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1.
Euro Surveill ; 26(45)2021 Nov.
Article in English | MEDLINE | ID: covidwho-1630353

ABSTRACT

We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.


Subject(s)
COVID-19 , Enterovirus D, Human , Enterovirus Infections , Enterovirus , Myelitis , Respiratory Tract Infections , Communicable Disease Control , Disease Outbreaks , Enterovirus D, Human/genetics , Enterovirus Infections/diagnosis , Enterovirus Infections/epidemiology , Europe/epidemiology , Humans , Myelitis/epidemiology , SARS-CoV-2
2.
Pan Afr Med J ; 39: 147, 2021.
Article in English | MEDLINE | ID: covidwho-1377121

ABSTRACT

INTRODUCTION: the World health organisation (WHO) African Region reported the first confirmed COVID-19 case caused by the SARS-CoV-2 on 25th February 2020, and the first case for the East Southern Africa (ESA) sub-region was on 5th March 2020. Almost all countries in the ESA sub region implemented the WHO-recommended preventive measures variably after the notification of community transmission of the COVID-19 disease. This resulted in the disruption of the outpatient, immunization surveillance, and the related supply chain activities. METHODS: a comparative analysis study design of secondary acute flaccid paralysis (AFP) surveillance data received from the East and Southern Africa sub-region countries to evaluate the effect of the COVID-19 pandemic in the AFP field surveillance for the same time period of March to December 2019 and 2020. RESULTS: we observed that 52.4% of second stool samples were received in the laboratory within 72 hours from March to December 2019, and only 48.1% in the same period of 2020. A 4.3% decline with a p-value of <0.0001 (95% CI, ranges from 2.326% to 6.269%). Similarly, we noted a 4.7% decline in the number of reported AFP cases in the ESA sub-region for March to December 2020 compared to the same period in 2019, a p-value of less than 0.001 (95% CI ranges from 2.785 to 6.614). For the percentage of stool adequacy, we observed a 3.37% decline for April in 2020 compared to April 2019 with a p-value of less than 0.001 (95% CI ranges from 2.059 to 4.690). CONCLUSION: we observed a decline in the core AFP surveillance (non polio) NP-AFP rate, and percentage of stool adequacy in countries severely affected by the COVID-19 disease. These countries implemented stringent transmission prevention measures such as lock-down and international transportation restrictions.


Subject(s)
COVID-19 , Central Nervous System Viral Diseases/diagnosis , Feces/virology , Myelitis/diagnosis , Neuromuscular Diseases/diagnosis , Population Surveillance/methods , Adolescent , Africa, Eastern/epidemiology , Africa, Southern/epidemiology , Central Nervous System Viral Diseases/epidemiology , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Myelitis/epidemiology , Neuromuscular Diseases/epidemiology
3.
Neurosci Lett ; 759: 136040, 2021 08 10.
Article in English | MEDLINE | ID: covidwho-1322284

ABSTRACT

Despite a likely underestimation due to the many obstacles of the highly infectious, intensive care setting, increasing clinical reports about COVID-19 patients developing acute paralysis for polyradiculoneuritis or myelitis determine additional impact on the disease course and outcome. Different pathogenic mechanisms have been postulated basing on clinical, laboratory and neuroimaging features, and response to treatments. Here we provide an overview with insights built on the available reports. Besides direct viral pathogenicity, a crucial role seems to be represented by immune-mediated mechanisms, supporting and further characterizing the already hypothesized neurotropic potential of SARS-CoV-2 and implying specific treatments. Proper clinical and instrumental depiction of symptomatic cases, as well as screening for their early recognition is advocated.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/virology , Myelitis/epidemiology , Myelitis/virology , Guillain-Barre Syndrome/pathology , Humans , Myelitis/pathology , SARS-CoV-2
4.
Sci Transl Med ; 13(584)2021 03 10.
Article in English | MEDLINE | ID: covidwho-1127537

ABSTRACT

Acute flaccid myelitis (AFM) recently emerged in the United States as a rare but serious neurological condition since 2012. Enterovirus D68 (EV-D68) is thought to be a main causative agent, but limited surveillance of EV-D68 in the United States has hampered the ability to assess their causal relationship. Using surveillance data from the BioFire Syndromic Trends epidemiology network in the United States from January 2014 to September 2019, we characterized the epidemiological dynamics of EV-D68 and found latitudinal gradient in the mean timing of EV-D68 cases, which are likely climate driven. We also demonstrated a strong spatiotemporal association of EV-D68 with AFM. Mathematical modeling suggested that the recent dominant biennial cycles of EV-D68 dynamics may not be stable. Nonetheless, we predicted that a major EV-D68 outbreak, and hence an AFM outbreak, would have still been possible in 2020 under normal epidemiological conditions. Nonpharmaceutical intervention efforts due to the ongoing COVID-19 pandemic are likely to have reduced the sizes of EV-D68 and AFM outbreaks in 2020, illustrating the broader epidemiological impact of the pandemic.


Subject(s)
Central Nervous System Viral Diseases/epidemiology , Central Nervous System Viral Diseases/virology , Enterovirus D, Human/physiology , Myelitis/epidemiology , Myelitis/virology , Neuromuscular Diseases/epidemiology , Neuromuscular Diseases/virology , Disease Susceptibility , Epidemiological Monitoring , Humans , Models, Biological , Spatio-Temporal Analysis , United States/epidemiology
6.
Rev Neurol (Paris) ; 177(1-2): 51-64, 2021.
Article in English | MEDLINE | ID: covidwho-978380

ABSTRACT

INTRODUCTION: The past two decades have been marked by three epidemics linked to emerging coronaviruses. The COVID-19 pandemic highlighted the existence of neurological manifestations associated with SARS-CoV-2 infection and raised the question of the neuropathogenicity of coronaviruses. The aim of this review was to summarize the current data about neurological manifestations and diseases linked to human coronaviruses. MATERIAL AND METHODS: Articles have been identified by searches of PubMed and Google scholar up to September 25, 2020, using a combination of coronavirus and neurology search terms and adding relevant references in the articles. RESULTS: We found five cohorts providing prevalence data of neurological symptoms among a total of 2533 hospitalized COVID-19 patients, and articles focusing on COVID-19 patients with neurological manifestations including a total of 580 patients. Neurological symptoms involved up to 73% of COVID-19 hospitalized patients, and were mostly headache, myalgias and impaired consciousness. Central nervous system (CNS) manifestations reported in COVID-19 were mostly non-specific encephalopathies that represented between 13% and 40% of all neurological manifestations; post-infectious syndromes including acute demyelinating encephalomyelitis (ADEM, n=13), acute necrotizing encephalopathy (ANE, n=4), Bickerstaff's encephalitis (n=5), generalized myoclonus (n=3) and acute transverse myelitis (n=7); other encephalitis including limbic encephalitis (n=9) and miscellaneous encephalitis with variable radiologic findings (n=26); acute cerebrovascular diseases including ischemic strokes (between 1.3% and 4.7% of COVID-19 patients), hemorrhagic strokes (n=17), cerebral venous thrombosis (n=8) and posterior reversible encephalopathy (n=5). Peripheral nervous system (PNS) manifestations reported in COVID-19 were the following: Guillain-Barré syndrome (n=31) and variants including Miller Fisher syndrome (n=3), polyneuritis cranialis (n=2) and facial diplegia (n=2); isolated oculomotor neuropathy (n=6); critical illness myopathy (n=6). Neuropathological studies in COVID-19 patients demonstrated different patterns of CNS damage, mostly ischemic and hemorrhagic changes with few cases of inflammatory injuries. Only one case suggested SARS-CoV-2 infiltration in endothelial and neural cells. We found 10 case reports or case series describing 22 patients with neurological manifestations associated with other human coronaviruses. Among them we found four MERS patients with ADEM or Bickerstaff's encephalitis, two SARS patients with encephalitis who had a positive SARS-CoV PCR in cerebrospinal fluid, five patients with ischemic strokes associated with SARS, eight MERS patients with critical illness neuromyopathy and one MERS patient with Guillain-Barré Syndrome. An autopsy study on SARS-CoV patients demonstrated the presence of the virus in the brain of eight patients. CONCLUSION: The wide range of neurological manifestations and diseases associated with SARS-CoV-2 is consistent with multiple pathogenic pathways including post-infectious mechanisms, septic-associated encephalopathies, coagulopathy or endothelitis. There was no definite evidence to support direct neuropathogenicity of SARS-CoV-2.


Subject(s)
COVID-19/complications , Nervous System Diseases/etiology , SARS-CoV-2 , Brain Diseases/epidemiology , Brain Diseases/etiology , Coronavirus Infections/complications , Coronavirus OC43, Human , Female , Guillain-Barre Syndrome/epidemiology , Guillain-Barre Syndrome/etiology , Humans , Male , Middle East Respiratory Syndrome Coronavirus , Myelitis/epidemiology , Myelitis/etiology , Nervous System Diseases/epidemiology , Severe Acute Respiratory Syndrome/complications , Stroke/epidemiology , Stroke/etiology
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