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Neuroimmune disorders in COVID-19.
Ariño, Helena; Heartshorne, Rosie; Michael, Benedict D; Nicholson, Timothy R; Vincent, Angela; Pollak, Thomas A; Vogrig, Alberto.
  • Ariño H; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
  • Heartshorne R; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Michael BD; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
  • Nicholson TR; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK.
  • Vincent A; The National Institute for Health Research Health Protection Research Unit for Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK.
  • Pollak TA; Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Sciences, University of Liverpool, Liverpool, UK.
  • Vogrig A; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
J Neurol ; 269(6): 2827-2839, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1767491
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the aetiologic agent of the coronavirus disease 2019 (COVID-19), is now rapidly disseminating throughout the world with 147,443,848 cases reported so far. Around 30-80% of cases (depending on COVID-19 severity) are reported to have neurological manifestations including anosmia, stroke, and encephalopathy. In addition, some patients have recognised autoimmune neurological disorders, including both central (limbic and brainstem encephalitis, acute disseminated encephalomyelitis [ADEM], and myelitis) and peripheral diseases (Guillain-Barré and Miller Fisher syndrome). We systematically describe data from 133 reported series on the Neurology and Neuropsychiatry of COVID-19 blog ( https//blogs.bmj.com/jnnp/2020/05/01/the-neurology-and-neuropsychiatry-of-covid-19/ ) providing a comprehensive overview concerning the diagnosis, and treatment of patients with neurological immune-mediated complications of SARS-CoV-2. In most cases the latency to neurological disorder was highly variable and the immunological or other mechanisms involved were unclear. Despite specific neuronal or ganglioside antibodies only being identified in 10, many had apparent responses to immunotherapies. Although the proportion of patients experiencing immune-mediated neurological disorders is small, the total number is likely to be underestimated. The early recognition and improvement seen with use of immunomodulatory treatment, even in those without identified autoantibodies, makes delayed or missed diagnoses risk the potential for long-term disability, including the emerging challenge of post-acute COVID-19 sequelae (PACS). Finally, potential issues regarding the use of immunotherapies in patients with pre-existent neuro-immunological disorders are also discussed.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / Stroke / COVID-19 / Nervous System Diseases Type of study: Etiology study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Neurol Year: 2022 Document Type: Article Affiliation country: S00415-022-11050-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Guillain-Barre Syndrome / Stroke / COVID-19 / Nervous System Diseases Type of study: Etiology study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: J Neurol Year: 2022 Document Type: Article Affiliation country: S00415-022-11050-w