Update on neurological symptoms in patients infected with severe acute respiratory syndrome coronavirus‐2

Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

Journal of Neurology ◽

10.1007/s00415-021-10406-y ◽

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.

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Cerebral venous sinus thrombosis associated with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh211004104n ◽

2021 ◽

pp. 104-104

Author(s):

Dragan Nikolic ◽

Marijana Basta-Nikolic ◽

Vladimir Manojlovic ◽

Zeljko Zivanovic ◽

Sanja Vickovic ◽

...

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Severe Acute Respiratory Syndrome ◽

High Mortality ◽

Clinical Presentation ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Neurological Symptoms ◽

Venous Sinus ◽

Venous Sinus Thrombosis

Introduction/Objective. Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. Objective: to present a series of CVST cases associated with SARS-CoV-2 infection. Methods. This retrospective study evaluated clinical, laboratory and radiological presentation, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection induced CVST. Results. The study comprised 6 patients diagnosed with COVID-19 induced CVST during the 18 months period. Majority (66.7%) had no significant risk factors for developing CVST. Median time from initial COVID-19 diagnosis to onset of neurologic deficit was 7 days (interquartile range 0.5-7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomarkers. The transverse (n = 4 or 66.7%), superior sagittal sinuses (n = 3 or 50%) and sigmoid sinus (n = 2 or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ? 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion. The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications.

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

Archives of Pediatric Infectious Diseases ◽

10.5812/pedinfect.113175 ◽

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.

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Potential neurological manifestations of COVID-19

Neurology Clinical Practice ◽

10.1212/cpj.0000000000000897 ◽

2020 ◽

pp. 10.1212/CPJ.0000000000000897 ◽

Cited By ~ 1

Author(s):

Anna S. Nordvig ◽

Kathryn T. Rimmer ◽

Joshua Z. Willey ◽

Kiran T. Thakur ◽

Amelia K. Boehme ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Neurological Complications ◽

Neurological Symptoms ◽

The Novel ◽

Altered Consciousness ◽

Human Coronavirus ◽

Neurological Morbidity ◽

Neurological Patients ◽

Neurological Effects

AbstractPurposeof review: Neurological complications are increasingly recognized in the Coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This coronavirus is related to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and other human coronavirus-related illnesses that are associated with neurological symptoms. These symptoms raise the question of a neuroinvasive potential of SARS-CoV-2.Recent findings:Potential neurological symptoms and syndromes of SARS-CoV-2 include headache, fatigue, dizziness, anosmia, ageusia, anorexia, myalgias, meningoencephalitis, hemorrhage, altered consciousness, Guillain-Barré Syndrome, syncope, seizure, and stroke. Additionally, we discuss neurological effects of other coronaviruses, special considerations for management of neurological patients, and possible long-term neurological and public health sequelae.Summary:As SARS-CoV-2 is projected to infect a large part of the world’s population, understanding the potential neurological implications of COVID-19 will help neurologists and others recognize and intervene in neurological morbidity during and after the pandemic of 2020.

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The SARS-CoV-2 spike (S) and the orthoreovirus p15 cause neuronal and glial fusion

10.1101/2021.09.01.458544 ◽

2021 ◽

Author(s):

Ramon Martinez-Marmol ◽

Rosina Giordano-Santini ◽

Eva Kaulich ◽

Ann-Na Cho ◽

Md Asrafuzzaman Riyadh ◽

...

Keyword(s):

Stem Cells ◽

Nervous System ◽

Immune System ◽

Severe Acute Respiratory Syndrome ◽

Embryonic Stem ◽

Neurological Symptoms ◽

Host Cells ◽

Enveloped Viruses ◽

Surface Molecules ◽

The Brain

Numerous enveloped viruses use specialized surface molecules called fusogens to enter host cells. During virus replication, these fusogens decorate the host cells membrane enabling them the ability to fuse with neighboring cells, forming syncytia that the viruses use to propagate while evading the immune system. Many of these viruses, including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infect the brain and may cause serious neurological symptoms through mechanisms which remain poorly understood. Here we show that expression of either the SARS-CoV-2 spike (S) protein or p15 protein from the baboon orthoreovirus is sufficient to induce fusion between interconnected neurons, as well as between neurons and glial cells. This phenomenon is observed across species, from nematodes to mammals, including human embryonic stem cells-derived neurons and brain organoids. We show that fusion events are progressive, can occur between distant neurites, and lead to the formation of multicellular syncytia. Finally, we reveal that in addition to intracellular molecules, fusion events allow diffusion and movement of large organelles such as mitochondria between fused neurons. Our results provide important mechanistic insights into how SARS-CoV-2 and other viruses could affect the nervous system circuitries causing neurological symptoms.

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Isolated neurological symptoms in a teenager with COVID-19

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1131 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Pezad N Doctor ◽

◽

Sowkya Rangarajan ◽

Jocelyn Ang ◽

◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Severe Acute Respiratory Syndrome ◽

Children And Adolescents ◽

Mental Status ◽

Respiratory System ◽

Altered Mental Status ◽

Neurological Symptoms ◽

Neurological Manifestations ◽

Inflammatory Syndrome

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) predominantly affects the respiratory system. However, COVID-19 associated Multisystem Inflammatory Syndrome in Children (MIS-C) is a state of hyper inflammatory shock affecting the cardiovascular, gastrointestinal, hematologic and central nervous system. Isolated neurological manifestations have rarely been reported, especially in children and adolescents. We describe a 17-year-old boy presenting with intermittent headaches, altered mental status and right sided weakness, was found to be positive for SARS-COV2 from nasopharyngeal sampling. His neurological symptoms lasted for three weeks and subsequently improved spontaneously. Keywords: SARS-CoV2; Encephalitis; Headaches.

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Exploring the clinical association between neurological symptoms and COVID-19 pandemic outbreak: A systematic review of current Literature

10.21203/rs.3.rs-27152/v1 ◽

2020 ◽

Author(s):

Davide Tiziano Di Carlo ◽

Nicola Montemurro ◽

Giandomenico Petrella ◽

Gabriele ◽

Roberto Ceravolo ◽

...

Keyword(s):

Systematic Review ◽

Severe Acute Respiratory Syndrome ◽

Early Recognition ◽

Significant Proportion ◽

Neurological Symptoms ◽

The Novel ◽

Neurologic Manifestations ◽

Neurological Manifestations ◽

Epidemic Period ◽

Male Patients

Abstract Object: The novel severe acute respiratory syndrome (SARS)-CoV-2 outbreak has been declared a pandemic in March, 2020. An increasing body of evidence suggests that patients with the coronavirus disease (COVID-19) might have a heterogeneous spectrum of neurological symptomsMethods. A systematic search of two databases was performed for studies published up to April 17th, 2020. PRISMA guidelines were followed.Results: We included 13 studies evaluating 2499 patients with laboratory-confirmed COVID-19 infections. The median age of patients was 50.3 (IQR 9.6), and the rate of male patients was 50% (95% CI 47.9-52%). The most common reported comorbidities were hypertension and diabetes (18.7%, 95% CI 16.9-20.7% and 9%, 95% CI 7.4-11.3%, respectively). Headache was reported in 17.9% of patients (95% CI 16.1-19.8%), and dizziness in 13.9% (95% CI 10.7-18%). Fatigue or myalgia, hypo/anosmia, and gustatory dysfunction were reported in 24%, 55.2%, and 55.4%, of patients, respectively.Conclusions: These data support accumulating evidence that a significant proportion of patients with COVID-19 infection develop neurological manifestations, especially olfactory and gustatory dysfunction. The pathophysiology of this association is under investigation and warrants additional studies, Physicians should be aware of this possible association because during the epidemic period of COVID-19, early recognition of neurologic manifestations otherwise not explained would raise the suspect of acute respiratory syndrome coronavirus 2 infection.

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