Neurological symptoms of COVID-19

2021 ◽  
Vol 36 (4) ◽  
pp. 285-296
Author(s):  
Adriana Wawer ◽  
Agnieszka Piechal
Keyword(s):  
Nervous System ◽  
Viral Infections ◽  
Harmful Effect ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Acute Respiratory Disease ◽  
Neurological Damage ◽  
Impaired Consciousness ◽  
Potential Impact ◽  
The Brain

Objective. Some viral infections can have a harmful effect on the functioning of the nervous system and can even cause serious neurological damage. This work aims to review the results of studies published so far concerning neurological complications in people infected with coronaviruses, especially SARS-CoV-2, and possible mechanisms responsible for nervous system damage. Literature review. Recently, there have been reports that coronaviruses, including SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), cause acute respiratory disease, exhibit neurotropic properties and can also cause neurological symptoms. There are studies published showing that these viruses may penetrate to the brain and cerebrospinal fluid. Conclusions. Coronaviruses are still poorly understood, so it seems important to study the potential impact of SARS-CoV-2 infections on the nervous system. It seems appropriate that patients infected with SARS-CoV-2 should be early evaluated for neurological symptoms, including headache and impaired consciousness.

scholarly journals Neuropathogenesis of SARS-CoV-2 infection

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Shumayila Khan ◽  
James Gomes
Keyword(s):  
Nervous System ◽  
Human Life ◽  
Neurological Complications ◽  
Pulmonary Complications ◽  
Neurological Damage ◽  
Sensory Impairments ◽  
Low Levels ◽  
Chief Symptom ◽  
The Brain ◽  
Initial Knowledge

The COVID-19 pandemic caused by the SARS-CoV-2 has recently emerged as a serious jolt to human life and economy. Initial knowledge established pulmonary complications as the chief symptom, however, the neurological aspect of the disease is also becoming increasingly evident. Emerging reports of encephalopathies and similar ailments with the detection of the virus in the CSF has elicited an urgent need for investigating the possibility of neuroinvasiveness of the virus, which cannot be ruled out given the expression of low levels of ACE2 receptors in the brain. Sensory impairments of the olfactory and gustatory systems have also been reported in a large proportion of the cases, indicating the involvement of the peripheral nervous system. Hence, the possibility of neurological damage caused by the virus demands immediate attention and investigation of the mechanisms involved, so as to customize the treatment of patients presenting with neurological complications.

scholarly journals ОСНОВНІ НЕВРОЛОГІЧНІ СИМТОМИ ТА ЇХ ПОШИРЕННЯ У СОБАК

2016 ◽  
Vol 18 (3(71)) ◽  
pp. 240-243
Author(s):  
V. Fedorovych ◽  
L. Slivinska ◽  
N. Fedorovych
Keyword(s):  
Nervous System ◽  
Pathological Process ◽  
Neurological Symptoms ◽  
Nervous System Diseases ◽  
Anatomical Localization ◽  
Neurological Research ◽  
The Brain

As a result of the ambulatory reception it was investigated 12233 animals, of which 5653 (46.2%) were dogs. In the neurological research it had shown the symptoms of the nervous system damage in 653 dogs (11.5%). In particular it was found that paresis and paralysis (23.4%) were the most common neurological symptoms in dogs. Number of animals with inclination of head, ataxia, myoclonus and epileptiform state was respectively 19.8; 14.7; 11.7 and 10.5%. The manifestations of the nervous system damage as nystagmus, tremor and lameness were registered in accordance with 8.3; 4.4 and 4.1% of sick dogs. The least number of dogs were with a disorder of vision (2,8%) and hearing (0,3%), which was associated with the pathology of the nervous system. The above mentioned symptoms of the nervous system diseases do not occur as a symptom, but it was marked their combination – syndromes. The conducted neurological research makes it possible to establish the location of the pathological process in the departments of nervous system (neurons anatomical localization).As a result of the research and the results found that most dogs manifest the symptoms of damage to the brain and spinal mozkupaytiyi. Based on the results of verification of the diagnosis will be made using the methods of visual diagnostics. 

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 Tembusu Virus entering the central nervous system caused nonsuppurative encephalitis without disrupting the blood-brain barrier

2021 ◽  
Author(s):  
Sheng Yang ◽  
Yufei Huang ◽  
Yonghong Shi ◽  
Xuebing Bai ◽  
Ping Yang ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Blood Brain Barrier ◽  
Neurological Symptoms ◽  
Brain Barrier ◽  
Poultry Industry ◽  
Blood Brain ◽  
The Central Nervous System ◽  
Tembusu Virus ◽  
The Brain

Tembusu Virus (TMUV) is an emerging and re-emerging zoonotic pathogen that adversely affects poultry industry in recent years. TMUV disease is characterized by nonsuppurative encephalitis in ducklings. The duckling infection model was established to study the mechanism of TMUV crossing the blood-brain barrier (BBB) into the central nervous system (CNS). Here, we showed that no obvious clinical symptoms and enhancement of BBB permeability occurred at the early stage of infection (3∼5 dpi). While simultaneously virus particles were observed by transmission electron microscopy in the brain, inducing the accumulation of inflammatory cytokines. Neurological symptoms and disruption of BBB appeared at the intermediate stage of infection (7∼9 dpi). It was confirmed that TMUV could survive and propagate in brain microvascular endothelial cells (BMECs), but did not affect the permeability of BBB in vivo and in vitro at an early date. In conclusion, TMUV enters the CNS then causes encephalitis, and finally destruct the BBB, which may be due to the direct effect of TMUV on BMECs and the subsequent response of “inflammatory storm”. IMPORTANCE The TMUV disease has caused huge losses to the poultry industry in Asia, which is potentially harmful to public health. Neurological symptoms and their sequelae are the main characters of this disease. However, the mechanism of how this virus enters the brain and causes encephalitis is unclear. In this study, we confirmed that the virus entered the CNS and then massively destroyed BBB and the BBB damage was closely associated with the subsequent outbreak of inflammation. TMUV may enter the CNS through the transcellular and “Trojan horse” pathways. These findings can fill the knowledge gap in the pathogenesis of TMUV-infected poultry and be benefit for the treatment of TMUV disease. What’s more, TMUV is a representative to study the infection of avian flavivirus. Therefore, our studies have significances both for understanding of the full scope of mechanisms of TMUV and other flavivirus infection, and conceivably, for therapeutics.

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 COVID-19 survivors and neuropsychological issues: A way forward

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Muhammad Rafiq ◽  
Umaiza Bashir ◽  
Jamshed Hasnain
Keyword(s):  
Mental Health ◽  
Nervous System ◽  
Intensive Care ◽  
Literature Review ◽  
Respiratory Symptoms ◽  
Viral Infections ◽  
Treatment Plan ◽  
Review Article ◽  
Limited Data ◽  
The Brain

Background: This brief article focuses on highlighting the importance of possible neuropsychological manifestations among the Coronavirus Disease 19 (COVID-19) survivors. Studies have evidenced that like other Coronaviruses, COVID-19 is highly contagious and also responsible for the development of mild to severe respiratory symptoms. As COVID-19 is a recently emerged pandemic that has resulted in more than six hundred thousand deaths around the globe as of July 2020 and most of the researches has focused on the physical manifestations. Purpose: The purpose of this review article was to highlight the importance of COVID-19 infection in perspective to mental health in those patients who are survived. Methodology: For this purpose, an intensive literature review was conducted through different scientific search engines including PubMed, Google Scholars, Science Direct, etc. Results and Conclusion: There is very limited data available on manifestations including psychological and neuropsychological. Studies have shown that viral infections including viruses from Coronaviridae have been implicated in the nervous system including the brain. So, it is important to investigate the post-COVID-19 infection in neuropsychological aspects. Such studies will highlight the importance of post-COVID-19 complications and will also help in redesigning the treatment plan for mental health. Keywords: COVID-19, neuropsychological issues, mental health, Coronavirus Disease 19 Survivors, depression, anxiety, stress Citation: Rafiq M, Bashir U, Hasnain J. COVID-19 survivors and neuropsychological issues: A way forward. Anaesth. pain intensive care 2020;24(5):

scholarly journals Isolated Chronic Aseptic Meningitis Due to SARS-COV-2 Unresponsive to Ordinary Treatments

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Abdollah Karimi ◽  
Sedigheh Rafiei Tabatabaei ◽  
Ghazal Shariatpanahi ◽  
Mohsen Javadzadeh ◽  
Shahnaz Armin ◽  
...  
Keyword(s):  
Nervous System ◽  
Severe Acute Respiratory Syndrome ◽  
Aseptic Meningitis ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Adult Patients ◽  
Immune Mediated

: Serious, and sometimes, deadly complications of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are devastating. Whereas most manifestations of COVID-19 are respiratory (fever, dry cough, fatigue, pneumonia), it is getting to be progressively recognized that numerous organ functions can be affected by this disease, and the nervous system is one of them as neurological complications can affect up to 36% of adult patients. However, the prevalence and pathophysiology of these complications have yet to be fully elucidated in children. Here, we discuss an infant with neurological symptoms manifested as chronic isolated aseptic meningitis associated with COVID-19, which was unresponsive to ordinary treatments and dramatically responsive to dexamethasone. Immune-mediated reactions may have had a major pathophysiologic role in this case.

scholarly journals COVID-19 Infection and Neurological Complications: Present Findings and Future Predictions

2020 ◽  
Vol 54 (5) ◽  
pp. 364-369 ◽  
Author(s):  
Ettore Beghi ◽  
Valery Feigin ◽  
Valeria Caso ◽  
Paola Santalucia ◽  
Giancarlo Logroscino
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Viral Infections ◽  
Neurological Diseases ◽  
Neurological Complications ◽  
Influenza Viruses ◽  
Surveillance Systems ◽  
Care Needs ◽  
The Past ◽  
Immune Mediated

The present outbreak caused by SARS-CoV-2, an influenza virus with neurotropic potential, presents with neurological manifestations in a large proportion of the affected individuals. Disorders of the central and peripheral nervous system are all present, while stroke, ataxia, seizures, and depressed level of consciousness are more common in severely affected patients. People with these severe complications are most likely elderly with medical comorbidities, especially hypertension and other vascular risk factors. However, postinfectious complications are also expected. Neurological disorders as sequelae of influenza viruses have been repeatedly documented in the past and include symptoms, signs, and diseases occurring during the acute phase and, not rarely, during follow-up. Postinfectious neurological complications are the result of the activation of immune mechanisms and can explain the insurgence of immune-mediated diseases, including the Guillain-Barré syndrome and other diseases of the central and peripheral nervous system that in the past occurred as complications of viral infections and occasionally with vaccines. For these reasons, the present outbreak calls for the introduction of surveillance systems to monitor changes in the frequency of several immune-mediated neurological diseases. These changes will determine a reorganization of the measures apt to describe the interaction between the virus, the environment, and the host in areas of different dimensions, from local communities to regions with several millions of inhabitants. The public health system, mainly primary care, needs to be strengthened to ensure that research and development efforts are directed toward right needs and directions. To cope with the present pandemic, better collaboration is required between international organizations along with more research funding, and tools in order to detect, treat, and prevent future epidemics.

scholarly journals Simian Immunodeficiency Virus-Infected Memory CD4+ T Cells Infiltrate to the Site of Infected Macrophages in the Neuroparenchyma of a Chronic Macaque Model of Neurological Complications of AIDS

mBio ◽  
2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Cheri A. Lee ◽  
Erin Beasley ◽  
Karthikeyan Sundar ◽  
Margery Smelkinson ◽  
Carol Vinton ◽  
...  
Keyword(s):  
Central Nervous System ◽  
T Cells ◽  
Nervous System ◽  
B Cells ◽  
Mononuclear Cells ◽  
Rhesus Macaques ◽  
Neurological Complications ◽  
Immunodeficiency Virus ◽  
The Central Nervous System ◽  
The Brain

ABSTRACT Simian immunodeficiency virus (SIV)-infected nonhuman primates can serve as a relevant model for AIDS neuropathogenesis. Current SIV-induced encephalitis (SIVE)/neurological complications of AIDS (neuroAIDS) models are generally associated with rapid progression to neuroAIDS, which does not reflect the tempo of neuroAIDS progression in humans. Recently, we isolated a neuropathogenic clone, SIVsm804E-CL757 (CL757), obtained from an SIV-infected rhesus macaque (RM). CL757 causes a more protracted progression to disease, inducing SIVE in 50% of inoculated animals, with high cerebral spinal fluid viral loads, multinucleated giant cells (MNGCs), and perivascular lymphocytic cuffing in the central nervous system (CNS). This latter finding is reminiscent of human immunodeficiency virus (HIV) encephalitis in humans but not generally observed in rapid progressor animals with neuroAIDS. Here, we studied which subsets of cells within the CNS were targeted by CL757 in animals with neurological symptoms of SIVE. Immunohistochemistry of brain sections demonstrated infiltration of CD4+ T cells (CD4) and macrophages (MΦs) to the site of MNGCs. Moreover, an increase in mononuclear cells isolated from the brain tissues of RMs with SIVE correlated with increased cerebrospinal fluid (CSF) viral load. Subset analysis showed a specific increase in brain CD4+ memory T cells (Br-mCD4), brain-MΦs (Br-MΦs), and brain B cells (Br-B cells). Both Br-mCD4s and Br-MΦs harbored replication-competent viral DNA, as demonstrated by virus isolation by coculture. However, only in animals exhibiting SIVE/neuroAIDS was virus isolated from Br-MΦs. These findings support the use of CL757 to study the pathogenesis of AIDS viruses in the central nervous system and indicate a previously unanticipated role of CD4s cells as a potential reservoir in the brain. IMPORTANCE While the use of combination antiretroviral therapy effectively suppresses systemic viral replication in the body, neurocognitive disorders as a result of HIV infection of the central nervous system (CNS) remain a clinical problem. Therefore, the use of nonhuman primate models is necessary to study mechanisms of neuropathogenesis. The neurotropic, molecular clone SIVsm804E-CL757 (CL757) results in neuroAIDS in 50% of infected rhesus macaques approximately 1 year postinfection. Using CL757-infected macaques, we investigate disease progression by examining subsets of cells within the CNS that were targeted by CL757 and could potentially serve as viral reservoirs. By isolating mononuclear cells from the brains of SIV-infected rhesus macaques with and without encephalitis, we show that immune cells invade the neuroparenchyma and increase in number in the CNS in animals with SIV-induced encephalitis (SIVE). Of these cells, both brain macrophages and brain memory CD4+ T cells harbor replication-competent SIV DNA; however, only brain CD4+ T cells harbored SIV DNA in animals without SIVE. These findings support use of CL757 as an important model to investigate disease progression in the CNS and as a model to study virus reservoirs in the CNS.

COVID-19 associated central nervous system manifestations, mental and neurological symptoms: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saber Soltani ◽  
Alireza Tabibzadeh ◽  
Armin Zakeri ◽  
Amir Mohammad Zakeri ◽  
Tayebeh Latifi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Viral Infections ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Olfactory Dysfunction ◽  
Neurological Symptoms ◽  
Online Databases ◽  
Pooled Prevalence ◽  
Wide Range

Abstract The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected more than 27 million confirmed cases and 8,90,000 deaths all around the world. Verity of viral infections can infect the nervous system; these viral infections can present a wide range of manifestation. The aim of the current study was to systematically review the COVID-19 associated central nervous system manifestations, mental and neurological symptoms. For that we conducted a comprehensive systematic literature review of four online databases, including Web of Science, PubMed, Scopus and Embase. All relevant articles that reported psychiatric/psychological symptoms or disorders in COVID-19 without considering time and language restrictions were assessed. All the study procedures were performed based on the PRISMA criteria. Due to the screening, 14 studies were included. The current study result indicated that, the pooled prevalence of CNS or mental associated disorders with 95% CI was 50.68% (6.68–93.88). The most prevalence symptoms were hyposmia/anosmia/olfactory dysfunction (number of study: 10) with 36.20% (14.99–60.51). Only one study reported numbness/paresthesia and dysphonia. Pooled prevalence of numbness/paresthesia and dysphonia was 5.83% (2.17–12.25) and 2.39% (10.75–14.22). The pooled prevalence of depression and anxiety was 3.52% (2.62–4.54) and 13.92% (9.44–19.08). Our findings demonstrate that COVID-19 has a certain relation with neurological symptoms. The hypsomia, anosmia or olfactory dysfunction was most frequent symptom. Other symptoms were headache or dizziness, dysgeusia or ageusia, dysphonia and fatigue. Depression, anxiety, and confusion were less frequent symptoms.

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