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1.
Front Endocrinol (Lausanne) ; 13: 801133, 2022.
Article in English | MEDLINE | ID: covidwho-1731766

ABSTRACT

Background: acute illnesses, like COVID-19, can act as a catabolic stimulus on muscles. So far, no study has evaluated muscle mass and quality through limb ultrasound in post-COVID-19 patients. Methods: cross sectional observational study, including patients seen one month after hospital discharge for SARS-CoV-2 pneumonia. The patients underwent a multidimensional evaluation. Moreover, we performed dominant medial gastrocnemius ultrasound (US) to characterize their muscle mass and quality. Results: two hundred fifty-nine individuals (median age 67, 59.8% males) were included in the study. COVID-19 survivors with reduced muscle strength had a lower muscle US thickness (1.6 versus 1.73 cm, p =0.02) and a higher muscle stiffness (87 versus 76.3, p = 0.004) compared to patients with normal muscle strength. Also, patients with reduced Short Physical Performance Battery (SPPB) scores had a lower muscle US thickness (1.3 versus 1.71 cm, p = 0.01) and a higher muscle stiffness (104.9 versus 81.07, p = 0.04) compared to individuals with normal SPPB scores. The finding of increased muscle stiffness was also confirmed in patients with a pathological value (≥ 4) at the sarcopenia screening tool SARC-F (103.0 versus 79.55, p < 0.001). Muscle stiffness emerged as a significant predictor of probable sarcopenia (adjusted OR 1.02, 95% C.I. 1.002 - 1.04, p = 0.03). The optimal ultrasound cut-offs for probable sarcopenia were 1.51 cm for muscle thickness (p= 0.017) and 73.95 for muscle stiffness (p = 0.004). Discussion: we described muscle ultrasound characteristics in post COVID-19 patients. Muscle ultrasound could be an innovative tool to assess muscle mass and quality in this population. Our preliminary findings need to be confirmed by future studies comparing muscle ultrasound with already validated techniques for measuring muscle mass and quality.


Subject(s)
COVID-19/epidemiology , Muscle Strength/physiology , Muscle, Skeletal/pathology , Muscular Diseases/diagnosis , Survivors , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/mortality , COVID-19/pathology , Cross-Sectional Studies , Extremities/diagnostic imaging , Extremities/physiopathology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Muscle, Skeletal/diagnostic imaging , Muscular Diseases/etiology , Muscular Diseases/pathology , Muscular Diseases/physiopathology , Organ Size , SARS-CoV-2/physiology , Sarcopenia/diagnosis , Sarcopenia/epidemiology , Sarcopenia/etiology , Survivors/statistics & numerical data , Ultrasonography
2.
Ann Neurol ; 91(4): 568-574, 2022 04.
Article in English | MEDLINE | ID: covidwho-1680263

ABSTRACT

Coronavirus disease 2019 (COVID-19) severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2 infection) can lead to intensive care unit (ICU) admission and critical illness myopathy (CIM). We examined 3 ICU patients with COVID-19 who required mechanical ventilation for pneumonia and developed CIM. Pathological examination of the skeletal muscle biopsies revealed myopathic changes consistent with CIM, variable inflammation with autophagic vacuoles, SARS-CoV immunostaining + fibers/granules, and electron microscopy findings of mitochondrial abnormalities and coronavirus-like particles. Although mitochondrial dysfunction with compromised energy production is a critical pathogenic mechanism of non-COVID-19-associated CIM, in our series of COVID-19-associated CIM, myopathic changes including prominent mitochondrial damage suggest a similar mechanism and association with direct SARS-CoV-2 muscle infection. ANN NEUROL 2022;91:568-574.


Subject(s)
COVID-19/complications , COVID-19/virology , Critical Illness , Muscular Diseases/etiology , Muscular Diseases/virology , SARS-CoV-2 , Adult , Aged , Autophagy , Fatal Outcome , Female , Humans , Inflammation/pathology , Intensive Care Units , Male , Middle Aged , Mitochondria/pathology , Muscle, Skeletal/pathology , Vacuoles/pathology
3.
Mediators Inflamm ; 2021: 2911578, 2021.
Article in English | MEDLINE | ID: covidwho-1455770

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), affecting multiple organ systems, including the respiratory tract and lungs. Several studies have reported that the tryptophan-kynurenine pathway is altered in COVID-19 patients. The tryptophan-kynurenine pathway plays a vital role in regulating inflammation, metabolism, immune responses, and musculoskeletal system biology. In this minireview, we surmise the effects of the kynurenine pathway in COVID-19 patients and how this pathway might impact muscle and bone biology.


Subject(s)
Bone Diseases/etiology , COVID-19/complications , Kynurenine/metabolism , Muscular Diseases/etiology , SARS-CoV-2 , Tryptophan/metabolism , Animals , Humans , Receptors, Aryl Hydrocarbon/physiology , Signal Transduction/physiology
4.
Mol Neurobiol ; 58(9): 4694-4715, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1281328

ABSTRACT

The unremitting coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) marked a year-long phase of public health adversaries and has severely compromised healthcare globally. Early evidence of COVID-19 noted its impact on the pulmonary and cardiovascular functions, while multiple studies in recent time shed light on its substantial neurological complications, though a comprehensive understanding of the cause(s), the mechanism(s), and their neuropathological outcomes is scarce. In the present review, we conferred evidence of neurological complications in COVID-19 patients and shed light on the SARS-CoV-2 infection routes including the hematogenous, direct/neuronal, lymphatic tissue or cerebrospinal fluid, or infiltration through infected immune cells, while the underlying mechanism of SARS-CoV-2 invasion to the central nervous system (CNS) was also discussed. In an up-to-date manner, we further reviewed the impact of COVID-19 in developing diverse neurologic manifestations associated with CNS, peripheral nervous system (PNS), skeletal muscle, and also pre-existing neurological diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, and myasthenia gravis. Furthermore, we discussed the involvement of key factors including age, sex, comorbidity, and disease severity in exacerbating the neurologic manifestations in COVID-19 patients. An outlook of present therapeutic strategies and state of existing challenges in COVID-19 management was also accessed. Conclusively, the present report provides a comprehensive review of COVID-19-related neurological complications and emphasizes the need for their early clinical management in the ongoing COVID-19 pandemic.


Subject(s)
COVID-19/complications , Nervous System Diseases/etiology , Pandemics , SARS-CoV-2/pathogenicity , Adult , Age Factors , Aged , Aged, 80 and over , Autoimmune Diseases of the Nervous System/epidemiology , Autoimmune Diseases of the Nervous System/etiology , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Central Nervous System/virology , Child , Comorbidity , Female , Humans , Immune System/virology , Inflammation , Male , Middle Aged , Models, Biological , Muscular Diseases/etiology , Nervous System Diseases/drug therapy , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Neurodegenerative Diseases/complications , Neurons/virology , Organ Specificity , Sex Factors , Viremia/chemically induced , Viremia/immunology , Virus Internalization
5.
Clin Neurophysiol ; 132(8): 1974-1981, 2021 08.
Article in English | MEDLINE | ID: covidwho-1237654

ABSTRACT

OBJECTIVE: To investigate the peripheral nerve and muscle function electrophysiologically in patients with persistent neuromuscular symptoms following Coronavirus disease 2019 (COVID-19). METHODS: Twenty consecutive patients from a Long-term COVID-19 Clinic referred to electrophysiological examination with the suspicion of mono- or polyneuropathy were included. Examinations were performed from 77 to 255 (median: 216) days after acute COVID-19. None of the patients had received treatment at the intensive care unit. Of these, 10 patients were not even hospitalized. Conventional nerve conduction studies (NCS) and quantitative electromyography (qEMG) findings from three muscles were compared with 20 age- and sex-matched healthy controls. RESULTS: qEMG showed myopathic changes in one or more muscles in 11 patients (55%). Motor unit potential duration was shorter in patients compared to healthy controls in biceps brachii (10.02 ± 0.28 vs 11.75 ± 0.21), vastus medialis (10.86 ± 0.37 vs 12.52 ± 0.19) and anterior tibial (11.76 ± 0.31 vs 13.26 ± 0.21) muscles. All patients with myopathic qEMG reported about physical fatigue and 8 patients about myalgia while 3 patients without myopathic changes complained about physical fatigue. CONCLUSIONS: Long-term COVID-19 does not cause large fibre neuropathy, but myopathic changes are seen. SIGNIFICANCE: Myopathy may be an important cause of physical fatigue in long-term COVID-19 even in non-hospitalized patients.


Subject(s)
COVID-19/complications , COVID-19/physiopathology , Fatigue/etiology , Fatigue/physiopathology , Muscular Diseases/etiology , Muscular Diseases/physiopathology , Adult , Aged , COVID-19/diagnosis , Electromyography/trends , Fatigue/diagnosis , Female , Humans , Male , Middle Aged , Muscular Diseases/diagnosis , Neural Conduction/physiology , Registries , Time Factors
6.
Acta Neurol Scand ; 144(2): 161-169, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1199639

ABSTRACT

BACKGROUND: Critical illness polyneuropathy and myopathy (CIPNM) is a frequent neurological manifestation in patients with acute respiratory distress syndrome (ARDS) from coronavirus disease 2019 (COVID-19) infection. CIPNM diagnosis is usually limited to clinical evaluation. We compared patients with ARDS from COVID-19 and other aetiologies, in whom a neurophysiological evaluation for the detection of CIPNM was performed. The aim was to determine if there were any differences between these two groups in frequency of CINPM and outcome at discharge from the intensive care unit (ICU). MATERIALS AND METHODS: This was a single-centre retrospective study performed on mechanically ventilated patients consecutively admitted (January 2016-June 2020) to the ICU of Careggi Hospital, Florence, Italy, with ARDS of different aetiologies. Neurophysiological evaluation was performed on patients with stable ventilation parameters, but marked widespread hyposthenia (Medical Research Council score <48). Creatine phosphokinase (CPK), lactic dehydrogenase (LDH) and mean morning glycaemic values were collected. RESULTS: From a total of 148 patients, 23 with COVID-19 infection and 21 with ARDS due to other aetiologies, underwent electroneurography/electromyography (ENG/EMG) recording. Incidence of CIPNM was similar in the two groups, 65% (15 of 23) in COVID-19 patients and 71% (15 of 21) in patients affected by ARDS of other aetiologies. At ICU discharge, subjects with CIPNM more frequently required ventilatory support, regardless the aetiology of ARDS. CONCLUSION: ENG/EMG represents a useful tool in the identification of the neuromuscular causes underlying ventilator wean failure and patient stratification. A high incidence of CIPNM, with a similar percentage, has been observed in ARDS patients of all aetiologies.


Subject(s)
COVID-19 , Electrodiagnosis , Muscular Diseases , Polyneuropathies , Respiration, Artificial , Respiratory Distress Syndrome , Adult , COVID-19/complications , COVID-19/epidemiology , Critical Illness , Electromyography , Female , Humans , Intensive Care Units/statistics & numerical data , Italy/epidemiology , Male , Middle Aged , Muscular Diseases/diagnosis , Muscular Diseases/epidemiology , Muscular Diseases/etiology , Muscular Diseases/physiopathology , Polyneuropathies/diagnosis , Polyneuropathies/epidemiology , Polyneuropathies/etiology , Polyneuropathies/physiopathology , Respiration, Artificial/statistics & numerical data , Respiratory Distress Syndrome/complications , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Retrospective Studies
7.
Skelet Muscle ; 11(1): 10, 2021 04 21.
Article in English | MEDLINE | ID: covidwho-1197351

ABSTRACT

BACKGROUND: SARS-CoV2 virus could be potentially myopathic. Serum creatinine phosphokinase (CPK) is frequently found elevated in severe SARS-CoV2 infection, which indicates skeletal muscle damage precipitating limb weakness or even ventilatory failure. CASE PRESENTATION: We addressed such a patient in his forties presented with features of severe SARS-CoV2 pneumonia and high serum CPK. He developed severe sepsis and acute respiratory distress syndrome (ARDS) and received intravenous high dose corticosteroid and tocilizumab to counter SARS-CoV2 associated cytokine surge. After 10 days of mechanical ventilation (MV), weaning was unsuccessful albeit apparently clear lung fields, having additionally severe and symmetric limb muscle weakness. Ancillary investigations in addition with serum CPK, including electromyogram, muscle biopsy, and muscle magnetic resonance imaging (MRI) suggested acute myopathy possibly due to skeletal myositis. CONCLUSION: We wish to stress that myopathogenic medication in SARS-CoV2 pneumonia should be used with caution. Additionally, serum CPK could be a potential marker to predict respiratory failure in SARS-CoV2 pneumonia as skeletal myopathy affecting chest muscles may contribute ventilatory failure on top of oxygenation failure due to SARS-CoV2 pneumonia.


Subject(s)
COVID-19/physiopathology , Creatine Kinase/blood , Muscle, Skeletal/physiopathology , Muscular Diseases/physiopathology , Quadriplegia/physiopathology , Respiratory Distress Syndrome/physiopathology , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Adult , Alanine/analogs & derivatives , Alanine/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Anticoagulants/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/therapy , Critical Illness , Dexamethasone/therapeutic use , Electromyography , Glucocorticoids/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Intensive Care Units , Magnetic Resonance Imaging , Male , Methicillin-Resistant Staphylococcus aureus , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/pathology , Muscular Diseases/blood , Muscular Diseases/diagnosis , Muscular Diseases/etiology , Neural Conduction , Pulmonary Embolism/diagnosis , Pulmonary Embolism/drug therapy , Pulmonary Embolism/etiology , Pulmonary Embolism/physiopathology , Quadriplegia/etiology , Respiration, Artificial , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , SARS-CoV-2 , Severity of Illness Index , Staphylococcal Infections/complications , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Ventilator Weaning
8.
Clin Neurophysiol ; 132(7): 1733-1740, 2021 07.
Article in English | MEDLINE | ID: covidwho-1163547

ABSTRACT

OBJECTIVE: The aim was to characterize the electrophysiological features and plasma biomarkers of critical illness polyneuropathy (CIN) and myopathy (CIM) in coronavirus disease 2019 (COVID-19) patients with intensive care unit acquired weakness (ICUAW). METHODS: An observational ICU cohort study including adult patients admitted to the ICU at Uppsala University Hospital, Uppsala, Sweden, from March 13th to June 8th 2020. We compared the clinical, electrophysiological and plasma biomarker data between COVID-19 patients who developed CIN/CIM and those who did not. Electrophysiological characteristics were also compared between COVID-19 and non-COVID-19 ICU patients. RESULTS: 111 COVID-19 patients were included, 11 of whom developed CIN/CIM. Patients with CIN/CIM had more severe illness; longer ICU stay, more thromboembolic events and were more frequently treated with invasive ventilation for longer than 2 weeks. In particular CIN was more frequent among COVID-19 patients with ICUAW (50%) compared with a non-COVID-19 cohort (0%, p = 0.008). Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAp) levels were higher in the CIN/CIM group compared with those that did not develop CIN/CIM (both p = 0.001) and correlated with nerve amplitudes. CONCLUSIONS: CIN/CIM was more prevalent among COVID-19 ICU patients with severe illness. SIGNIFICANCE: COVID-19 patients who later developed CIN/CIM had significantly higher NfL and GFAp in the early phase of ICU care, suggesting their potential as predictive biomarkers for CIN/CIM.


Subject(s)
COVID-19/complications , Muscular Diseases/etiology , Polyneuropathies/etiology , Aged , Biomarkers/blood , COVID-19/physiopathology , Critical Illness , Female , Humans , Intensive Care Units , Length of Stay/statistics & numerical data , Male , Middle Aged , Muscle Weakness/etiology , Muscular Diseases/blood , Muscular Diseases/physiopathology , Polyneuropathies/blood , Polyneuropathies/physiopathology , Prospective Studies , Respiration, Artificial/statistics & numerical data , Thromboembolism/etiology
9.
Clin Neurophysiol ; 132(6): 1241-1242, 2021 06.
Article in English | MEDLINE | ID: covidwho-1157199
11.
Clin Neurophysiol ; 131(12): 2809-2816, 2020 12.
Article in English | MEDLINE | ID: covidwho-898641

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has a high incidence of intensive care admittance due to the severe acute respiratory syndrome (SARS). Intensive care unit (ICU)-acquired weakness (ICUAW) is a common complication of ICU patients consisting of symmetric and generalised weakness. The aim of this study was to determine the presence of myopathy, neuropathy or both in ICU patients affected by COVID-19 and whether ICUAW associated with COVID-19 differs from other aetiologies. METHODS: Twelve SARS CoV-2 positive patients referred with the suspicion of critical illness myopathy (CIM) or polyneuropathy (CIP) were included between March and May 2020. Nerve conduction and concentric needle electromyography were performed in all patients while admitted to the hospital. Muscle biopsies were obtained in three patients. RESULTS: Four patients presented signs of a sensory-motor axonal polyneuropathy and seven patients showed signs of myopathy. One muscle biopsy showed scattered necrotic and regenerative fibres without inflammatory signs. The other two biopsies showed non-specific myopathic findings. CONCLUSIONS: We have not found any distinctive features in the studies of the ICU patients affected by SARS-CoV-2 infection. SIGNIFICANCE: Further studies are needed to determine whether COVID-19-related CIM/CIP has different features from other aetiologies. Neurophysiological studies are essential in the diagnosis of these patients.


Subject(s)
COVID-19/complications , Intensive Care Units , Muscular Diseases/etiology , Polyneuropathies/etiology , SARS-CoV-2 , Aged , Biopsy , Critical Illness , Electromyography/methods , Female , Humans , Male , Middle Aged , Muscle Weakness/diagnosis , Muscle Weakness/etiology , Muscle Weakness/pathology , Muscle, Skeletal/pathology , Muscular Diseases/diagnosis , Muscular Diseases/pathology , Muscular Diseases/physiopathology , Neural Conduction , Polyneuropathies/diagnosis , Polyneuropathies/physiopathology
12.
Brain Nerve ; 72(10): 1045-1048, 2020 Oct.
Article in Japanese | MEDLINE | ID: covidwho-869293

ABSTRACT

Severe acute respiratory syndrome-correlated new coronavirus (SARS-Cov-2) continues to spread rapidly around the world. Reports regarding the neuropathy and myopathy associated with SARS-Cov-2 increase everyday. SARS-Cov-2 infection may result in peripheral neuropathy and myopathy, although direct infection of the peripheral nerve and muscle by SARS-Cov-2 is exceedingly rare. When initiating clinical treatment for COVID-19, it is crutial to distinguish the peripheral neuropathy or myopathy caused directly or indirectly by SARS-Cov-2 from those caused by other conditions. In this review, we aimed to report the peripheral nerve and muscle disorders associated with SARS-Cov-2 and their possible underlying pathophysiological mechanisms.


Subject(s)
Betacoronavirus , Coronavirus Infections , Muscular Diseases , Pandemics , Peripheral Nervous System Diseases , Pneumonia, Viral , COVID-19 , Coronavirus Infections/complications , Humans , Muscular Diseases/etiology , Peripheral Nervous System Diseases/etiology , Pneumonia, Viral/complications , SARS-CoV-2
13.
Neurologia (Engl Ed) ; 35(9): 621-627, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-759217

ABSTRACT

INTRODUCTION: We analysed the neurological complications of patients with severe SARS-CoV-2 infection who required intensive care unit (ICU) admission. PATIENTS AND METHODS: We conducted a retrospective, observational, descriptive study of consecutive patients admitted to the ICU due to severe respiratory symptoms secondary to SARS-CoV-2 infection between 1 April and 1 June 2020. RESULTS: We included 30 patients with neurological symptoms; 21 were men (72.40%), and mean age (standard deviation [SD]) was 57.41 years (11.61). The mean duration of ICU stay was 18.83 days (14.33). The neurological conditions recorded were acute confusional syndrome in 28 patients (93.33%), neuromuscular disease in 15 (50%), headache in 5 (16.66%), cerebrovascular disease in 4 (13.33%), and encephalopathies/encephalitis in 4 (13.33%). CSF analysis results were normal in 6 patients (20%). Brain MRI or head CT showed alterations in 20 patients (66.6%). EEG was performed in all patients (100%), with 8 (26.66%) showing abnormal findings. In 5 of the 15 patients with clinical myopathy, diagnosis was confirmed with electroneuromyography. We found a correlation between older age and duration of ICU stay (P=.002; 95%CI: 4.032-6.022; OR: 3,594). CONCLUSIONS: Severe COVID-19 mainly affects men, as observed in other series. Half of our patients presented acute myopathy, and almost all patients left the ICU with acute confusional syndrome, which fully resolved; no correlation was found with EEG or neuroimaging findings. Older age is associated with longer ICU stay.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Critical Illness , Muscular Diseases/etiology , Nervous System Diseases/etiology , Pandemics , Pneumonia, Viral/complications , Acute Disease , Adult , Age Factors , Aged , COVID-19 , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/epidemiology , Cerebral Hemorrhage/etiology , Confusion/epidemiology , Confusion/etiology , Coronavirus Infections/epidemiology , Critical Care , Female , Humans , Length of Stay/statistics & numerical data , Magnetic Resonance Imaging , Male , Middle Aged , Muscular Diseases/epidemiology , Nervous System Diseases/epidemiology , Neuroimaging , Pneumonia, Viral/epidemiology , Retrospective Studies , SARS-CoV-2 , Spain/epidemiology
14.
Can J Neurol Sci ; 48(1): 9-24, 2021 01.
Article in English | MEDLINE | ID: covidwho-697107

ABSTRACT

BACKGROUND: Albeit primarily a disease of respiratory tract, the 2019 coronavirus infectious disease (COVID-19) has been found to have causal association with a plethora of neurological, neuropsychiatric and psychological effects. This review aims to analyze them with a discussion of evolving therapeutic recommendations. METHODS: PubMed and Google Scholar were searched from 1 January 2020 to 30 May 2020 with the following key terms: "COVID-19", "SARS-CoV-2", "pandemic", "neuro-COVID", "stroke-COVID", "epilepsy-COVID", "COVID-encephalopathy", "SARS-CoV-2-encephalitis", "SARS-CoV-2-rhabdomyolysis", "COVID-demyelinating disease", "neurological manifestations", "psychosocial manifestations", "treatment recommendations", "COVID-19 and therapeutic changes", "psychiatry", "marginalised", "telemedicine", "mental health", "quarantine", "infodemic" and "social media". A few newspaper reports related to COVID-19 and psychosocial impacts have also been added as per context. RESULTS: Neurological and neuropsychiatric manifestations of COVID-19 are abundant. Clinical features of both central and peripheral nervous system involvement are evident. These have been categorically analyzed briefly with literature support. Most of the psychological effects are secondary to pandemic-associated regulatory, socioeconomic and psychosocial changes. CONCLUSION: Neurological and neuropsychiatric manifestations of this disease are only beginning to unravel. This demands a wide index of suspicion for prompt diagnosis of SARS-CoV-2 to prevent further complications and mortality.


Les impacts neurologiques et neuropsychiatriques d'une infection à la COVID-19. CONTEXTE: Bien qu'il s'agisse principalement d'une maladie des voies respiratoires, la maladie infectieuse à coronavirus apparue en 2019 (COVID-19) s'est avérée avoir un lien de causalité avec une pléthore d'impacts d'ordre neurologique, neuropsychiatrique et psychologique. Cette étude entend donc analyser ces impacts tout en discutant l'évolution des recommandations thérapeutiques se rapportant à cette maladie. MÉTHODES: Les bases de données PubMed et Google Scholar ont été interrogées entre les 1er janvier et 30 mai 2020. Les termes clés suivants ont été utilisés : « COVID-19 ¼, « SRAS ­ CoV-2 ¼, « Pandémie ¼, « Neuro ­ COVID ¼, « AVC ­ COVID ¼, « Épilepsie ­ COVID ¼, « COVID ­ encéphalopathie ¼, « SRAS ­ CoV-2 ­ encéphalite ¼, « SRAS ­ CoV-2 ­ rhabdomyolyse ¼, « COVID ­ maladie démyélinisante ¼, « Manifestations neurologiques ¼, « Manifestations psychosociales ¼, « Recommandations thérapeutiques ¼, « COVID-19 et changement thérapeutiques ¼, « Psychiatrie ¼, « Marginalisés ¼, « Télémédecine ¼, « Santé mentale ¼, « Quarantaine ¼, « Infodémique ¼ et « Médias sociaux ¼. De plus, quelques articles de journaux relatifs à la pandémie de COVID-19 et à ses impacts psychosociaux ont également été ajoutés en fonction du contexte. RÉSULTATS: Il appert que les manifestations neurologiques et neuropsychiatriques des infections à la COVID-19 sont nombreuses. Les caractéristiques cliniques d'une implication des systèmes nerveux central et périphérique sautent désormais aux yeux. Ces caractéristiques ont fait l'objet d'une brève analyse systématique à l'aide de publications scientifiques. En outre, la plupart des impacts d'ordre psychologique de cette pandémie se sont révélés moins apparents que les changements réglementaires, socioéconomiques et psychosociaux. CONCLUSION: Les manifestations neurologiques et neuropsychiatriques de cette maladie ne font que commencer à être élucidées. Cela exige donc une capacité accrue de vigilance en vue d'un diagnostic rapide, et ce, afin de prévenir des complications additionnelles et une mortalité accrue.


Subject(s)
COVID-19/physiopathology , Nervous System Diseases/physiopathology , Ageusia/etiology , Ageusia/physiopathology , Alzheimer Disease/therapy , Angiotensin-Converting Enzyme 2 , Anosmia/etiology , Anosmia/physiopathology , Brain Diseases , COVID-19/complications , COVID-19/epidemiology , COVID-19/psychology , Cerebellar Ataxia/etiology , Cerebellar Ataxia/physiopathology , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/physiopathology , Comorbidity , Delivery of Health Care , Demyelinating Diseases/therapy , Disease Management , Dizziness/etiology , Dizziness/physiopathology , Epilepsy/therapy , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/physiopathology , Headache/etiology , Headache/physiopathology , Humans , Hypoxia, Brain/physiopathology , Inflammation/physiopathology , Meningoencephalitis/etiology , Meningoencephalitis/physiopathology , Muscular Diseases/etiology , Muscular Diseases/physiopathology , Myelitis, Transverse/etiology , Myelitis, Transverse/physiopathology , Myoclonus/etiology , Myoclonus/physiopathology , Nervous System Diseases/epidemiology , Nervous System Diseases/etiology , Parkinson Disease/therapy , Polyneuropathies/etiology , Polyneuropathies/physiopathology , SARS-CoV-2 , Seizures/etiology , Seizures/physiopathology , Stroke/therapy , Viral Tropism
15.
J Neurol Sci ; 417: 117085, 2020 10 15.
Article in English | MEDLINE | ID: covidwho-695572

ABSTRACT

INTRODUCTION: Coronavirus disease-19 (COVID-19) pandemic continues to grow all over the world. Several studies have been performed, focusing on understanding the acute respiratory syndrome and treatment strategies. However, there is growing evidence indicating neurological manifestations occur in patients with COVID-19. Similarly, the other coronaviruses (CoV) epidemics; severe acute respiratory syndrome (SARS-CoV-1) and Middle East respiratory syndrome (MERS-CoV) have been associated with neurological complications. METHODS: This systematic review serves to summarize available information regarding the potential effects of different types of CoV on the nervous system and describes the range of clinical neurological complications that have been reported thus far in COVID-19. RESULTS: Two hundred and twenty-five studies on CoV infections associated neurological manifestations in human were reviewed. Of those, 208 articles were pertinent to COVID-19. The most common neurological complaints in COVID-19 were anosmia, ageusia, and headache, but more serious complications, such as stroke, impairment of consciousness, seizures, and encephalopathy, have also been reported. CONCLUSION: There are several similarities between neurological complications after SARS-CoV-1, MERS-CoV and COVID-19, however, the scope of the epidemics and number of patients are very different. Reports on the neurological complications after and during COVID-19 are growing on a daily basis. Accordingly, comprehensive knowledge of these complications will help health care providers to be attentive to these complications and diagnose and treat them timely.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Nervous System Diseases/etiology , Pandemics , Pneumonia, Viral/complications , COVID-19 , Consciousness Disorders/etiology , Cranial Nerve Diseases/etiology , Encephalitis, Viral/etiology , Humans , Magnetic Resonance Imaging , Muscular Diseases/etiology , Neuroimaging , Peripheral Nervous System Diseases/etiology , SARS-CoV-2 , Seizures/etiology , Severe Acute Respiratory Syndrome/complications , Stroke/etiology
16.
Int J Infect Dis ; 99: 276-278, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-693741

ABSTRACT

This paper describes a patient who developed diffuse and symmetrical muscle weakness after a long stay in the intensive care unit (ICU) due to coronavirus disease 2019 (COVID-19). The patient underwent a neurophysiological protocol, including nerve conduction studies, concentric needle electromyography (EMG) of the proximal and distal muscles, and direct muscle stimulation (DMS). Nerve conduction studies showed normal sensory conduction and low-amplitude compound muscle action potentials (CMAPs). EMG revealed signs of myopathy, which were more pronounced in the lower limbs. The post-DMS CMAP was absent in the quadriceps and of reduced amplitude in the tibialis anterior muscle. Based on these clinical and neurophysiological findings, a diagnosis of critical illness myopathy was made according to the current diagnostic criteria. Given the large number of patients with COVID-19 who require long ICU stays, many are very likely to develop ICU-acquired weakness, as did the patient described here. Health systems must plan to provide adequate access to rehabilitative facilities for both pulmonary and motor rehabilitative treatment after COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Critical Illness , Muscular Diseases/etiology , Pneumonia, Viral/complications , COVID-19 , Female , Humans , Middle Aged , Pandemics , SARS-CoV-2
17.
J Clin Neurosci ; 79: 241-245, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-671055

ABSTRACT

One of the major concerns of the health care community and the public surrounding the SARS-CoV-2 pandemic is the availability and use of ventilators. Unprecedented surges of patients presented to intensive care units across the country, with older adults making up a large proportion of the patient population. This paper illustrates contemporary approaches to critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) in older patients, including incidence, risk factors, mechanisms for pathology, diagnosis, contemporary treatment approaches, and outcomes. We hope that the following analysis may help educate clinicians and ultimately decrease the duration of the mechanical ventilation required by these patients, resulting in improved clinical outcomes and an increase in ventilator availability for other patients in need.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Muscular Diseases/etiology , Pneumonia, Viral/complications , Polyneuropathies/etiology , Animals , COVID-19 , Coronavirus Infections/therapy , Critical Illness , Humans , Pandemics , Pneumonia, Viral/therapy , Respiration, Artificial , Risk Factors , SARS-CoV-2
19.
Neurology ; 94(22): 959-969, 2020 06 02.
Article in English | MEDLINE | ID: covidwho-52532

ABSTRACT

The coronavirus 2019 (COVID-19) pandemic has potential to disproportionately and severely affect patients with neuromuscular disorders. In a short period of time, it has already caused reorganization of neuromuscular clinical care delivery and education, which will likely have lasting effects on the field. This article reviews (1) potential neuromuscular complications of COVID-19, (2) assessment and mitigation of COVID-19-related risk for patients with preexisting neuromuscular disease, (3) guidance for management of immunosuppressive and immunomodulatory therapies, (4) practical guidance regarding neuromuscular care delivery, telemedicine, and education, and (5) effect on neuromuscular research. We outline key unanswered clinical questions and highlight the need for team-based and interspecialty collaboration. Primary goals of clinical research during this time are to develop evidence-based best practices and to minimize morbidity and mortality related to COVID-19 for patients with neuromuscular disorders.


Subject(s)
Coronavirus Infections/therapy , Immunosuppressive Agents/adverse effects , Neuromuscular Diseases/therapy , Pneumonia, Viral/therapy , Antiviral Agents/adverse effects , COVID-19 , COVID-19 Vaccines , Chloroquine/adverse effects , Coronavirus Infections/complications , Coronavirus Infections/prevention & control , Delivery of Health Care , Deprescriptions , Disease Progression , Drug Development , Enzyme Inhibitors/adverse effects , Guillain-Barre Syndrome/etiology , House Calls , Humans , Hydroxychloroquine/adverse effects , Immunologic Factors/adverse effects , Immunologic Factors/therapeutic use , Immunosuppressive Agents/therapeutic use , Infusions, Subcutaneous , Macrolides/adverse effects , Muscular Diseases/etiology , Myasthenia Gravis/chemically induced , Neurology/education , Neuromuscular Diseases/complications , Pandemics/prevention & control , Pneumonia, Viral/complications , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Research , Risk Reduction Behavior , Self Administration , Telemedicine , Viral Vaccines/therapeutic use
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