COVID-19 and Neurology – An Emerging Association

Author(s):  
Amit Gupta ◽  
Prakrati Yadav ◽  
Deepak Kumar

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, which is a cause of the ongoing pandemic, has the potential to infect the nervous system and causing neurological manifestations. However, patients with primarily neurological symptoms are often overlooked and tested later. Objective : We aim to summarise all the neurological manifestations which are reported so far to aid in early diagnosis and preventingze all the neurological manifestations that are reported so far to aid in early diagnosis and prevent further complication of the disease. Methods and Material: We did a literature search on the topic using Google search engine through Google Scholar, PubMed, and WHO resources by keywords including Coronavirus, SARS-CoV-2, COVID-19, Clinical features, Stroke, Transverse myelitis, Encephalitis, Encephalopathy, Guillain-Barre syndrome, Hypogeusia, Hyposmia, Anosmia, and Neurological manifestations. Discussion: SARS-CoV-2 can affect the neuronal cells by both direct and indirect mechanisms. This can lead to various neurological manifestations ranging from subtle symptoms of myalgia, headache, dizziness, hypogeusia, hyposmia to dreaded complications like stroke, encephalitis, demyelinating disease like Guillain-Barre syndrome. Conclusions: Presentation of COVID-19 with neurological features is not uncommon, and these patients should be tested earlier to help in the prevention of transmission, early diagnosis, and management.

2022 ◽  
Vol 12 (1) ◽  
pp. 74
Author(s):  
Doaa A. Mekkawy ◽  
Sherif Hamdy ◽  
Maged Abdel-Naseer ◽  
Hatem S. Shehata ◽  
Ahmed Al Halfawy ◽  
...  

Background: The COVID-19 pandemic has reached over 276 million people globally with 5.3 million deaths as of 22nd December 2021. COVID-19-associated acute and long-term neurological manifestations are well recognized. The exact profile and the timing of neurological events in relation to the onset of infection are worth exploring. The aim of the current body of work was to determine the frequency, pattern, and temporal profile of neurological manifestations in a cohort of Egyptian patients with confirmed COVID-19 infection. Methods: This was a prospective study conducted on 582 hospitalized COVID-19 patients within the first two weeks of the diagnosis of COVID-19 to detect any specific or non-specific neurological events. Results: The patients’ mean (SD) age was 46.74 (17.26) years, and 340 (58.42%) patients were females. The most commonly encountered COVID-19 symptoms were fever (90.72%), cough (82.99%), and fatigue (76.98%). Neurological events (NE) detected in 283 patients (48.63%) and were significantly associated with a severe COVID-19 at the onset (OR: 3.13; 95% CI: 2.18–4.51; p < 0.0001) and with a higher mortality (OR: 2.56; 95% CI: 1.48–5.46; p = 0.019). The most frequently reported NEs were headaches (n = 167) and myalgias (n = 126). Neurological syndromes included stroke (n = 14), encephalitis (n = 12), encephalopathy (n = 11), transverse myelitis (n = 6) and Guillain-Barré syndrome (n = 4). Conclusions: Neurological involvement is common (48.63%) in COVID-19 patients within the first two weeks of the illness. This includes neurological symptoms such as anosmia, headaches, as well as a constellation of neurological syndromes such as stroke, encephalitis, transverse myelitis, and Guillain-Barré syndrome. Severity of acute COVID-19 illness and older age are the main risk factors.


2019 ◽  
Vol 12 (4) ◽  
pp. e228845 ◽  
Author(s):  
Sajid Hameed ◽  
Sara Khan

Chikungunya (CHIK) viral fever is a self-limiting illness that presents with severe debilitating arthralgia, myalgia, fever and rash. Neurological complications are rare. We present a case of a 36-year-old woman who presented with acute onset progressive difficulty swallowing and left arm weakness. She was diagnosed with CHIK viral fever 4 weeks prior to admission. After investigations, she was diagnosed with a pharyngeal–cervical–brachial variant of Guillain-Barré syndrome. In hospital, she required ventilator support. Her condition improved after five sessions of intravenous immunoglobulin with almost complete resolution within 6 months of symptom onset. With frequent CHIK outbreaks, the neurological complications are increasingly seen in the emergency department. The knowledge of these associations will result in early diagnosis and treatment.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Shujuan Li ◽  
Ming Yu ◽  
Haifeng Li ◽  
Hongliang Zhang ◽  
Yanfang Jiang

Guillain-Barré syndrome (GBS) is an acute autoimmune-mediated inflammatory demyelinating disease that causes rapidly progressing paralysis and occasionally respiratory failure. We hypothesized that interleukin (IL)-17 and IL-22 are elevated in GBS and participate in the autoimmune inflammatory response of GBS. We used sandwich enzyme-linked immunosorbent assay (ELISA) to measure the IL-17 and IL-22 levels in the CSF, and plasma from 22 GBS patients at the acute phase and 18 healthy controls (HC). The results show that CSF and plasma levels of IL-17 and IL-22 are elevated in GBS patients compared with HC. IL-17 and IL-22 levels in CSF, respectively, are correlated with GBS disability scale scores (GDSs). Meanwhile, IL-17 and IL-22 levels in CSF, IL-22 in CSF, and plasma of GBS patients have positive correlation, respectively. The increased levels of IL-17 and IL-22 in CSF may be explained by the disruption of blood-brain barrier (BBB) and peripheral nervous system (PNS) local inflammation in GBS. Meanwhile, the elevated levels of these two cytokines in plasma suggest the activation of Th17 and Th22 cells in the systemic immune response of GBS. Our data provide preliminary evidence that GBS is associated with high levels of IL-17 and IL-22 in CSF and plasma. These cytokines display pathogenic potential and may serve as useful biomarkers for GBS.


2022 ◽  
Vol 7 (4) ◽  
pp. 326-333
Author(s):  
Madhavi Karri ◽  
Deepak Jacob ◽  
Balakrishnan Ramasamy ◽  
Santhosh Perumal

A novel coronavirus (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2). This pandemic has been globally alarming in the current period. Several neurological manifestations are reported occurring with the infection. Guillain barre syndrome (GBS) or acute onset inflammatory polyradiculoneuropathy has been among the frequent manifestations observed among them. To know the pattern and outcome of GBS in COVID-19 affected individuals. We have taken six individuals admitted with flaccid quadriparesis in the last two months. All were affected recently by COVID 19 infection, which RT PCR of the nasopharyngeal swab confirmed. The study participants have undergone nerve conduction studies and have been diagnosed with Guillain Barre syndrome using Brighton criteria. We did cerebrospinal fluid (CSF) analysis after admission. We initiated all patients on Intravenous immunoglobulin according to body weight (2g/kg divided over five days). We used the Barthel index score to assess the outcome of the individuals. We observed a mean duration of 18.25 days between the COVID-19 infection and the onset of symptoms. Apart from motor quadriparesis and sensory symptoms being in common, we also noticed cranial nerves and autonomic involvement. We made the diagnosis using the nerve conduction studies and Brighton criteria. After initiating intravenous immunoglobulin, all patients had a good outcome, and quality of life was better after two months of follow up. Guillain Barre syndrome is one of the neurological manifestations of COVID-19 and has a dramatic response with intravenous immunoglobulin and better outcome with treatment.


1991 ◽  
Vol 35 ◽  
pp. 163 ◽  
Author(s):  
X.-H. Xu ◽  
X.-D. Wei ◽  
M.-Q. Zhao ◽  
Y.-K. Hu ◽  
Y.-K. Gu ◽  
...  

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