections which could not be encountered in the literature review. As a result; in regions such as our country where both brucellosis and CCHF are seen as endemic, it is very important to keep these diseases in mind in the differential diagnosis of COVID-19 infection.


Subject(s)
Brucellosis , COVID-19 , Hemorrhagic Fever Virus, Crimean-Congo , Hemorrhagic Fever, Crimean , Adult , Arthralgia/complications , Arthralgia/diagnosis , Arthralgia/epidemiology , Brucellosis/complications , Brucellosis/diagnosis , Brucellosis/drug therapy , COVID-19/diagnosis , Diagnosis, Differential , Female , Headache/complications , Headache/diagnosis , Hemorrhagic Fever Virus, Crimean-Congo/genetics , Hemorrhagic Fever, Crimean/complications , Hemorrhagic Fever, Crimean/diagnosis , Humans , Pandemics , SARS-CoV-2
3.
Acta Neurol Taiwan ; 31(4): 170-173, 2022 Dec 30.
Article in English | MEDLINE | ID: covidwho-1801464

ABSTRACT

PURPOSE: To highlight the factors leading to the delayed diagnosis of basilar artery occlusion and poor outcome in the postpartum period during the prevailing Corona Virus Disease-2019 (COVID-19) pandemic. CASE REPORT: We here report a case of a 34-year female who presented with a headache localized to the occipital region after cesarean section under spinal anesthesia. Her headache severity increased over time, and she developed a generalized seizure episode and became unconscious. Subsequently, basilar artery thrombosis was diagnosed. Despite all efforts, she succumbed to death. We believe that we might have saved the patient's life if we could have made the diagnosis beforehand. CONCLUSION: We recommend that unless shown otherwise, postpartum headache and neck discomfort, even in individuals with no known risk factors, should have a low index of suspicion, early diagnosis using non-invasive radiological study such MRI to rule out this uncommon but deadly illness quickly.


Subject(s)
COVID-19 , Thrombosis , Basilar Artery/diagnostic imaging , COVID-19/complications , Cesarean Section/adverse effects , Female , Headache/complications , Humans , Pandemics , Postpartum Period , Pregnancy , Thrombosis/etiology
4.
Tuberk Toraks ; 70(1): 27-36, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1776525

ABSTRACT

Introduction: Neurological aspect of COVID-19 is less understood compared to its respiratory and systemic effects. We aimed to define subacute neurological sequelae in patients who recovered from mild COVID-19. Materials and Methods: This study enrolled long COVID patients who had mild infection, were non-hospitalized, and admitted to our hospital with neurological complaints occurring after COVID-19. The evaluation included detailed history of the symptoms, neurological examination, blood tests and necessary investigations relevant to their personal medical situation, and also a retrospective inquiry about their respiratory and neurological status during the acute phase of infection. Descriptive statistical measures, Chi-square and Student's t-test were utilized. Result: We identified 50 patients (29F/21M) with a mean age of 36.9 ± 1.6 (mean ± SEM). The average time from COVID-19 to admission was 99 days(min-max= 15-247). Most frequent neurological complaints were headache (42%) and cognitive dysfunction (42%). Sleep disturbance (36%), prolonged anosmia (30%), prolonged ageusia (22%), fatigue (22%), and dizziness (8%) followed. Most patients with headache experienced headache also as an acute manifestation of COVID-19 (p= 0.02). Acute-stage sleep disorders were found to be more associated with subacute cognitive symptoms than other central symptoms (p= 0.008). The most common neurological symptom in the acute phase was headache (74%). Six patients, despite the absence of any acute-stage neurological symptoms, presented with emergence of subacute neurological sequela. There were only five patients with pulmonary involvement during the acute stage, who were not different from the rest of the cohort in terms of neurological sequelae. There was no increase of inflammatory markers in the blood tests at the subacute stage, or no association of the symptoms to biochemical parameters. Conclusions: This study gives a description of neurological sequelae of mild COVID-19 at the subacute stage, in a relatively young group, and reveals that cognitive disturbances, as well as headache, are quite frequent.


Subject(s)
COVID-19 , Adult , COVID-19/complications , Headache/complications , Headache/etiology , Humans , Outpatients , Retrospective Studies
5.
Neurol Sci ; 43(5): 2951-2956, 2022 May.
Article in English | MEDLINE | ID: covidwho-1712255

ABSTRACT

BACKGROUND: The coronavirus pandemic became the hard challenge for the modern global health system. To date, vaccination is the best strategy against Sars-Cov-2-related illness. About 3 billions of people received at least one of the approved vaccines. The related adverse events were reported during the various experimental phases, but newer and less common side effects are emerging post-marketing. Vaccine-induced thrombocytopenia with thrombosis (VITT) is one of these insidious adverse reactions and it is considered responsible of venous thrombosis, in both the splanchnic and the cerebral circulation. Although its mechanism has been presumably established, resembling that observed in heparin-induced thrombocytopenia, some venous thromboses seem not to recognize this etiology and their pathogenesis remains unknown. Here we described a case of cerebral venous thrombosis after administration of the Ad26.COV2.S, presenting without thrombocytopenia, paving the way for possible novel causes of this vaccine-induced pathological condition. CASE PRESENTATION: A 45-year-old woman came to our observation for bilateral periorbital headache associated with retro-orbital pain started 8 days after administration of COVID vaccine Jannsen. Ophthalmologic exam showing a bilateral papilledema raised the suspicion of intracranial hypertension. Cerebral magnetic resonance imaging revealed signal alteration with T1-positive contrast enhancement in the right temporal and insular lobes suggestive of cerebral venous thrombosis. The absence of thrombocytopenia and platelet factor 4 (PF-4) antibodies led the clinicians to rule out VITT. The patient was treated successfully with warfarin. CONCLUSION: Venous thrombosis occurring after COVID-19 vaccination represents an adverse event of special interest. Patients with thrombosis and thrombocytopenia appear to be affected by a general thrombophilic state, sustained by an autoimmune mechanism, and show a higher mortality. Thrombosis without thrombocytopenia's pathogenesis has not yet been clarified, but laboratory data and good response to vitamin K antagonists help clinicians in the differential diagnosis with VITT. Future research will allow us to discover other possible mechanisms and maybe identify a subgroup of patients with a higher risk of developing this medical complication.


Subject(s)
COVID-19 , Intracranial Thrombosis , Thrombocytopenia , Thrombosis , Vaccines , Venous Thrombosis , COVID-19/complications , COVID-19 Vaccines/adverse effects , Female , Headache/complications , Humans , Intracranial Thrombosis/chemically induced , Intracranial Thrombosis/diagnostic imaging , Middle Aged , SARS-CoV-2 , Thrombocytopenia/chemically induced , Thrombocytopenia/diagnosis , Thrombosis/complications , Vaccines/adverse effects , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/drug therapy , Venous Thrombosis/etiology
6.
J Infect ; 84(2): 158-170, 2022 02.
Article in English | MEDLINE | ID: covidwho-1603797

ABSTRACT

BACKGROUND: Data on the long-term impact of SARS-CoV-2 infection in children and young people (CYP) are conflicting. We assessed evidence on long-term post-COVID symptoms in CYP examining prevalence, risk factors, type and duration. METHODS: Systematic search of published and unpublished literature using 13 online databases between 01/12/2019 and 31/07/2021. Eligible studies reported CYP ≤19 years with confirmed or probable SARS-CoV-2 with any symptoms persisting beyond acute illness. Random effects meta-analyses estimated pooled risk difference in symptom prevalence (controlled studies only) and pooled prevalence (uncontrolled studies also included). Meta-regression examined study characteristics hypothesised to be associated with symptom prevalence. Prospectively registered: CRD42021233153. FINDINGS: Twenty two of 3357 unique studies were eligible, including 23,141 CYP. Median duration of follow-up was 125 days (IQR 99-231). Pooled risk difference in post-COVID cases compared to controls (5 studies) were significantly higher for cognitive difficulties (3% (95% CI 1, 4)), headache (5% (1, 8)), loss of smell (8%, (2, 15)), sore throat (2% (1, 2)) and sore eyes (2% (1, 3)) but not abdominal pain, cough, fatigue, myalgia, insomnia, diarrhoea, fever, dizziness or dyspnoea. Pooled prevalence of symptoms in post-COVID participants in 17 studies ranged from 15% (diarrhoea) to 47% (fatigue). Age was associated with higher prevalence of all symptoms except cough. Higher study quality was associated with lower prevalence of all symptoms, except loss of smell and cognitive symptoms. INTERPRETATION: The frequency of the majority of reported persistent symptoms was similar in SARS-CoV-2 positive cases and controls. This systematic review and meta-analysis highlights the critical importance of a control group in studies on CYP post SARS-CoV-2 infection.


Subject(s)
COVID-19 , Adolescent , Child , Fatigue , Fever/etiology , Headache/complications , Headache/etiology , Humans , SARS-CoV-2
7.
Medicine (Baltimore) ; 100(49): e28174, 2021 Dec 10.
Article in English | MEDLINE | ID: covidwho-1566098

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease which making people difficult to breathe and often accompanied with headache. Acupuncture have been proved the therapeutic effect on headache, but there has been no high-quality evidence on acupuncture for the headache in COVID-19. This study is designed to evaluate the effectiveness and safety of acupuncture for headache in COVID-19. METHODS: Randomized controlled trials from December 2019 to July 2021 will be included without restrictions on language or publication date. PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Databases, China National Knowledge Infrastructure, Wanfang database, and VIP database will be searched. Two researchers will independently select studies, extract data and evaluate study quality. Cochrane risk of bias tool for randomized trials will be used to assess the risk of bias of included studies. Statistical analyses will be performed using the Review Manager V.5.3 and stata 14.0. ETHICS AND DISSEMINATION: This study will not involve personal information. Ethical approval will not be required. We will publish the results in a peer-reviewed journal. PROSPERO TRIAL REGISTRATION NUMBER: CRD42021270722.


Subject(s)
Acupuncture Therapy , COVID-19/complications , Headache/complications , Headache/therapy , Meta-Analysis as Topic , Systematic Reviews as Topic/methods , Humans , SARS-CoV-2
10.
Sci Rep ; 11(1): 16144, 2021 08 09.
Article in English | MEDLINE | ID: covidwho-1349688

ABSTRACT

COVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17-87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.


Subject(s)
Alopecia/diagnosis , Attention Deficit Disorder with Hyperactivity/diagnosis , COVID-19/complications , Dyspnea/diagnosis , Fatigue/diagnosis , Headache/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Alopecia/complications , Attention Deficit Disorder with Hyperactivity/complications , COVID-19/virology , Dyspnea/complications , Fatigue/complications , Headache/complications , Humans , Middle Aged , SARS-CoV-2/physiology , Young Adult
11.
J Headache Pain ; 22(1): 51, 2021 Jun 04.
Article in English | MEDLINE | ID: covidwho-1346199

ABSTRACT

BACKGROUND: The presence of headache during the acute phase of COVID-19 could be associated with the innate response and the cytokine release. We aim to compare the cytokine and interleukin profile in hospitalized COVID-19 patients at the moment of admission with and without headache during the course of the disease. METHODS: An observational analytic study with a case control design was performed. Hospitalized patients from a tertiary hospital with confirmed COVID-19 disease were included. Patients were classified into the headache or the control group depending on whether they presented headache not better accounted for by another headache disorder other than acute headache attributed to systemic viral infection. Several demographic and clinical variables were studies in both groups. We determined the plasmatic levels of 45 different cytokines and interleukins from the first hospitalization plasma extraction in both groups. RESULTS: One hundred and four patients were included in the study, aged 67.4 (12.8), 43.3% female. Among them, 29 (27.9%) had headache. Patients with headache were younger (61.8 vs. 69.5 years, p = 0.005) and had higher frequency of fever (96.6 vs. 78.7%, p = 0.036) and anosmia (48.3% vs. 22.7%, p = 0.016). In the comparison of the crude median values of cytokines, many cytokines were different between both groups. In the comparison of the central and dispersion parameters between the two groups, GROa, IL-10, IL1RA, IL-21, IL-22 remained statistically significant. After adjusting the values for age, sex, baseline situation and COVID-19 severity, IL-10 remained statistically significant (3.3 vs. 2.2 ng/dL, p = 0.042), with a trend towards significance in IL-23 (11.9 vs. 8.6 ng/dL, p = 0.082) and PIGF1 (1621.8 vs. 110.6 ng/dL, p = 0.071). CONCLUSIONS: The higher levels of IL-10 -an anti-inflammatory cytokine- found in our sample in patients with headache may be explained as a counteract of cytokine release, reflecting a more intense immune response in these patients.


Subject(s)
COVID-19 , Cytokines , Case-Control Studies , Female , Headache/complications , Humans , Interleukins , Male , SARS-CoV-2
13.
World Neurosurg ; 152: e678-e687, 2021 08.
Article in English | MEDLINE | ID: covidwho-1275760

ABSTRACT

BACKGROUND: Pituitary apoplexy (PA) is a rare, but life-threatening, condition characterized by pituitary infarction and hemorrhage, most often in the setting of a preexisting adenoma. The risk factors and mechanisms associated with PA are poorly understood. Although neurovascular manifestations of coronavirus disease 2019 (COVID-19) infection have been documented, its association with PA has not yet been determined. METHODS: From a prospectively collected database of patients treated at a tertiary care center for pituitary adenoma, we conducted a retrospective medical record review of PA cases during the COVID-19 pandemic from March 2020 to December 2020. We also conducted a literature review to identify other reported cases. RESULTS: We identified 3 consecutive cases of PA and concomitant COVID-19 infection. The most common symptoms at presentation were headache and vision changes. The included patients were successfully treated with surgical decompression and medical management of the associated endocrinopathy, ultimately experiencing improvement in their visual symptoms at the latest follow-up examination. COVID-19 infection in the perioperative period was corroborated by polymerase chain reaction test results in all the patients. CONCLUSIONS: With the addition of our series to the literature, 10 cases of PA in the setting of COVID-19 infection have been confirmed. The present series was limited in its ability to draw conclusions about the relationship between these 2 entities. However, COVID-19 infection might represent a risk factor for the development of PA. Further studies are required.


Subject(s)
Adenoma/surgery , COVID-19/surgery , Pituitary Apoplexy/surgery , Pituitary Neoplasms/surgery , Adult , COVID-19/complications , Female , Headache/complications , Humans , Hypopituitarism/complications , Male , Middle Aged
14.
J Neurovirol ; 27(1): 86-93, 2021 02.
Article in English | MEDLINE | ID: covidwho-1014250

ABSTRACT

The COVID-19 pandemic has infected more than 22 million people worldwide. Although much has been learned about COVID-19, we do not know much about its neurological features and their outcome. This observational study was conducted on the patients of Imam Hossein Hospital, and 361 adult patients (214 males) with confirmed diagnosis of COVID-19 from March 5, 2020 to April 3, 2020, were enrolled. Data was gathered on age, sex, comorbidities, initial symptoms, symptoms during the disease course, neurological symptoms, and outcome. The mean age of the patients was 61.90 ± 16.76 years. The most common initial symptoms were cough, fever, and dyspnea. In 21 patients (5.8%), the initial symptom was neurological. History of dementia was associated with severe COVID-19 disease (odds ratio = 1.28). During the course of the disease, 186 patients (51.52%) had at least one neurological symptom, the most common being headache (109 [30.2%]), followed by anosmia/ageusia (69, [19.1%]), and dizziness (54, [15%]). Also, 31 patients had neurological complications (8.58%). Anosmia, ageusia, dizziness, and headache were associated with favorable outcome (P < 0.001), while altered mental status and hemiparesis were associated with poor outcome. The mortality rate of patients who had neurological complications was more than twice than that of patients without neurological complication (P = 0.008). Almost half of the patients experienced at least one neurological symptom, which may be the initial presentation of COVID-19. Dementia appears to be associated with severe COVID-19. Mortality was higher in patients with neurological complications, and these patients needed more intensive care.


Subject(s)
COVID-19/complications , Dementia/complications , Dyspnea/complications , Headache/complications , Paresis/complications , SARS-CoV-2/pathogenicity , Adult , Aged , Aged, 80 and over , Ageusia/complications , Ageusia/diagnosis , Ageusia/mortality , Ageusia/virology , Anosmia/complications , Anosmia/diagnosis , Anosmia/mortality , Anosmia/virology , COVID-19/diagnosis , COVID-19/mortality , COVID-19/virology , Cough/complications , Cough/diagnosis , Cough/mortality , Cough/virology , Dementia/diagnosis , Dementia/mortality , Dementia/virology , Dyspnea/diagnosis , Dyspnea/mortality , Dyspnea/virology , Female , Fever/complications , Fever/diagnosis , Fever/mortality , Fever/virology , Headache/diagnosis , Headache/mortality , Headache/virology , Humans , Male , Middle Aged , Paresis/diagnosis , Paresis/mortality , Paresis/virology , Retrospective Studies , Severity of Illness Index , Survival Analysis
15.
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
16.
Ideggyogy Sz ; 73(11-12): 427-430, 2020 Nov 30.
Article in Hungarian | MEDLINE | ID: covidwho-953180

ABSTRACT

The clinical signs of SARS-CoV-2 infection has become more recognisable in recent times. In addition to common symptoms such as fever, cough, dyspnea, pneumonia and ageusia, less common complications can be identified, including many neurological manifestations. In this paper, we discuss three Covid-19 associated neurological disorders (Case 1: Covid-19 encephalitis, Case 2: Covid-19 organic headache, Case 3: SARS-CoV-2-infection and ischaemic stroke). We emphasize in our multiple case study that during the present pandemic, it is especially important for neurologists to be aware of the nervous system complications of the virus infection, thus saving unnecessary examinations and reducing the frequency of patients' contact with health care personnel.


Subject(s)
Brain Ischemia/virology , COVID-19 , Coronavirus Infections/diagnosis , Headache/virology , Pneumonia, Viral/diagnosis , Stroke/virology , Brain Ischemia/complications , Coronavirus , Coronavirus Infections/complications , Encephalitis , Headache/complications , Humans , Nervous System Diseases/complications , Nervous System Diseases/virology , Pneumonia, Viral/complications , Stroke/complications
18.
Neurologia (Engl Ed) ; 35(9): 628-632, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-747866

ABSTRACT

INTRODUCTION: In recent months, doubts have arisen among patients, general practitioners, and neurologists as to whether some drugs commonly used in patients with headaches and neuralgia may favour or complicate the disease caused by SARS-CoV-2. MATERIAL AND METHODS: We collected information on the opinions of scientific societies and medicines agencies (American, European, and Spanish) to clarify doubts regarding the use of drugs such as lisinopril, candesartan, ibuprofen, corticosteroids, carbamazepine, and monoclonal antibodies targeting the calcitonin gene-related peptide in the context of the COVID-19 pandemic. RESULTS: We make recommendations about the use of standard headache treatments in the context of the COVID-19 pandemic, based on the current scientific evidence. CONCLUSIONS: At present, there is no robust scientific argument to formally contraindicate any of the standard treatments employed for headaches and neuralgias.


Subject(s)
Analgesics/adverse effects , Coronavirus Infections/complications , Headache/drug therapy , Neuralgia/drug therapy , Pneumonia, Viral/complications , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/therapeutic use , Analgesics/pharmacology , Analgesics/therapeutic use , Angiotensin-Converting Enzyme 2 , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal/therapeutic use , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Antihypertensive Agents/adverse effects , Antihypertensive Agents/therapeutic use , Antiviral Agents/pharmacology , Benzimidazoles/adverse effects , Benzimidazoles/therapeutic use , Betacoronavirus , Biphenyl Compounds , COVID-19 , Calcitonin Gene-Related Peptide Receptor Antagonists/adverse effects , Calcitonin Gene-Related Peptide Receptor Antagonists/therapeutic use , Carbamazepine/adverse effects , Carbamazepine/therapeutic use , Coronavirus Infections/drug therapy , Disease Susceptibility/chemically induced , Drug Interactions , Enzyme Induction/drug effects , Headache/complications , Headache/prevention & control , Humans , Ibuprofen/adverse effects , Ibuprofen/pharmacology , Ibuprofen/therapeutic use , Lisinopril/adverse effects , Lisinopril/therapeutic use , Neuralgia/complications , Pandemics , Peptidyl-Dipeptidase A/biosynthesis , Peptidyl-Dipeptidase A/genetics , Receptors, Virus/biosynthesis , Receptors, Virus/genetics , Risk Factors , SARS-CoV-2 , Tetrazoles/adverse effects , Tetrazoles/therapeutic use
19.
J Neurovirol ; 26(5): 619-630, 2020 10.
Article in English | MEDLINE | ID: covidwho-728290

ABSTRACT

The recent pandemic outbreak of coronavirus is pathogenic and a highly transmittable viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). In this time of ongoing pandemic, many emerging reports suggested that the SARS-CoV-2 has inimical effects on neurological functions, and even causes serious neurological damage. The neurological symptoms associated with COVID-19 include headache, dizziness, depression, anosmia, encephalitis, stroke, epileptic seizures, and Guillain-Barre syndrome along with many others. The involvement of the CNS may be related with poor prognosis and disease worsening. Here, we review the evidence of nervous system involvement and currently known neurological manifestations in COVID-19 infections caused by SARS-CoV-2. We prioritize the 332 human targets of SARS-CoV-2 according to their association with brain-related disease and identified 73 candidate genes. We prioritize these 73 genes according to their spatio-temporal expression in the different regions of brain and also through evolutionary intolerance analysis. The prioritized genes could be considered potential indicators of COVID-19-associated neurological symptoms and thus act as a possible therapeutic target for the prevention and treatment of CNS manifestations associated with COVID-19 patients.


Subject(s)
Betacoronavirus/pathogenicity , Brain/metabolism , Coronavirus Infections/genetics , Host-Pathogen Interactions/genetics , Nerve Tissue Proteins/genetics , Pneumonia, Viral/genetics , Viral Proteins/genetics , Brain/pathology , Brain/virology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/pathology , Coronavirus Infections/virology , Depression , Dizziness/complications , Dizziness/genetics , Dizziness/pathology , Dizziness/virology , Encephalitis/complications , Encephalitis/genetics , Encephalitis/pathology , Encephalitis/virology , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/genetics , Guillain-Barre Syndrome/pathology , Guillain-Barre Syndrome/virology , Headache/complications , Headache/genetics , Headache/pathology , Headache/virology , Humans , Nerve Tissue Proteins/classification , Nerve Tissue Proteins/metabolism , Olfaction Disorders/complications , Olfaction Disorders/genetics , Olfaction Disorders/pathology , Olfaction Disorders/virology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Protein Interaction Mapping , SARS-CoV-2 , Seizures/complications , Seizures/genetics , Seizures/pathology , Seizures/virology , Severity of Illness Index , Stroke/complications , Stroke/genetics , Stroke/pathology , Stroke/virology , Viral Proteins/metabolism
20.
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
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