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 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 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 Mild to Severe Neurological Manifestations of COVID-19: Cases Reports

2021 ◽  
Vol 18 (7) ◽  
pp. 3673
Author(s):  
Gabriele Melegari ◽  
Veronica Rivi ◽  
Gabriele Zelent ◽  
Vincenzo Nasillo ◽  
Elena De Santis ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Olfactory Bulb ◽  
Deep Sedation ◽  
Case Reports ◽  
Neurological Complications ◽  
Pulmonary Complications ◽  
Cytokine Storm ◽  
Neurological Manifestations ◽  
Cerebral Thrombosis ◽  
Screening Procedures

The main focus of Coronavirus disease 2019 (COVID-19) infection is pulmonary complications through virus-related neurological manifestations, ranging from mild to severe, such as encephalitis, cerebral thrombosis, neurocognitive (dementia-like) syndrome, and delirium. The hospital screening procedures for quickly recognizing neurological manifestations of COVID-19 are often complicated by other coexisting symptoms and can be obscured by the deep sedation procedures required for critically ill patients. Here, we present two different case-reports of COVID-19 patients, describing neurological complications, diagnostic imaging such as olfactory bulb damage (a mild and unclear underestimated complication) and a severe and sudden thrombotic stroke complicated with hemorrhage with a low-level cytokine storm and respiratory symptom resolution. We discuss the possible mechanisms of virus entrance, together with the causes of COVID-19-related encephalitis, olfactory bulb damage, ischemic stroke, and intracranial hemorrhage.

scholarly journals nCoV-2019 infection induced neurological outcome and manifestation, linking its historical ancestor SARS-CoV and MERS-CoV: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ajay Prakash ◽  
Harvinder Singh ◽  
Phulen Sarma ◽  
Anusuya Bhattacharyya ◽  
Deba Prasad Dhibar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurological Outcome ◽  
Case Reports ◽  
Meta Analysis ◽  
Signs And Symptoms ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Cross Sectional ◽  
Early Management ◽  
Neurological Signs

AbstractThe first systematic review and meta-analysis to help clinician to identify early signs and symptoms of neurological manifestation in COVID-19 positive patients which will further help in early management of patients. Present systematic review and meta-analysis aimed to discuss the prevalence of neurological involvement of the 2019-nCoV patients and assess the symptomatic trend of events as compared to the 2002 “SARS” and 2012 “MERS” pandemics. The articles were systematically screened through several search engine and databases. The articles published or in preprint were included in the study till 15th May 2020. The systematic review done as per the published literatures which included 31 cross sectional, observational studies and case reports which revealed neurological signs and symptoms in SARS-COV-2 disease. For meta-analysis, we included 09 observational and cross-sectional studies which included COVID-19 positive patients and assessed the predominance of various neurological signs and symptoms in COVID-19 patients with relation to SARS-2002 and MERS-2012. Data was analyzed by using the “MedCalc” Statistical Software version 19.2.6 and reported as pooled prevalence. Standard I2 test was used to analyze the heterogeneity. We have collected and screened about a total 2615articles, finally we have included 31articles for the systematic review and 09 for meta-analysis as per the inclusion/exclusion criteria. The analysis was made as per the prevalence rate of neurological symptoms in COVID-19 positive patients. The cumulative neurological outcome of SARS-2002 and MERS-2012 was assessed to get the trends which was further tried to correlate the events with the current pandemic. During the analysis severity and outcome of neurological manifestations range from simple headache to vague non-focal complaints to severe neurologic impairment associated with seizure or meningitis. Central and peripheral nervous system (CNS/PNS) manifestations were seen during the SARS-2002, MERS-2012 and COVID-19. However, none of the publication had primary or secondary objectives of searching neurological manifestations in the COVID-19 patients and the pathogenic mechanism which will subsequently strengthen the importance to start more prospective clinical trials. The prevalence of neurological signs and symptoms were taken as primary objective. Thereafter, the prevalence of each CNS/PNS symptoms was categorized and their prevalence studied. The selection of Bagheri et al., 2020 may be discussed because they have done the cross-sectional study with the neurological finding and correlated the data with prevalence of the COVID-19 positive patients. The proportion of patients presenting with neurological outcome and clinical/PCR positivity were done. We had searched and followed all the possible online/web source, still the data collection process may remain a limitation of work due to addition of several publications on COVID-19 every day. Due to lack of data of SARS-CoV and MERS-CoV, we have included the case reports, MERS and COVID-19 in CNS/PNS manifestations.

scholarly journals Neurological Manifestations and Complications of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Ahmed Yassin ◽  
Mohammed Nawaiseh ◽  
Ala' Shaban ◽  
Khalid Alsherbini ◽  
Khalid El-Salem ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Early Recognition ◽  
Case Reports ◽  
Meta Analysis ◽  
Age Groups ◽  
Cerebrovascular Diseases ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Summary Estimate

Abstract Background: The spectrum of neurological involvement in COVID-19 is not thoroughly understood. To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between severe and non-severe cases has been published. The aim of this study is to assess the frequency of neurological manifestations and complications, identify the neurodiagnostic findings, and compare these aspects between severe and non-severe COVID-19 cases.Methods: A systematic search of PubMed, Scopus, EBSCO, Web of Science, and Google Scholar databases was conducted for studies published between the 1st of January 2020 and 22nd of April 2020. In addition, we scanned the bibliography of included studies to identify other potentially eligible studies. The criteria for eligibility included studies published in English language (or translated to English), those involving patients with COVID-19 of all age groups, and reporting neurological findings. Data were extracted from eligible studies. Meta-analyses were conducted using comprehensive meta-analysis software. Random-effects model was used to calculate the pooled percentages and means with their 95% confidence intervals (CIs). Sensitivity analysis was performed to assess the effect of individual studies on the summary estimate. A subgroup analysis was conducted according to severity. The main outcomes of the study were to identify the frequency and nature of neurological manifestations and complications, and the neuro-diagnostic findings in COVID-19 patients.Results: 44 articles were included with a pooled sample size of 13480 patients. The mean age was 50.3 years and 53% were males. The most common neurological manifestations were: Myalgia (22.2%, 95% CI, 17.2% to 28.1%), taste impairment (19.6%, 95% CI, 3.8% to 60.1%), smell impairment (18.3%, 95% CI, 15.4% to 76.2%), headache (12.1%, 95% CI, 9.1% to 15.8%), dizziness (11.3%, 95% CI, 8.5% to 15.0%), and encephalopathy (9.4%, 95% CI, 2.8% to 26.6%). Nearly 2.5% (95% CI, 1% to 6.1%) of patients had acute cerebrovascular diseases (CVD). Myalgia, elevated CK and LDH, and acute CVD were significantly more common in severe cases. Moreover, 20 case reports were assessed qualitatively, and their data presented separately.Conclusions: Neurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.

scholarly journals Neurological manifestations and complications of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Yassin ◽  
Mohammed Nawaiseh ◽  
Ala Shaban ◽  
Khalid Alsherbini ◽  
Khalid El-Salem ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Early Recognition ◽  
Case Reports ◽  
Meta Analysis ◽  
Age Groups ◽  
Cerebrovascular Diseases ◽  
Neurological Involvement ◽  
Neurological Manifestations ◽  
Summary Estimate

Abstract Background The spectrum of neurological involvement in COVID-19 is not thoroughly understood. To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between severe and non-severe cases has been published. The aim of this study is to assess the frequency of neurological manifestations and complications, identify the neurodiagnostic findings, and compare these aspects between severe and non-severe COVID-19 cases. Methods A systematic search of PubMed, Scopus, EBSCO, Web of Science, and Google Scholar databases was conducted for studies published between the 1st of January 2020 and 22nd of April 2020. In addition, we scanned the bibliography of included studies to identify other potentially eligible studies. The criteria for eligibility included studies published in English language (or translated to English), those involving patients with COVID-19 of all age groups, and reporting neurological findings. Data were extracted from eligible studies. Meta-analyses were conducted using comprehensive meta-analysis software. Random-effects model was used to calculate the pooled percentages and means with their 95% confidence intervals (CIs). Sensitivity analysis was performed to assess the effect of individual studies on the summary estimate. A subgroup analysis was conducted according to severity. The main outcomes of the study were to identify the frequency and nature of neurological manifestations and complications, and the neuro-diagnostic findings in COVID-19 patients. Results 44 articles were included with a pooled sample size of 13,480 patients. The mean age was 50.3 years and 53% were males. The most common neurological manifestations were: Myalgia (22.2, 95% CI, 17.2 to 28.1%), taste impairment (19.6, 95% CI, 3.8 to 60.1%), smell impairment (18.3, 95% CI, 15.4 to 76.2%), headache (12.1, 95% CI, 9.1 to 15.8%), dizziness (11.3, 95% CI, 8.5 to 15.0%), and encephalopathy (9.4, 95% CI, 2.8 to 26.6%). Nearly 2.5% (95% CI, 1 to 6.1%) of patients had acute cerebrovascular diseases (CVD). Myalgia, elevated CK and LDH, and acute CVD were significantly more common in severe cases. Moreover, 20 case reports were assessed qualitatively, and their data presented separately. Conclusions Neurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.

scholarly journals Relevance and Clinical Significance of Magnetic Resonance Imaging of Neurological Manifestations in COVID-19: A Systematic Review of Case Reports and Case Series

2020 ◽  
Vol 10 (12) ◽  
pp. 1017
Author(s):  
Anisa Chowdhary ◽  
Roshan Subedi ◽  
Medha Tandon ◽  
Sijin Wen ◽  
Jenil Patel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Case Series ◽  
Neurological Complications ◽  
Inflammatory Disorder ◽  
Neurological Manifestations ◽  
Resonance Imaging ◽  
Mri Findings

We performed a systematic literature review of neuroimaging, predominantly focusing on magnetic resonance imaging (MRI) findings associated with neurological manifestations of coronavirus disease-2019 (COVID-19). We screened articles from PubMed, Google Scholar and Scopus, looking for reports that would potentially have neuroimaging findings in patients with COVID-19. Data analysis was performed with patient-based data based on the availability of clinical characteristics and outcomes for each individual patient from the studies. Chi square and Wilcoxon rank-sum tests were used to report COVID-19 severity and outcomes based on neurological imaging indicators and pathophysiology. A total of 171 patients with COVID-19 having neurological complications, from 134 studies, were identified in our review. The most common neuroimaging finding was ischemic stroke (62, 36.2%) cases, followed by CNS inflammatory disorder (44, 25.7%), and hemorrhagic stroke (41, 24.0%). Around 51% of all the fatal COVID-19 cases had an ischemic stroke. Among patients with ischemic stroke, the mean age of those who suffered from COVID-19 infection was 57.5 years (SD = 15.4) whereas it was 50.7 years (SD = 15.1) among those without stroke/other diagnosis. Fatality was more common in patients with ischemic stroke compared to those with other diagnosis (40% vs. 22%, p = 0.011). The most frequently published neuroimaging findings in patients with COVID-19 were ischemic stroke, CNS inflammatory disorder, and hemorrhagic disorder. In those studies, ischemic stroke was associated with fatality, and was more frequently seen in older patients. Based on our findings, early usage of MRI in COVID-19 patients may be recommended.

scholarly journals COVID-19: A Chronological Review of the Neurological Repercussions - What do We Know by May, 2020?

2020 ◽  
Author(s):  
Paulo Afonso Mei ◽  
Laura Loeb
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Publication Date ◽  
Neurological Manifestations ◽  
Disease Group ◽  
Pubmed Central ◽  
Medical Databases ◽  
Neurological Patients ◽  
Life Threatening ◽  
Neurological Conditions

Abstract Introduction: Despite the new SARS-CoV-2 (COVID-19) be the seventh of the coronavirus family viruses known to cause human disease, little is known about potential symptoms and syndromes secondary to the compromise of the central and peripheral nervous systems. We reviewed neurological manifestations due to the new coronavirus, thus far published in the literature, as well as guidelines issued by sub-specialties in Neurology, to tackle the disease. Methods: we searched medical databases, such as PubMed, PubMed Central, LILACS and Google scholar for papers (case reports, short letters, case series, etc) describing neurological symptoms in patients with confirmed or suspect COVID-19 diagnosis and also searched webpages of associations and organizations that deal with neurological disorders. Results: we describe briefly each article considered for this review. Forty-one papers were found associating neurological conditions and COVID-19. Cases are divided by disease groups and, within each disease group, results are listed in chronological order or publication date. We also discuss briefly recommendations for neurological patients, according to disease group. Conclusion: Although there is evidence of neurological manifestations with previous coronaviruses, COVID-19 is assuring a volume of published papers not seen before for other coronavirus infections. Most neurological cases are not life-threatening, but 10 to 20% of cases will require hospitalization and are in risk for sequelae and death. Although a lot of data coming from these papers is amassing, researchers must bear in mind that many papers currently published are not yet peer-reviewed, and thus are prone to further corrections.

scholarly journals Relapsing Neurological Complications in a Child With ATP1A3 Gene Mutation and Influenza Infection: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Raffaella Pisapia ◽  
Nicolina Capoluongo ◽  
Giulia Palmiero ◽  
Carlo Tascini ◽  
Carolina Rescigno
Keyword(s):  
Preventive Measures ◽  
Influenza Infection ◽  
Influenza Virus Infection ◽  
Neurological Complications ◽  
Neurological Involvement ◽  
Gene Encoding ◽  
Α3 Subunit ◽  
Neurological Conditions ◽  
Febrile Episodes ◽  
Atp1a3 Gene

Mutations in the ATP1A3 gene encoding the α3 subunit of Na+/K+-ATPase are associated with different neurological manifestations that may be elicited by febrile episodes. A recently described phenotype, linked to the p.Arg756Cys mutation, is clinically characterized by Relapsing Encephalopathy with Cerebellar Ataxia (RECA). In our case, a diagnosis of RECA has been established, and despite an alternative, reasonable cause had been already identified.We describe the case of a child with two recurrent episodes, 2 years apart, of hypotonia and ataxia. In both episodes, a laboratory-confirmed influenza virus infection suggested the diagnosis of influenza-associated encephalopathy. After the second episode, a search for genetic mutations was performed, and ATP1A3 mutation associated to RECA was found. After both episodes, the child was discharged after partial improvement of neurological conditions.The diagnosis of encephalopathy in children is often challenging. A genetic predisposition to neurological decompensation should be suspected in case of recurrent episodes, even if an alternative diagnosis has been established. Indeed, febrile infections may only represent the trigger of neurological involvement. In these patients, the knowledge of a genetic predisposing factors may help in the prevention of neurological episodes by the prompt use of anti-pyrectics and preventive measures as appropriate vaccination.

scholarly journals Pontine demyelination as a late complication of resolved mild COVID-19 infection

2021 ◽  
Vol 9 (41) ◽  
pp. 60-63
Author(s):  
Nouran Eshak ◽  
Mahmoud Abdelnabi ◽  
Roy Jacob ◽  
Drew Payne
Keyword(s):  
Case Reports ◽  
Neurological Complication ◽  
Late Complication ◽  
Lamina Cribrosa ◽  
Neurological Complications ◽  
Neurological Sequelae ◽  
Olfactory Tract ◽  
Wide Range ◽  
Cerebrovascular Stroke ◽  
The Brain

Previous case reports have demonstrated COVID-19 related neurotropism. Neural infection may result from trans-lamina cribrosa invasion that allows COVID-19 to reach the brain through the olfactory tract. A wide range of symptoms from headaches, anosmia, dysgeusia to neuropathy, encephalitis, cerebrovascular stroke, and rarely demyelination has been reported. Here, we report a case of pontine demyelination causing generalized weakness as a rare neurological complication in a COVID-19 survivor. Our case highlights that even mild and moderate COVID-19 infection can have late neurological sequelae. Keywords: COVID-19, demyelination, neurological complications, corticosteroids

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