scholarly journals Ischaemic stroke as an initial presentation in patients with COVID-19: evaluation of a case series in an emergency in Brazil

2021 ◽  
pp. 197140092098735
Author(s):  
Isabella B Oliveira ◽  
Mariana SL Pessoa ◽  
Carla FC Lima ◽  
Jorge LB Holanda ◽  
Pablo P de A Coimbra
Keyword(s):  
Respiratory Tract ◽  
Ischaemic Stroke ◽  
Laboratory Tests ◽  
Case Series ◽  
Neurological Symptoms ◽  
Initial Presentation ◽  
Cytokine Storm ◽  
Neurological Manifestations ◽  
Global Impact

The disease caused by the new coronavirus, initially described in China in December 2019, became known as coronavirus disease 2019 and quickly spread to countries on all continents, becoming a pandemic with an important global impact. Despite being a virus that typically affects the respiratory tract, some studies have already described neurological manifestations associated with this infection, including acute ischaemic vascular insult. We report a case series including 30 patients, who presented with neurological symptoms during admission to our service, being diagnosed with ischaemic stroke and, concomitantly, coronavirus disease 2019. In the subgroup of patients analysed, a state of hypercoagulability and pro thrombosis was observed through laboratory tests, probably related to the cytokine storm syndrome associated with infection by this virus. With that, we discussed the possibility of this finding being an aggravating factor in the occurrence of stroke in these patients.

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 Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study

2020 ◽  
Author(s):  
Ling Mao ◽  
Mengdie Wang ◽  
Shengcai Chen ◽  
Quanwei He ◽  
Jiang Chang ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Nervous System ◽  
Case Series ◽  
Cerebrovascular Diseases ◽  
Hospitalized Patients ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Impaired Consciousness ◽  
Retrospective Case ◽  
Neurologic Symptoms

ABSTRACTOBJECTIVETo study the neurological manifestations of patients with coronavirus disease 2019 (COVID-19).DESIGNRetrospective case seriesSETTINGThree designated COVID-19 care hospitals of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China.PARTICIPANTSTwo hundred fourteen hospitalized patients with laboratory confirmed diagnosis of severe acute respiratory syndrome from coronavirus 2 (SARS-CoV-2) infection. Data were collected from 16 January 2020 to 19 February 2020.MAIN OUTCOME MEASURESClinical data were extracted from electronic medical records and reviewed by a trained team of physicians. Neurological symptoms fall into three categories: central nervous system (CNS) symptoms or diseases (headache, dizziness, impaired consciousness, ataxia, acute cerebrovascular disease, and epilepsy), peripheral nervous system (PNS) symptoms (hypogeusia, hyposmia, hypopsia, and neuralgia), and skeletal muscular symptoms. Data of all neurological symptoms were checked by two trained neurologists.RESULTSOf 214 patients studied, 88 (41.1%) were severe and 126 (58.9%) were non-severe patients. Compared with non-severe patients, severe patients were older (58.7 ± 15.0 years vs 48.9 ± 14.7 years), had more underlying disorders (42 [47.7%] vs 41 [32.5%]), especially hypertension (32 [36.4%] vs 19 [15.1%]), and showed less typical symptoms such as fever (40 [45.5%] vs 92 [73%]) and cough (30 [34.1%] vs 77 [61.1%]). Seventy-eight (36.4%) patients had neurologic manifestations. More severe patients were likely to have neurologic symptoms (40 [45.5%] vs 38 [30.2%]), such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]) and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]).CONCLUSIONCompared with non-severe patients with COVID-19, severe patients commonly had neurologic symptoms manifested as acute cerebrovascular diseases, consciousness impairment and skeletal muscle symptoms.

scholarly journals Being aware of the neurological manifestations of COVID-19 infection

2021 ◽  
Vol 40 (3) ◽  
pp. 187-189
Author(s):  
Basak Atalay
Keyword(s):  
Respiratory Tract ◽  
Sore Throat ◽  
Strong Evidence ◽  
Initial Presentation ◽  
The Novel ◽  
Neurologic Manifestations ◽  
Neurological Manifestations ◽  
Impaired Consciousness ◽  
Atypical Symptoms ◽  
Novel Coronavirus

The novel coronavirus disease- 2019 (COVID-19) is first reported from China, and unfortunately, no longer restricted, and spreads in all geographies.(1) The main symptoms of COVID-19 infection are respiratory tract related. Infected patients usually have symptoms such as fever, sore throat, and fatigue, and they may have atypical symptoms like headache, seizure, anosmia, stroke, and even impaired consciousness. Strong evidence of an association between COVID-19 infection and neurological manifestations has been reported. Besides, the neurologic manifestations may be the initial presentation of COVID-19 infection.

Persons with co-existing neurological disorders: Risk analysis, considerations and management in COVID-19 pandemic

2021 ◽  
Vol 20 ◽  
Author(s):  
Sumit Sharma ◽  
Sonali Batra ◽  
Saurabh Gupta ◽  
Vivek Kumar Sharma ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Risk Analysis ◽  
Respiratory Tract ◽  
Cohort Studies ◽  
Cerebrovascular Disease ◽  
Neurological Disorders ◽  
Management Strategy ◽  
Clinical Manifestations ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Standardized Diagnostic

: Increasing reports of neurological symptoms in COVID-19 patient’s warrant clinicians to adopt and define the standardized diagnostic and managing protocols in order to investigate the linkage of neurological symptoms in COVID-19. Encephalitis, anosmia, acute cerebrovascular disease and ageusia are some of the emerging neurological manifestations which are reported in several cohort studies on hospitalized patients with COVID-19. Although the COVID-19 pandemic is primarily associated with respiratory tract system but measures like lockdown and restricted physical movements to control the spread of this infection will certainly have neurobehavioural implications. Additionally, some of the patients with pre-existing neurological manifestations like epilepsy, Parkinson’s and Alzheimer’s disease are more prone to infection and demands extra as well as improvisation in their treatment therapy. In this review we have focused on the neurovirological clinical manifestations associated with COVID-19 pandemic. Although the prevalence of neurovirological manifestations is rare but increasing reports cannot be ignored and needs to be discussed thoroughly with respect to risk analysis and considerations for developing management strategy. This also helps in defining the burden of neurological disorders associated with COVID-19 patients.

scholarly journals Neurological manifestations of COVID-19 – an approach to categories of pathology

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Yana Leven ◽  
Julian Bösel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cerebrovascular Disease ◽  
Literature Search ◽  
Case Series ◽  
Neurological Symptoms ◽  
Comparable Data ◽  
Neurological Manifestations ◽  
Case Definitions ◽  
The Central Nervous System

Abstract Background Various neurological manifestations of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported, associated with a broad spectrum of diverse neurological symptoms and syndromes. Estimating rate and relevance of these manifestations remains difficult as there is a lack of standardised case definitions. Methods We defined comprehensive categories including most reported neurological manifestations associated with SARS-CoV-2 to allow for a more standardised data collection. After a literature search of MEDLINE with ten keywords, 12 selected studies and larger case series were included. We compared the rate and relevance of neurological manifestations in hospitalized patients. We propose four main categories including 1) cerebrovascular disease, 2) inflammatory syndromes of the central nervous system (CNS), peripheral nervous system (PNS) and muscle, 3) metabolic/toxic dysfunction of CNS, PNS and muscle and 4) miscellaneous disorders. Conclusion Ageusia (702) and anosmia (805) have been reported as the most common and the first occurring neurological symptoms. Cerebrovascular disease (451) and encephalopathy (663) were associated with a more severe course and worse clinical outcome. Any neurological manifestation was associated with a longer hospital stay and a higher morbidity and mortality compared to patients without neurological manifestations. We suggest reporting future neurological manifestations of coronavirus disease-19 (COVID-19) following a pathophysiology-based approach using standardized pre-defined case definitions to yield more specific and comparable data.

SARS-CoV-2 Induced Neurological Manifestations Entangles Cytokine Storm That Implicates For Therapeutic Strategies

2021 ◽  
Vol 28 ◽  
Author(s):  
Zhao-Zhong Chong ◽  
Nizar Souayah
Keyword(s):  
Nervous System ◽  
Immune Responses ◽  
Neurological Complications ◽  
Therapeutic Strategies ◽  
Neurological Symptoms ◽  
The Novel ◽  
Cytokine Storm ◽  
Neurological Manifestations ◽  
Direct Invasion ◽  
Insight Into

Abstract: The new coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can present with neurological symptoms and induce neurological complications. The involvement in both the central and peripheral nervous systems in COVID-19 patients has been associated with direct invasion of the virus and the induction of cytokine storm. This review discussed the pathways for the virus invasion into the nervous system and characterized the SARS-CoV-2 induced cytokine storm. In addition, the mechanisms underlying the immune responses and cytokine storm induction after SARS-CoV-2 infection were also discussed. Although some neurological symptoms are mild and disappear after recovery from infection, some severe neurological complications contribute to the mortality of COVID-19 patients. Therefore, the insight into the cause of SARS-CoV-2 induced cytokine storm in context with neurological complications will formulate the novel management of the disease and further identify new therapeutic targets for COVID-19.

scholarly journals A case series of ischemic stroke with coronavirus disease 2019 in two Egyptian centers

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Nevine El Nahas ◽  
Tamer Roushdy ◽  
Eman Hamid ◽  
Sherien Farag ◽  
Hossam Shokri ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Severe Acute Respiratory Syndrome ◽  
Cerebrovascular Disorders ◽  
Case Series ◽  
Neurological Manifestations ◽  
Case Presentation ◽  
Novel Virus

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus that has been reported to have various neurological manifestations. Cerebrovascular disorders have been encountered as a coronavirus disease 2019 (COVID-19) presentation in our center during the pandemic. Case presentation We are presenting 10 cases with cerebrovascular manifestations after having COVID-19 few days prior to stroke. Conclusion Cerebrovascular manifestations can occur in association with COVID-19 and may have significant implications on prognosis and management.

scholarly journals Cytokine storm induced by SARS-CoV-2 infection: The spectrum of its neurological manifestations

Cytokine ◽  
2021 ◽  
Vol 138 ◽  
pp. 155404
Author(s):  
Parisorn Thepmankorn ◽  
John Bach ◽  
Ahmed Lasfar ◽  
Xilin Zhao ◽  
Sami Souayah ◽  
...  
Keyword(s):  
Cytokine Storm ◽  
Neurological Manifestations

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.

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