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COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2.
Sriwastava, Shitiz; Tandon, Medha; Podury, Sanjiti; Prasad, Apoorv; Wen, Sijin; Guthrie, Garret; Kakara, Mihir; Jaiswal, Shruti; Subedi, Roshan; Elkhooly, Mahmoud; Lisak, Robert P.
  • Sriwastava S; Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV, 26506, USA. Shitiz.sriwastava@hsc.wvu.edu.
  • Tandon M; West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA. Shitiz.sriwastava@hsc.wvu.edu.
  • Podury S; Department of Neurology, Wayne State University, Detroit, MI, USA. Shitiz.sriwastava@hsc.wvu.edu.
  • Prasad A; Deaprtment of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Wen S; Army College of Medical Sciences, New Delhi, India.
  • Guthrie G; Department of Neurology, Berkeley Medical Center, West Virginia University, Martinsburg, WV, USA.
  • Kakara M; Department of Biostatistics, West Virginia University, Morgantown, WV, USA.
  • Jaiswal S; Department of Biostatistics, West Virginia University, Morgantown, WV, USA.
  • Subedi R; Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
  • Elkhooly M; West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA.
  • Lisak RP; Nepal Health Research Council, Kathmandu, Nepal.
J Neurol ; 268(12): 4448-4478, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1233263
ABSTRACT

BACKGROUND:

The literature on neurological manifestations in COVID-19 patients has been rapidly increasing with the pandemic. However, data on CNS inflammatory disorders in COVID-19 are still evolving. We performed a literature review of CNS inflammatory disorders associated with coronavirus disease-2019 (COVID-19).

METHODS:

We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords; "SARS-CoV-2 and neurological complication", "SARS-CoV-2 and CNS Complication" looking for reports of transverse myelitis, longitudinally extensive transverse myelitis, neuromyelitis optica, myelitis, Myelin Oligodendrocyte Glycoprotein Antibody Disorder (MOGAD), Acute Disseminated Encephalomyelitis (ADEM), Acute Hemorrhagic Necrotizing Encephalitis/Acute Hemorrhagic Leukoencephalitis (AHNE/AHLE), Cytotoxic lesion of the Corpus Callosum/Mild Encephalopathy Reversible Splenium Lesion(CLOCC/MERS) and Optic neuritis published between December 01, 2019 and March 15, 2021.

RESULTS:

Our literature search revealed 43 patients meeting the diagnosis of myelitis, including Transverse Myelitis, ADEM, AHNE/AHLE or CLOCC/MERS and Optic neuritis. Acute myelitis was most commonly associated with non-severe COVID-19 and all reported cases of AHNE/AHLE had severe COVID-19 infection. Based on IDSA/ATS criteria of either requiring vasopressor for septic shock or mechanical ventilation, 49% (n = 18) patients were considered to have a severe COVID infection. There were 7 (n = 19%) fatalities.

CONCLUSION:

To our knowledge, this is among the first reviews that includes the clinical features, neuroimaging, CSF findings and outcomes in COVID-19-associated CNS inflammatory disorders. Our observational review study reveals that although rare, myelitis, ADEM, AHNE and CLOCC can be associated with COVID-19 infection. Further studies using MRI imaging and CSF analysis in early diagnosis and intervention of these disorders are warranted.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Central Nervous System Diseases / COVID-19 / Myelitis, Transverse Type of study: Observational study / Prognostic study / Reviews Topics: Vaccines Limits: Humans Language: English Journal: J Neurol Year: 2021 Document Type: Article Affiliation country: S00415-021-10611-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Central Nervous System Diseases / COVID-19 / Myelitis, Transverse Type of study: Observational study / Prognostic study / Reviews Topics: Vaccines Limits: Humans Language: English Journal: J Neurol Year: 2021 Document Type: Article Affiliation country: S00415-021-10611-9