scholarly journals Neurological manifestations in coronavirus disease 2019 (COVID-19) patients: a systematic review of literature

CNS Spectrums ◽  
2020 ◽  
pp. 1-12
Author(s):  
Wael Ibrahim
Keyword(s):  
Wide Spectrum ◽  
Neurological Complications ◽  
Severe Form ◽  
Small Sample ◽  
Neurological Symptoms ◽  
Controlled Trials ◽  
Neurological Manifestations ◽  
Number Of Patients ◽  
Wide Range ◽  
Neurological Patients

Abstract Background The exact incidence of neurological complications from coronavirus disease 2019 (COVID-19) infection remains unknown. Neurological symptoms are more common with severe form of the disease. Through neuro-invasion, the virus can affect both neurons and glial cells and induce wide range of neurological pathologies. Objectives To systematically assess the neurological manifestations in patients diagnosed with COVID-19. Methods A systematic literature search of the PubMed, Scopus, and Cochrane databases was performed. Randomized controlled trials, nonrandomized controlled trials, observational studies of neurological manifestations in patients diagnosed with COVID-19. Results All three-database search identified 89 publications. A total of 22 full-text articles assessed for eligibility with 12 articles excluded. Altogether, the included studies reported 290 patients with neurological manifestations. Neurological manifestations were subdivided into central causes (CNS) and peripheral causes (PNS). CNS symptoms is commoner representing 91% of all neurological patients with 9% only with PNS. Headache represented the commonest neurological symptoms in regard to number of patients, meanwhile dizziness has the highest incidence with 11.9%. Neurological manifestations were divided according to COVID-19 severity into: (1) nonsevere and (2) severe; with all CNS manifestations were more in severe patients except headache were more in nonsevere patients. All included studies were on adult patients except one study in pediatric patients with limited number of participants. Conclusions From the descriptive analyses and available data of relatively small sample-sized studies, it can be concluded that in spite of the aforementioned limitations, that a wide spectrum of neurological manifestations including CNS and PNS can occur in COVID-19 patients.

scholarly journals SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms

2020 ◽  
Vol 21 (15) ◽  
pp. 5475 ◽  
Author(s):  
Manuela Pennisi ◽  
Giuseppe Lanza ◽  
Luca Falzone ◽  
Francesco Fisicaro ◽  
Raffaele Ferri ◽  
...  
Keyword(s):  
Nervous System ◽  
Molecular Mechanisms ◽  
Neuronal Damage ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Wide Range ◽  
Inflammatory State ◽  
Acute Polyneuropathy ◽  
The Central Nervous System ◽  
The Impact

Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.

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 associated with SARS-CoV-2 infection: a narrative review

2021 ◽  
Author(s):  
Poliana Rafaela dos Santos Araújo ◽  
Kauan Alves Sousa Madruga ◽  
Bruna Alves Rocha ◽  
Lucas Oliveira Braga
Keyword(s):  
Nervous System ◽  
Meta Analysis ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Narrative Review ◽  
Common Symptom ◽  
Neurological Manifestations ◽  
Cns Involvement ◽  
Pubmed Database ◽  
Critical Patients

Background: Coronavirus disease (COVID-19), once identified, soon spread globally, becoming a pandemic. Although patients present mainly with respiratory complaints, several neurological symptoms have been reported. Symptoms range from headache and nonspecific dizziness to seizures and cerebrovascular disease (CVD). It has also been shown that the severity of the infection is directly proportional to the development of neurological symptoms, especially CVD and changes in mental status. Objective: The present study aims to briefly review the neurological manifestations of COVID-19 and discuss the pathogenic mechanisms of Central Nervous System (CNS) involvement. Methods: This is an exploratory narrative review with a descriptive approach, consisting of an active search for scientific articles in the PubMed database. The descriptors “coronavirus infections”, “COVID-19” and “Nervous system” were used, with the Boolean operators “OR” and “AND”. Eighteen articles of systematic review and meta-analysis were included. Results: CNS manifestations included, among others: encephalitis, encephalopathy, consciousness decrease, headache, dizziness, acute myelitis, and stroke. As for the peripheral nervous system, skeletal muscle damage, chemosensory dysfunction, and Guillain-Barré syndrome were observed, with hyposmia being the most common symptom. CNS involvement may be related to a worse prognosis. Conclusion: The clinical involvement of the nervous system in COVID-19 is not uncommon, and can result in several neurological complications, especially in the most critical patients. The pathophysiological mechanisms of these events still need further investigation. In the meantime, physicians should value extra-respiratory symptoms ranging from hyposmia, to potentially fatal manifestations, such as stroke and encephalopathy.

scholarly journals HCV-Related Nervous System Disorders

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Salvatore Monaco ◽  
Sergio Ferrari ◽  
Alberto Gajofatto ◽  
Gianluigi Zanusso ◽  
Sara Mariotto
Keyword(s):  
Nervous System ◽  
Chronic Infection ◽  
Wide Spectrum ◽  
Neurological Complications ◽  
Extrahepatic Manifestations ◽  
Cytokines And Chemokines ◽  
Extrahepatic Replication ◽  
Organ Systems ◽  
Number Of Patients ◽  
Neural Tissues

Chronic infection with hepatitis C virus (HCV) is associated with a wide spectrum of extrahepatic manifestations, affecting different organ systems. Neurological complications occur in a large number of patients and range from peripheral neuropathy to cognitive impairment. Pathogenetic mechanisms responsible for nervous system dysfunction are mainly related to the upregulation of the host immune response with production of autoantibodies, immune complexes, and cryoglobulins. Alternative mechanisms include possible extrahepatic replication of HCV in neural tissues and the effects of circulating inflammatory cytokines and chemokines.

scholarly journals The Common Neurological Presentations and Clinical Outcomes of Coronavirus Disease 2019 in Saudi Arabia

2021 ◽  
Vol 12 ◽  
Author(s):  
Walid A. Alkeridy ◽  
Mohammed H. Alanazy ◽  
Nada Alamri ◽  
Awyshah Alqahtani ◽  
Adel Alhazzani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Clinical Outcomes ◽  
Neurological Disease ◽  
Neurological Complications ◽  
Arab Countries ◽  
Neurological Manifestations ◽  
Older Individuals ◽  
Wide Range ◽  
The Common ◽  
Poor Outcomes

Background: Neurological manifestations have increasingly become recognized in COVID-19. People from different ethnic backgrounds are experiencing different outcomes related to SARS-CoV-2 infection. Several cohort studies reported the common neurological manifestations and complications associated with COVID-19 disease around the world however, the prevalence of neurological complications associated with SARS-CoV-2 infection in the Arab countries and Saudi Arabia is still unknown.Objective: To study the prevalence, risk factors, and characteristics of the neurological complications associated with COVID-19 and their relationship with clinical outcomes.Methods: We conducted a prospective, single-center, observational, cohort study of consecutive hospitalized adults COVID-19 patients with and without neurological manifestation admitted between March 2020 until the end of December 2020. Data was collected prospectively using electronic medical records; Cases and controls were observed until they either get discharged from the hospital or died. The primary outcomes were death, survival, and survival with sequalae.Results: Among 497 patients with COVID-19, 118 patients (23.7%) had neurological complications, 94 patients (18.9%) had encephalopathy, and 16 patients (3.2%) had cerebrovascular accidents (CVA). Patients with COVID-19-related neurological complications were older and more likely to have a pre-existing neurological disease. The most common neurological syndrome associated with COVID-19 were encephalopathy (18.9%) and headache (13.7%). Pre-existing neurological disease and an elevated neutrophil count were the strongest predictors of developing any neurological complications. Death form COVID-19 was associated with age (OR 1.06, 95% CI 1.02–1.10, P = 0.001), invasive ventilation (OR 37.12, 95% CI 13.36–103.14), COVID-19-related-neurological complications (OR 3.24, 95% CI 1.28–8.21, P = 0.01), and elevated CRP level (OR 1.01, 95% CI 1.00–1.01, P = 0.01).Conclusions: COVID-19 is associated with a wide range of neurological manifestations in people living in Saudi Arabia, with older individuals and those with underlying neurological disorders being most at risk. The presence of neurological complications was associated with increased mortality and poor outcomes.

scholarly journals Neurological manifestations associated with COVID- 19: a review

2021 ◽  
Vol 1 (4) ◽  
pp. 31-44
Author(s):  
Yasmim Berni Ferreira ◽  
Flávia Maria Ramos Freire ◽  
Victor Oliveira Araújo ◽  
Isadora Mônica Ponte De Oliveira ◽  
Lara Maria de Oliveira Paiva Freitas ◽  
...  
Keyword(s):  
Neurological Complications ◽  
Brain Parenchyma ◽  
Neurological Manifestations ◽  
Term Care ◽  
Pubmed Database ◽  
The Social ◽  
Wide Range ◽  
Systemic Manifestations ◽  
Novel Coronavirus ◽  
The Brain

The knowledge of the spinal cord irrigation is important for the therapeutic planning "COVID-19" is a potentially serious, highly transmissible infectious disease that was first identified in Wuhan, China in December 2019. Individuals infected with SARS-CoV-2 can evolve asymptomatically, with respiratory symptoms or with systemic manifestations affecting, for example, the nervous system. This review aims to discuss the neurological manifestations of SARS-CoV-2 infection, citing the prevalence of each. This study analyzed scientific articles published from 2010 to 2021 in the PubMed database. More than 35% of patients who contract the novel coronavirus develop neurological symptoms. SARS-CoV enters the brain mainly through the olfactory bulb and spreads rapidly via transneuronal route to other related areas such as cerebellum, insula, encephalon, vessels and nerves, and the brain parenchyma itself. This causes manifestations in the CNS (dizziness and ataxias), PNS (anosmia and ageusia), and the musculoskeletal system. Given existing knowledge of other coronaviruses and respiratory viruses, the wide range of CNS and PNS associations with COVID-19 is not surprising, and this is the focus of most current reports. Neurological complications, particularly encephalitis and stroke, can cause lifelong disability, requiring long-term care and substantial costs in the social and economic sphere.

Neurological Manifestations in Gaucher Disease Patients and Relatives.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3838-3838
Author(s):  
Pilar Giraldo ◽  
Pilar Alfonso ◽  
Paz Latre ◽  
Miguel Pocovi ◽  
Keyword(s):  
Peripheral Neuropathy ◽  
Gaucher Disease ◽  
Wide Spectrum ◽  
Correlation Study ◽  
Postal Survey ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Genetic Characteristics ◽  
Neurological Problem

Abstract Aims: Gaucher disease (GD) is characterized by a wide spectrum of manifestations. Several reports have indicated that GD relatives could developed neurological abnormalities. In order to detect neurological symptoms in GD patients and their relatives we have designed a specific prospective inquiry in Spanish GD families. Patients and Methods: the Spanish GD Registry is an independent registry working since 1993, sponsored by the Spanish Gaucher Foundation (FEETEG). From January to December 2006 we have perform a postal survey contacting 42 physicians and 92 families to evaluate neurological symptoms and correlated with genetic characteristics. The data were included in a SPSS 12.0 data base to perform statistical analysis using descriptive parameters, ANOVA, t-test and correlation study including Pearson coefficient. Results: We have obtained information from 72 families (78.3% responses) that included 92 type 1 and 7 type 3 GD patients and 266 relatives. Thirty (32.6%) of type 1 GD reported any neurological problem: tremor 8 (8.7%), uncordinated movements 9 (13.8%), concentration defects 11 (11.9%), strabismus 7 (7.6%), deafness 8 (8.7%), Parkinson disease (PD) 7 (7.6%), peripheral neuropathy 10 (10.9%). Thirty six (13.5%) first or second degrees relatives from 72 families presented neurological manifestations: PD 14 (5.3%), epilepsia 8 (3.0%), tremor 7 (2.6%), deafness 2 (0.7%), others 5 (1.9%). Patients with PD had mutations: S364R, D409H, L444P, [IVS2-2A>G]+ [c.(− 203)A>G], c.500insT, L336P. In relatives with PD a wide spectrum of mutations were observed: L444P, N370S, V398I, G202R, c.1439–1445del7, [E326K]+[N188S] and c.953delT, in others neurological manifestations as epilepsia, tremor or peripheral neuropathy predominant mutations were D409H, G195W, R120W; R147X, L336P and G377S. Conclusions: We have found a higher incidence than expected of PD and other neurological symptoms in GD1 patients and relatives. These manifestations appear frequently in carriers of L444P or rare mutations. It is important to perform a systematic neurological exam in GD1 patients and carriers with risk mutations. This work is partially supported by the grant FIS: 06/1253.

scholarly journals Potential neurological manifestations of COVID-19

2020 ◽  
pp. 10.1212/CPJ.0000000000000897 ◽  
Author(s):  
Anna S. Nordvig ◽  
Kathryn T. Rimmer ◽  
Joshua Z. Willey ◽  
Kiran T. Thakur ◽  
Amelia K. Boehme ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
The Novel ◽  
Altered Consciousness ◽  
Human Coronavirus ◽  
Neurological Morbidity ◽  
Neurological Patients ◽  
Neurological Effects

AbstractPurposeof review: Neurological complications are increasingly recognized in the Coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This coronavirus is related to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and other human coronavirus-related illnesses that are associated with neurological symptoms. These symptoms raise the question of a neuroinvasive potential of SARS-CoV-2.Recent findings:Potential neurological symptoms and syndromes of SARS-CoV-2 include headache, fatigue, dizziness, anosmia, ageusia, anorexia, myalgias, meningoencephalitis, hemorrhage, altered consciousness, Guillain-Barré Syndrome, syncope, seizure, and stroke. Additionally, we discuss neurological effects of other coronaviruses, special considerations for management of neurological patients, and possible long-term neurological and public health sequelae.Summary:As SARS-CoV-2 is projected to infect a large part of the world’s population, understanding the potential neurological implications of COVID-19 will help neurologists and others recognize and intervene in neurological morbidity during and after the pandemic of 2020.

Keraunoparalysis, a neurological manifestation after lightning strike: a case Report

2017 ◽  
Vol 4 (1) ◽  
pp. 47-50
Author(s):  
Sumana Bajracharya ◽  
Ashis Shrestha ◽  
Sajan Shrestha ◽  
Sitaram Shrestha ◽  
Samita Acharya ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiac Rhythm ◽  
Neuropsychiatric Symptoms ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestation ◽  
Lightning Strike ◽  
Wide Range ◽  
Secondary Injuries ◽  
Tissue Damages

Lightning strike can have wide range of physical and neuropsychiatric symptoms. Burn, extensive tissue damages, cardiac rhythm disturbances and secondary injuries are well described and observed. The patient may also go through transient neurological symptoms, which may go unseen in some cases while in some cases it may get extra attention and series of investigations. Keraunoparalysis is one of the immediate neurological complications encountered after lightning strike. This manifests as transient self-limiting symptoms.

Safety and diagnostic accuracy of neuroendoscopic biopsies: an international multicenter study

2013 ◽  
Vol 11 (6) ◽  
pp. 704-709 ◽  
Author(s):  
Shlomi Constantini ◽  
Aaron Mohanty ◽  
Samuel Zymberg ◽  
Sergio Cavalheiro ◽  
Conor Mallucci ◽  
...  
Keyword(s):  
Open Surgery ◽  
Influential Factors ◽  
Small Sample ◽  
Management Decision ◽  
Third Ventriculostomy ◽  
Low Grade ◽  
Intraoperative Bleeding ◽  
Medical Centers ◽  
Number Of Patients ◽  
Wide Range

Object Analysis of the safety and morbidity of neuroendoscopic biopsies (NEBs), as well as the reliability in obtaining an accurate diagnosis, has until now been based on studies with relatively small sample sizes. Through the cooperative efforts of several international medical centers, authors of the present study collected data on a large number of patients to obtain better insight into this issue. When possible, they compared pathology obtained through an NEB with the “gold-standard” pathology obtained in open surgery. Methods Thirteen randomly chosen medical centers in 9 countries collected data for patients who had undergone NEB, which were then analyzed for universal complications, bleeding, navigation technique, pathology, mismatch between biopsy results and final diagnosis, and a number of other potentially influential factors. Results Data for 293 patients were analyzed. Sixty percent of the patients were male, and patient ages ranged from 0.1 to 78.7 years (median age 20.4 years). The most common tumor locations were pineal (33.1%), thalamic (16.7%), tectal (13%), and hypothalamic (4.4%). Fifty percent of the tumors were larger than 20 mm, 36% were between 10 and 20 mm, and 14% were smaller than 10 mm. Intraoperative bleeding was seen in 275 patients (94%). The amount of blood was noted as mild in 75%, moderate in 13%, and severe in 6%. Infection occurred in 8 patients (3%). Death occurred in 1 patient (0.3%), which was caused by severe intraoperative bleeding. Biopsies were informative in 265 patients (90.4%). Seventy-eight patients (26.6%) had open surgery following the NEB. For these patients, the pathology results from the NEB were compared with those from the open surgery that followed. In 14 cases (17.9%) there was disagreement on the pathology. Of these cases, a meaningful mismatch, in which the erroneous NEB pathology could have led to an inappropriate management decision, occurred in 9 cases (11.5%). Most of these meaningful mismatches were lesions diagnosed as low-grade or pilocytic astrocytoma on the NEB and later proved to be high-grade astrocytoma (4 cases) and 1 case each of meningioma, cavernoma, primitive neuroectodermal tumor, neurocysticercosis, and pineocytoma. Conclusions In experienced hands, NEBs can be performed with low morbidity and mortality, providing meaningful pathological data for the majority of patients with a wide range of tumor types, locations, and presentations. These biopsies also offer other advantages, such as the ability to perform concomitant endoscopic third ventriculostomy and septum pellucidotomy. However, due caution must be maintained, since pathology obtained from an NEB, as with stereotactic biopsies, may be subject to sampling errors, especially when the results seem to indicate a low-grade glial tumor.

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