scholarly journals Neurological manifestations of COVID-19: A literature review

2021 ◽  
Vol 10 (2) ◽  
pp. 97-102
Author(s):  
Suman Adhikari ◽  
Prabin Bhandari ◽  
Naresh Poudel ◽  
Nikunj Yogi ◽  
Balgopal Karmacharya ◽  
...  
Keyword(s):  
Severe Disease ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Altered Consciousness ◽  
Angiotensin Converting Enzyme 2 ◽  
The Common ◽  
Novel Coronavirus ◽  
And Control ◽  
The Brain ◽  
Common Manifestation

A novel coronavirus that started from the Wuhan province of China is affecting the whole world. As of this date, more than 222 million cases are reported with more than 4.60 million fatalities. Nepal has more than 771,000 cases reported with almost 11,000 death recorded to date. Though most of the patients present with flu-like symptoms, people with comorbidities like Diabetes mellitus, hypertension, lung, and heart disease most likely suffer from severe disease and even death. As reported, neurological manifestations are common in critically ill patients. The most common manifestation of CNS is headache, dizziness, and encephalopathy whereas loss of smell and taste is the common PNS manifestation. Other neurological complications seen are fatigue, myalgias, hemorrhage, altered consciousness, Guillain-Barre Syndrome, syncope, seizure, and stroke. Non-specific neurological symptoms may be present in the early stages which can mislead the treatment. In some cases, neurological manifestations precede the typical presentation of fever, cough, and shortness of breath and later develop into typical features. The virus enters the brain through 2 systems: hematogenous route or olfactory route. Angiotensin-converting enzyme-2 (ACE-2) is the port of entry to the brain for COVID- 19(SARS-CoV-2) which was also the entry point for SARS-CoV. Covid-19 cases are increasing in the world and prevention and control of spread are a must. Understanding the neurological invasion pathogenesis, and manifestation will help the neurologists and physicians on frontlines to recognize early cases with nervous system involvement, neurological complications, and sequelae during and after the pandemic.

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.

scholarly journals Men and COVID-19: A Pathophysiologic Review

2020 ◽  
Vol 14 (5) ◽  
pp. 155798832095402 ◽  
Author(s):  
Martin S. Lipsky ◽  
Man Hung
Keyword(s):  
Early Recognition ◽  
Severe Disease ◽  
Health Policies ◽  
World Health ◽  
Angiotensin Converting Enzyme 2 ◽  
Public Health Policies ◽  
Animal Data ◽  
The Common ◽  
Novel Coronavirus ◽  
Health Organization

Coronaviruses are single-stranded ribonucleic acid viruses that can cause illnesses in humans ranging from the common cold to severe respiratory disease and even death.In March 2020, the World Health Organization declared the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as the first pandemic. Compared to women, most countries with available data report that men with COVID-19 have greater disease severity and higher mortality. Lab and animal data indicate that men respond differently to the SARS-CoV-2 infection, offering possible explanations for the epidemiologic observations. The plausible theories underlying these observations include sex-related differences in angiotensin-converting enzyme 2 receptors, immune function, hormones, habits, and coinfection rates.In this review we examine these factors and explore the rationale as to how each may impact COVID-19. Understanding why men are more likely to experience severe disease can help in developing effective treatments, public health policies, and targeted strategies such as early recognition and aggressive testing in subgroups.

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 Median Nerve Neuritis after Infection by the SARS-CoV-2 Virus

2021 ◽  
Vol 6 (1) ◽  
pp. 1-4
Author(s):  
Marcelo de Pinho Teixeira Alves ◽  
João Pedro Gouveia Nóbrega
Keyword(s):  
Median Nerve ◽  
Metabolic Diseases ◽  
Severe Disease ◽  
Neurological Complications ◽  
Neurological Manifestations ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
First Case ◽  
Asymptomatic Patients ◽  
The Right

Background: The spectrum of neurological complications from SARS-CoV-2 infection is under constant investigation. According to numerous publications, occurrence of neurological complications can be about 36.4%. There are no reports to date of the occurrence of bilateral median nerve neuritis in the wrist after SARS-CoV-2 infection. Case: A previously healthy 24 years old female was observed in March 2021 due to dysesthesias in both hands, associated with nocturnal discomfort and decreased grip strength. The symptoms started a month earlier with acroparesthesias. SARS-CoV-2 virus infection was in January 2021 and evolved favorably, with progressive remission in about 10 days. Prior to the infection she didn’t have any of the hand symptoms; denied diabetes or metabolic diseases. Negative tests for SARS-CoV-2 infection since February. April 2021, the patient returned with persistent dysesthesias in her hands. Normal EMG, however with Sensitive Conduction Speed (SCS) of 50 m/sec on the right wrist; on the left SCS 55 m/sec. Sensitive latency 2.8 on the right and 2.6 on the left. Amplitude 17 on the right and 24 on the left. MRI detected an increase in signal in PDFS sequences in both median nerves, in the carpal tunnel, with no detected variations in cross-sectional areas or masses. The treatment was a 30 days 150 mg benfotiamine in two daily doses. Discussion: There is a wide variation in the clinical presentation of SARS-CoV-2 infection, ranging from asymptomatic patients to death. Most frequent symptoms are fever, dry cough, sore throat, dyspnea, myalgia, fatigue, chills, diarrhea, chest pain and vomiting, and the most common complications pneumonia and acute respiratory distress syndrome. Neurological manifestations of viral infection can occur in about 36.4% and in 45.5% in severe disease. They include Guillán-Barré and Miller Fischer syndrome; however, these conditions usually occur in more severe cases of the disease, but this patient hadn’t the typical picture of ataxia, ophthalmoplegia and areflexia. Benfotiamine is a synthetic derivative of thiamine with a multifaceted therapeutic profile, with a therapeutic role especially in diabetic neuropathy. Conclusion: Knowledge and recognition of neurological manifestations of SARS-CoV-2 infection and early detection of secondary peripheral neuropathies result in improvement of patients' clinical results and development of ideal ways of treatment. Although only a small percentage of patients develop peripheral neuropathy, in a pandemic this can result in a major social and health impact. The reported case is the first case of bilateral secondary median nerve neuritis in the literature. Level of evidence 4.

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 Reversible cerebral vasoconstriction syndrome in a patient with COVID-19

2021 ◽  
Vol 26 (4) ◽  
pp. 829-834
Author(s):  
Arpan Dutta ◽  
Atanu Chandra ◽  
Subhadeep Gupta ◽  
Biman Kanti Ray ◽  
Deep Das ◽  
...  
Keyword(s):  
Cerebral Angiography ◽  
Rare Complication ◽  
Cerebral Arteries ◽  
Neurological Complications ◽  
Cerebrovascular Diseases ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Angiotensin Converting Enzyme 2 ◽  
Cerebral Vasoconstriction ◽  
Middle Cerebral Arteries ◽  
Novel Coronavirus

COVID-19 infection is well-known to produce different neurological complications, including cerebrovascular diseases. Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by transient segmental vasoconstriction of the cerebral vasculature, has been rarely reported in association with COVID-19 infection. The causative agent, the novel coronavirus (SARS-CoV-2), binds to the angiotensin-converting enzyme 2 (ACE-2) receptors for its entry into the host cell. This leads to downregulation of the ACE-2 and increased activity of the renin-angiotensin-aldosterone (RAAS) axis resulting in sympathetic overactivity and vasoconstriction. This might be the possible mechanism of RCVS in COVID-19. We hereby report a case of RCVS occurring in a SARS-CoV-2 infected patient. This was a 38-year-old male without any comorbidities or risk factors, who presented with headache and confusion. His SARS-CoV-2 RT-PCR was positive. MRI of the brain was normal but cerebral angiography revealed segmental vasoconstriction in bilateral middle cerebral arteries and the terminal part of the internal carotid arteries, which resolved almost completely after 2 weeks. He was treated with oral nimodipine 60 mg every 6 hourly. A database search revealed 2 previous cases of RCVS associated with COVID-19. In conclusion, RCVS is a rare complication of COVID-19. It is possibly under-recognized as only a few COVID-19 patients with headaches undergo cerebral angiography especially when parenchymal brain imaging is normal.

scholarly journals Neurological Manifestations of Novel Coronavirus Disease in a 2-Month-Old Infant: A Case Report

2020 ◽  
Author(s):  
Mojtaba Kamali Aghdam ◽  
Hassan Bakhtiari ◽  
Diana Noemi Diaz ◽  
Kambiz Eftekhari
Keyword(s):  
Respiratory Symptoms ◽  
Clinical Evidence ◽  
Neurological Manifestations ◽  
Computed Tomography Scan ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
A Minor ◽  
The Brain ◽  
Tomography Scan

AbstractThe main manifestations of novel coronavirus usually include fever and cough. Neurological manifestations have not been properly identified in children. A 65-day-old infant was hospitalized due to poor feeding, weakness, lethargy, and occasional cough. She suffered several seizures during her hospitalization. The brain computed tomography scan depicted a minor hemorrhage. Due to the exacerbation of her condition during hospital stay and the presence of respiratory symptoms in her parents, coronavirus disease was suspected. Reverse transcription–polymerase chain reaction (PCR) of coronavirus was positive for both: child and parents. In children with neurological manifestations such as lethargy, recurrent seizures, cerebral hemorrhage, and clinical evidence of respiratory symptoms in his/her relatives, PCR testing for coronavirus is recommended.

scholarly journals COVID–19: Guidance Outlines on Infection Prevention and Control for Health Care Workers

2020 ◽  
Vol 32 (1) ◽  
pp. 8-14
Author(s):  
Suresh Kumar Sharma ◽  
Shiv Mudgal ◽  
Prasan Panda ◽  
Pratima Gupta ◽  
Pradeep Aggarwal
Keyword(s):  
Severe Disease ◽  
Respiratory Illness ◽  
World Health ◽  
Infection Prevention And Control ◽  
The People ◽  
Moderate Disease ◽  
Care Workers ◽  
Novel Coronavirus ◽  
Health Organization ◽  
And Control

Coronavirus are a common family of viruses and there are seven different types of coronaviruses including this new member of coronavirus i.e. 2019 novel coronavirus, which can make the people infected and sick. Some strains of this family of virus cause mild to moderate disease symptoms like common cold while other strains cause very severe disease like Severe Acute Respiratory Syndrome (SARS) and Middle East respiratory syndrome (MERS).(1,2) In late December, in Wuhan Hubei Province, China a number of people suffered with severe respiratory illness including a cluster of pneumonia cases. On 31 December 2019, China notified the World Health Organization (WHO) about cluster of patient with symptoms of respiratory illness of unknown cause, which were connected to an open seafood and animal market of Wuhan city, China.(3)

scholarly journals Neurological Involvement in COVID-19

2021 ◽  
Author(s):  
Valentina Opancina ◽  
Kristijan Krstic ◽  
Predrag Sazdanovic ◽  
Nebojsa Zdravkovic ◽  
Ruzica Radojevic Marjanovic ◽  
...  
Keyword(s):  
Indirect Effects ◽  
Case Reports ◽  
Experimental Studies ◽  
Neurological Complications ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Neural Tissues ◽  
Neurological Conditions ◽  
The Brain ◽  
Common Target

The respiratory system is the most common target of COVID-19, however, various experimental studies and case reports have shown its affinity for neural tissues. In this chapter, we described pathogenesis and propagation of SARS-CoV-2 virus in the nervous system, potential routes of the SARS-CoV-2 invasion in the brain, as well as indirect effects of COVID-19 on multiorgan disorders. We have also presented all of the reported neurological manifestations in COVID-19 with an explanation of possible underlying pathways. Among patients who tested positive on SARS-CoV-2, various neurological irregularities have been described, affecting both the central and peripheral nervous systems. In general, neurological complications in COVID-19 patients occur within 1 and 14 days, in most cases on average on the 5th day of the incubation period. We have demonstrated all of the reported neurological findings, whereas the most commonly reported were headache, dizziness, myalgia, hypogeusia, hyposmia, and impaired consciousness. More serious neurological conditions in COVID-19 included meningitis, encephalitis, and ischemic or hemorrhagic stroke.

scholarly journals Neurological aspects that should not be forgotten during the COVID-19 pandemic

2020 ◽  
Vol 3 ◽  
Author(s):  
Luis Enrique Fernández-Garza ◽  
Alejandro Marfil
Keyword(s):  
Nervous System ◽  
Severe Disease ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
The Body ◽  
Angiotensin Converting Enzyme 2 ◽  
Direct Invasion ◽  
Cerebrovascular Events ◽  
The Central Nervous System ◽  
Systemic Symptoms

COVID-19 disease, in addition to causing the most common respiratory and systemic symptoms, such as cough and fever, has the ability to cause neurological manifestations such as headache, dizziness and altered mental status, which should not be overlooked by physicians when evaluating their patients, because even these manifestations suggest the presence of more severe disease, due to a poor immune response of the body against the virus. SARS-CoV2 infects cells through the Angiotensin-Converting Enzyme 2 (ACE2) receptor, because it is a receptor that is located in neurons, glial cells, and vascular endothelium, it is believed that the neurological symptoms are due to the direct invasion of the virus into the nervous system. Also, neurological complications to which this disease can lead have been identified, such as acute ischemic and hemorrhagic cerebrovascular events and direct infections to the central nervous system, such as meningoencephalitis and acute myelitis. For this reason, all physicians must take into account the neurological aspects involved in SARS-CoV2 infection, from the evaluation of suspected COVID-19 patients to the follow-up of confirmed cases throughout their disease.

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