scholarly journals Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

2021 ◽  
Author(s):  
Biyan Nathanael Harapan ◽  
Hyeon Joo Yoo
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Case Reports ◽  
Case Series ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Fisher Syndrome ◽  
Novel Coronavirus ◽  
The Impact

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.

scholarly journals Neurological Manifestations of Patients Infected with COVID-19: A Systematic Review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jafari N ◽  
◽  
Khoshghamat N ◽  
Ghaderi MS ◽  
Yazdani S ◽  
...  
Keyword(s):  
Nervous System ◽  
Case Reports ◽  
Cerebrovascular Disorders ◽  
Case Series ◽  
Neurological Complications ◽  
Observational Research ◽  
Neurological Manifestations ◽  
Qualitative Synthesis ◽  
Systematic Analysis ◽  
Fisher Syndrome

In the light of the recent evidence, neurological manifestations have been reported in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). To shed light on a clear-cut explanation of neurological complications followed by SARS-CoV-2, a systematic analysis was reviewed. To this point, general medical databases, such as PubMed, Scopus, and Google Scholar from January 1, 2020, to September 20, 2020, were systematically searched to find related published articles. Through the search strategy, 93 studies for qualitative synthesis were included. Finally, the available data of 8,753 hospitalized patients with coronavirus disease 2019 (COVID-19) showed that the most prevalent Central Nervous System (CNS) manifestations of COVID-19 were headache (1137 cases, 18%) and dizziness (142 cases, 2%). On the other hand, some peripheral nervous system (PNS) symptoms were muscle pain (3300 cases, 53%), hypogeusia (646 cases, 11%), anosmia (545 cases, 9%), and hyposmia (379 cases, 6%). Furthermore, a small proportion of patients had ageusia (74 cases, 1%), cerebrovascular disorders (66 cases, 0.75%), and impaired consciousness (21 cases, 0.2%). Besides, some neurological features, such as encephalitis, neuralgia, ataxia, Guillain- Barre syndrome, miller fisher syndrome, intracerebral hemorrhage, polyneuritis cranialis, and dystonic posture were reported in the literature as case reports and case series. Conclusion: Taken together, data from our systematic analysis indicated that neurological manifestations in both CNS and PNS were reported in COVID-19 patients. Further observational research in this field with more participants are needed to detect the specific risk concerning neurological complications in COVID-19 infection.

scholarly journals Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Nikita Mohan ◽  
Muhammad Ali Fayyaz ◽  
Christopher del Rio ◽  
Navpreet Kaur Rajinder Singh Khurana ◽  
Sampada Sandip Vaidya ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Case Reports ◽  
Healthcare Providers ◽  
Case Series ◽  
Altered Mental Status ◽  
Common Finding ◽  
Cochrane Library ◽  
Neurological Manifestations ◽  
The Cochrane Library ◽  
Ct And Mri

Abstract Background The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information. Objective To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2. To identify neuro-invasive pathways of COVID infection. Methods Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020. Results Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases. Conclusion The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.

scholarly journals Environmental Issues and Neurological Manifestations Associated with COVID-19 Pandemic: New Aspects of the Disease?

2020 ◽  
Vol 17 (21) ◽  
pp. 8049
Author(s):  
Luigi Bellocchio ◽  
Ioana Roxana Bordea ◽  
Andrea Ballini ◽  
Felice Lorusso ◽  
Denisa Hazballa ◽  
...  
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Transverse Myelitis ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Current Evidence ◽  
Pubmed Central ◽  
Global Pandemic ◽  
Neurological Features ◽  
Specific Symptoms

Coronavirus (SARS-CoV-2) emerged in China in December 2019 and rapidly caused a global health pandemic. Current evidence seems to suggest a possible link with ecosystem disequilibrium and even air pollution. The primary manifestations affect respiratory and circulatory systems, but neurological features are also being reported through case reports and case series. We summarize neurological symptoms and complications associated with COVID-19. We have searched for original articles published in PubMed/Medline, PubMed Central and Google Scholar using the following keywords: “COVID-19”, “Coronavirus”, “pandemic”, “SARS-COV-2”, “neurology”, “neurological”, “complications” and “manifestations”. We found around 1000 publications addressing the issue of neurological conditions associated with COVID-19 infection. Amongst those, headache and dizziness are the most common reported symptoms followed by encephalopathy and delirium, while the most frequent complications are cerebrovascular accidents, Guillain–Barré syndrome, acute transverse myelitis, and acute encephalitis. Specific symptoms affecting the peripheral nervous system such as hyposmia and dysgeusia are the most common manifestations recorded in the selected studies. Interestingly, it was noted that these kinds of neurological symptoms might precede the typical features, such as fever and cough, in COVID patients. Neurological symptoms and complications associated with COVID-19 should be considered as a part of the clinical features of this novel global pandemic.

scholarly journals IVIG: The Heart Savior in Covid 19 era

2021 ◽  
Vol 3 (3) ◽  
pp. 01-05
Author(s):  
Rima Chaddad ◽  
Matina Hamadeh ◽  
Amena Khatoun ◽  
Zouheir Kreidly ◽  
Claudette Najjar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Severe Acute Respiratory Syndrome ◽  
Case Reports ◽  
Case Series ◽  
Cytokine Storm ◽  
Wuhan City ◽  
Direct Reports ◽  
Target Populations ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

Coronavirus disease 2019 (COVID-19) is defined as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV), which was first identified as an outbreak in Wuhan City, Hubei Province, China [1]. Cases of multisystem inflammatory syndrome after Covid – 19 infection have been extensively documented in children. CDC reported 27 cases of multisystem inflammatory syndrome in adults (MIS-A) in direct reports through October 2020, as well as various case series and published case reports [2]. Cytokine storm, as a trigger of the progression of HF in patients with COVID-19, has become a novel focus to explore therapies for target populations [3]. In this article, we briefly present a case of a Covid-19 infection associated myocarditis complicated by acute heart failure successfully treated with IVIG.

scholarly journals Relevance and Clinical Significance of Magnetic Resonance Imaging of Neurological Manifestations in COVID-19: A Systematic Review of Case Reports and Case Series

2020 ◽  
Vol 10 (12) ◽  
pp. 1017
Author(s):  
Anisa Chowdhary ◽  
Roshan Subedi ◽  
Medha Tandon ◽  
Sijin Wen ◽  
Jenil Patel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Case Series ◽  
Neurological Complications ◽  
Inflammatory Disorder ◽  
Neurological Manifestations ◽  
Resonance Imaging ◽  
Mri Findings

We performed a systematic literature review of neuroimaging, predominantly focusing on magnetic resonance imaging (MRI) findings associated with neurological manifestations of coronavirus disease-2019 (COVID-19). We screened articles from PubMed, Google Scholar and Scopus, looking for reports that would potentially have neuroimaging findings in patients with COVID-19. Data analysis was performed with patient-based data based on the availability of clinical characteristics and outcomes for each individual patient from the studies. Chi square and Wilcoxon rank-sum tests were used to report COVID-19 severity and outcomes based on neurological imaging indicators and pathophysiology. A total of 171 patients with COVID-19 having neurological complications, from 134 studies, were identified in our review. The most common neuroimaging finding was ischemic stroke (62, 36.2%) cases, followed by CNS inflammatory disorder (44, 25.7%), and hemorrhagic stroke (41, 24.0%). Around 51% of all the fatal COVID-19 cases had an ischemic stroke. Among patients with ischemic stroke, the mean age of those who suffered from COVID-19 infection was 57.5 years (SD = 15.4) whereas it was 50.7 years (SD = 15.1) among those without stroke/other diagnosis. Fatality was more common in patients with ischemic stroke compared to those with other diagnosis (40% vs. 22%, p = 0.011). The most frequently published neuroimaging findings in patients with COVID-19 were ischemic stroke, CNS inflammatory disorder, and hemorrhagic disorder. In those studies, ischemic stroke was associated with fatality, and was more frequently seen in older patients. Based on our findings, early usage of MRI in COVID-19 patients may be recommended.

scholarly journals What can the neurological manifestations of COVID-19 tell us: a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuanyuan He ◽  
Xiaojie Bai ◽  
Tiantian Zhu ◽  
Jialin Huang ◽  
Hong Zhang
Keyword(s):  
Nervous System ◽  
English Literature ◽  
Meta Analysis ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Cochrane Library ◽  
Neurological Manifestations ◽  
Global Pandemic ◽  
The Future

Abstract Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model. Results A total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.

Neurological Complications in COVID-19 Patients and its Implications for Associated Mortality

2020 ◽  
Vol 17 (4) ◽  
pp. 522-530
Author(s):  
Hanin A. AboTaleb
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Current Knowledge ◽  
Rna Virus ◽  
Delayed Diagnosis ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Positive Polarity ◽  
Zoonotic Viruses ◽  
The Common ◽  
The Impact

: Coronavirus is an enveloped, non-segmented, positive-polarity and single-stranded RNA virus. It has four types of genera that infect mammals and birds, with only alpha and beta types found to affect humans with varying severity. A specific clade of beta coronaviruses is reported as lethal zoonotic viruses and has created major epidemic troubles, starting with the severe acute respiratory syndrome (SARS) in 2002, then the Middle East respiratory syndrome (MERS) in 2012, and lastly Coronavirus Disease 2019 (COVID-19) in 2019. However, many neurological complications reported in COVID-19 patients have highlighted a critical pattern of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Awareness of such an association could create new insight to consider neurological manifestations as a COVID-19 differential diagnosis during the pandemic period of COVID-19 to avoid delayed diagnosis and prevent further transmission. : This mini-review aims to collect the current knowledge regarding the mechanism behind the neuroinvasive capacity of SARS-CoV-2, to summarize the common documented neurological symptoms and associated complications in COVID-19 patients, and to review the impact of neurological manifestations on COVID-19 mortality.

scholarly journals Neurological Complications of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Prateek Kumar Panda ◽  
Indar Kumar Sharawat ◽  
Pragnya Panda ◽  
Vivekanand Natarajan ◽  
Rahul Bhakat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Meta Analysis ◽  
Random Effect ◽  
Case Series ◽  
Neurological Complications ◽  
Severe Illness ◽  
Neurological Manifestations ◽  
Eligibility Criteria ◽  
Symptomatic Seizures

Abstract Background Knowledge about neurological complications of COVID-19 in children is limited due to the paucity of data in the existing literature. Some systematic reviews are available describing overall clinical features of COVID-19 in children and neurological complications of COVID-19 in adults. But to the best of our knowledge, no systematic review has been performed to determine neurological manifestations of COVID-19. Methods Six different electronic databases (MEDLINE, EMBASE, Web of Science, CENTRAL, medRxiv and bioRxiv) were searched for articles related to COVID-19 and neurological complications in children. Studies/case series reporting neurological manifestations of COVID-19 in patients aged ≤18 years, as well as case reports, as neurological complications appear to be rare. The pooled estimate of various non-specific and specific neurological manifestations was performed using a random effect meta-analysis. Results Twenty-one studies/case series and five case reports (3707 patients) fulfilled the eligibility criteria and were included in this systematic review, from a total of 460 records. Headache, myalgia and fatigue were predominant non-specific neurological manifestations, presenting altogether in 16.7% cases. Total of 42 children (1%) were found to have been reported with definite neurological complications, more in those suffering from a severe illness (encephalopathy—25, seizure—12, meningeal signs—17). Rare neurological complications were intracranial hemorrhage, cranial nerve palsy, Guillain–Barré syndrome and vision problems. All children with acute symptomatic seizures survived suggesting a favorable short-term prognosis. Conclusion Neurological complications are rare in children suffering from COVID-19. Still, these children are at risk of developing seizures and encephalopathy, more in those suffering from severe illness.

scholarly journals What can the neurological manifestations of COVID-19 tell us : a meta-analysis

2021 ◽  
Author(s):  
Yuanyuan He ◽  
Xiaojie Bai ◽  
Tiantian Zhu ◽  
Jialin Huang ◽  
Hong Zhang
Keyword(s):  
Nervous System ◽  
English Literature ◽  
Meta Analysis ◽  
Damage Mechanism ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Global Pandemic ◽  
Taste Dysfunction

Abstract Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aim to gather and discuss COVID-19 various neurological symptoms of infection, and to assess the prevalence of each of the nervous system symptoms, and characterized by neurological in-depth discussions of nervous system damage mechanism, biomarkers and inspection methods, recovery and prognosis, and provide the research behind the potential target and direction. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020 to November 20, 2020 in Pubmed, Embase, and Cochrane library.The keywords used were COVID-19 and terminology related to nervous system performance.All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data was then collected for meta-analysis using a random-effects model. Results A total of 62 articles (n =32729) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were altered mental status (39% ; 95% CI 0.17-0.64 ; I 2 98.59%), encephalopathy (37% ; 95% CI 0.17-0.60 ; I 2 97.36%), myalgia(31% ; 95% CI 0.25-0.38; I 2 98.79%), headache(30% ; 95% CI 0.22-0.37; I 2 99.28%), smell impairment(28% ; 95% CI 99.57% ; I 2 0.17-0.39), taste dysfunction (27% ; 95% CI 0.18 -0.38 ; I 2 99.35%), acute ischemic stroke (23% ; 95% CI 0.06-0.47 ; I 2 99.30%), alteration of consciousness(17% ; 95% CI 0.06-0.31 ; I 2 96.78%), dizziness (10% ; 95% CI 0.06-0.15; I 2 95.30%), intracerebral haemorrhage (7% ; 95% CI 0.02-0.14 ; I 2 93.64%), vision impairment(5% ; 95% CI 0.02-0.10 ; I 2 92.73%), seizure(2% ; 95% CI 0.01-0.04 ; I 2 84.67%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, so as to detect and treat early neurological complications of COVID-19 and reduce mortality.

Atypical Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children: A Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Sofia Βenou ◽  
Shamez Ladhani ◽  
Gabriel Dimitriou ◽  
Despoina Gkentzi
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Upper Respiratory Infection ◽  
Mild Disease ◽  
Atypical Manifestations ◽  
Novel Coronavirus ◽  
Atypical Presentations

Background: In December 2019, a local outbreak of pneumonia presented in Wuhan (China), and quickly identified to be caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 was named COVID-19 and was soon declared as pandemic because of the millions of infections and thousands of deaths worldwide. Children infected with SARS-CoV-2 usually develop asymptomatic or mild disease compared to adults. They are also more likely to have atypical and non-specific clinical manifestations than adults. Methods: A literature search was performed in PubMed and Scopus to summarize the extrapulmonary manifestations of SARS-CoV-2 infection in children since the beginning of the pandemic. Peer-reviewed papers in English were retrieved using the following keywords and combinations: ‘pediatric’, ‘child’, ‘infant’, ‘neonate’, ‘novel coronavirus’, ‘SARS-CoV-2’, ‘COVID 19’ and ‘gastrointestinal’, ‘renal’, ‘cardiac’, ‘dermatologic’ or ‘ophthalmologic’. We included published case series and case reports providing clinical symptoms and signs in SARS-CoV2 pediatric patients. Results: Although fever and symptoms of upper respiratory infection are the most frequently presented, a variety of other atypical presentations has also been reported. The clinical spectrum includes dermatological, ophthalmological, neurological, cardiovascular, renal, reproductive, and gastrointestinal presentations. In addition, a rare multi-inflammatory syndrome associated with SARS-CoV-2 infection has been reported in children, often leading to shock requiring inotropic support and mechanical ventilation. Conclusions: Clinicians need to be aware of the wider range of extrapulmonary atypical manifestations of SARS-CoV-2 infection in children, so that appropriate testing, treatment, and public health measures can be implemented rapidly.

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