scholarly journals Argentine Registry of neurological manifestations due to coronavirus-19 (COVID-19)

Author(s):  
Mariana Bendersky ◽  
Lucas Alessandro ◽  
Franco Appiani ◽  
Brenda Borrego Guerrero ◽  
Patricia Cairola ◽  
...  

COVID-19 disease has spread around the world since December 2019. Neurological symptoms are part of its clinical spectrum. Objective: To know the neurological manifestations in patients infected by COVID-19 in Argentina. Methods: Multicenter study conducted in adults, from May 2020 to January 2021, with confirmed COVID-19 and neurological symptoms. Demographic variables, existence of systemic or neurological comorbidities, the form of onset of the infection, alteration in complementary studies and the degree of severity of neurological symptoms were recorded. Results: 817 patients from all over the country were included, 52% male, mean age 38 years, most of them without comorbidities or previous neurological pathology. The first symptom of the infection was neurological in 56.2% of the cases, predominantly headache (69%), then anosmia / ageusia (66%). Myalgias (52%), allodynia / hyperalgesia (18%), and asthenia (6%) were also reported. 3.2% showed diffuse CNS involvement such as encephalopathy or seizures. 1.7% had cerebrovascular complications. Sleep disorders were observed in 3.2%. 6 patients were reported with Guillain Barre (GBS), peripheral neuropathy (3.4%), tongue paresthesia (0.6%), hearing loss (0.4%), plexopathy (0.3%). The severity of neurological symptoms was correlated with age and the existence of comorbidities. Conclusions: Our results, similar to those of other countries, show two types of neurological symptoms associated with COVID-19: some potentially disabling or fatal such as GBS or encephalitis, and others less devastating, but more frequent such as headache or anosmia that demand increasingly long-term care.

2021 ◽  
Author(s):  
Nayara de Lima Froio ◽  
Ana Luisa Rosas Sarmento ◽  
Sonia Maria Cesar de Azevedo Silva ◽  
Lilia Azzi Collet da Rocha Camargo

Context: Neurological manifestations of Sars-CoV-2 are progressively emerging. Cases of Guillain-Barré syndrome and its variants, with onset about 5-10 days after influenza symptoms, have been described. This paper reports a case of polyneuropathy with onset 90 days after a sore throat episode and persistence of IgM positivity in serology for Sars- Cov-2. We aim to raise awareness of this possibility. Case Report: A 56-year-old male, hypertensive, presented with sore throat on April 21, 2020. Serology for Covid-19 was performed with positive IgM. There was complete improvement of the symptom. At the end of July, he started a symmetrical paresthesia in the feet with ascension to the knees and, on August 20, paresthesia in the hands too. So, he went to IAMSPE (SP) and tactile and painful hypoesthesia in hands and feet, hypopalesthesia in lower limbs, a fall in the lower limbs upon Mingazzini’s maneuver, global hyporeflexia and talon gait were found. Just the following tests were changed: second Covid-19 serology IgM and IgG positives; ENMG: sensory motor polyneuropathy, primarily axonal, with signs of chronicity and without signs of acute denervation in the current. Started gabapentin and physical therapy. Patient still has paresthesia in hands and feet, but with partial improvement. Conclusion: This case alerts to neurological symptoms of Covid-19 in the medium and long term.


2021 ◽  
Author(s):  
Poliana Rafaela dos Santos Araújo ◽  
Kauan Alves Sousa Madruga ◽  
Bruna Alves Rocha ◽  
Lucas Oliveira Braga

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.


Author(s):  
Hernández Ramos, F J, PhD, MD ◽  
Hernández Chamorro, F J, ◽  
Palomino García, A ◽  
Jiménez Hernández, MD

We´re witnessing a pandemic due to COVID-19, which has generated a strong impact in Public Health, Health Services and a economic level, still to be determinated. It´s a recently discovered respiratory virus that has the capacity to produce neurological symptoms, either indirectly o directly. Much has been written about neurological symptoms, mainly by no-neurologist, and the frecuency and type of neurological manifestations must be precisely defined in both, acute and medium-long term phases. After carrying out and extensive bibliographic review, the objective of this paper is to analyze what has been described so far and how it can be improved to know exactly the type and frecuency of neurological manifestations related to COVID-19.


2021 ◽  
Author(s):  
Andrea Pilotto ◽  
Viviana Cristillo ◽  
Stefano Cotti Piccinelli ◽  
Nicola Zoppi ◽  
Giulio Bonzi ◽  
...  

ABSTRACTBackgroundPreclinical and clinical investigations have argued for nervous system involvement in SARS-CoV-2 infection and for long term sequalae including neurological manifestationsMethodsa sample of 208 previously hospitalized COVID-19 patients, 165 patients were re-assessed at 6 months according to a structured standardized clinical protocol. Premorbid comorbidities and clinical status, severity of COVID-19 disease, complications during and after hospitalization were recorded.ResultsAt 6-month follow-up after hospitalisation due to COVID-19 disease, patients displayed a wide array of neurological symptoms, being fatigue (34%), memory/attention (31%), and sleep disorders (30%) the most frequent. Subjects reporting neurological symptoms were affected by more severe respiratory SARS-CoV-2 infection parameters during hospitalisation. At neurological examination, 37.4% of patients exhibited neurological abnormalities, being cognitive deficits (17.5%), hyposmia (15.7%) and postural tremor (13.8%) the most common. Patients with cognitive deficits at follow-up were comparable for age, sex and pre-admission comorbidities but experienced worse respiratory SARS-CoV-2 infection disease and longer hospitalisation.Conclusionslong term neurological manifestations after hospitalization due to COVID-19 infection affects one third of survivors. Multiple neurological abnormalities including mild cognitive impairment are associated with severity of respiratory SARS-CoV-2 infection.


2020 ◽  
Author(s):  
William E Mansbach ◽  
Ryan A Mace ◽  
Melissa A Tanner

BACKGROUND Older adults are at high risk for developing serious somatic and psychological symptoms from the 2019 novel coronavirus (COVID-19). Available instruments may not be sensitive to concerns about COVID-19 in post-acute and long-term care (PA/LTC) and have unknown utility for telehealth. OBJECTIVE We investigated the psychometric properties of the Mood-5 Scale (M5) as a rapid self-assessment of COVID-19 psychological burden in PA/LTC residents. METHODS Residents (N = 131, age ≥ 50) in 20 Maryland, USA PA/LTC settings were evaluated in-person or via telehealth (33%) during a four-week COVID-19 period (05/11/2020 – 06/05/2020). COVID psychological burden was rated by psychologists who independently reviewed clinical documentation. Psychometric analyses were performed on the M5 in relation to psychological tests, COVID-19 psychological burden, and diagnostic data collected during the evaluation. RESULTS The M5 demonstrated acceptable internal consistency (???? = .77). M5 scores were not confounded by demographic variables or telehealth administration (ps > 0.08). Convergent validity for the M5 was established via positive associations with anxiety (r = 0.56, p < 0.001) and depressive (r = 0.49, p < 0.001) symptoms. A M5 cutoff of 3 demonstrated strong sensitivity (.92) and adequate specificity (.75) for identifying COVID-19 psychological distress in PA/LTC residents (AUC = .89, PPV = .79, NPV = .91). CONCLUSIONS The M5 is a reliable and valid mood self-assessment that can identify residents with significant psychological burden associated with COVID-19. It can be completed in less than one minute and is appropriate for in-person and virtual visits.


2011 ◽  
Vol 16 (1) ◽  
pp. 18-21
Author(s):  
Sara Joffe

In order to best meet the needs of older residents in long-term care settings, clinicians often develop programs designed to streamline and improve care. However, many individuals are reluctant to embrace change. This article will discuss strategies that the speech-language pathologist (SLP) can use to assess and address the source of resistance to new programs and thereby facilitate optimal outcomes.


Author(s):  
Oscar D. Guillamondegui

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.


2001 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Carol Winchester ◽  
Cathy Pelletier ◽  
Pete Johnson

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.


2015 ◽  
Vol 24 (4) ◽  
pp. 140-145
Author(s):  
Kevin R. Patterson

Decision-making capacity is a fundamental consideration in working with patients in a clinical setting. One of the most common conditions affecting decision-making capacity in patients in the inpatient or long-term care setting is a form of acute, transient cognitive change known as delirium. A thorough understanding of delirium — how it can present, its predisposing and precipitating factors, and how it can be managed — will improve a speech-language pathologist's (SLPs) ability to make treatment recommendations, and to advise the treatment team on issues related to communication and patient autonomy.


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