COVID-19-Associated Acute Brain Dysfunction Related to Sepsis

Tong, Dao Ming; Zhou, Yi; Wang, Yuan Wei

doi:10.14740/jocmr4437

Cited by 5 publications

(3 citation statements)

References 116 publications

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“…In DEL, greater severity of delirium predicted lower levels of PaO 2 and PaO 2 /FiO 2 . Severity of delirium has been mainly investigated as a consequence, rather than a cause, of reduced oxygenation in inpatients with COVID-19 [ 51 , 52 , 53 ] or other pulmonary disorders [ 54 ] and a direct effect of severity of delirium on PaO 2 and PaO 2 /FiO 2 levels has not being investigated. Nevertheless, results are in line with studies documenting an increase of use or failure of ventilatory support devices commonly used in COVID-19-associated acute respiratory distress syndrome (ARDS), such as noninvasive ventilation (NIV) [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Delirium and Depression with Respiratory and Outcome Measures in COVID-19 Inpatients

Simonetti

Pais

Savoia

et al. 2023

JPM

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Delirium (DEL) and depression (DEP) may impair the course and severity of acute respiratory illness. The impact of such syndromes on respiratory and outcome parameters in inpatients with COVID-19 needs clarification. To clarify the relationship between DEL and DEP and respiratory outcome measures, we enrolled 100 inpatients from COVID-19 units of the Fondazione Policlinico Universitario Agostino Gemelli IRCCS of Rome. Participants were divided into those with DEL, DEP, or absence of either delirium or depression (CONT). Delirium severity was assessed with the Neelson and Champagne Confusion Scale (NEECHAM). Psychopathology was assessed with the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), and the Brief Psychiatric Rating Scale (BPRS). Dependent variables include: (a) respiratory parameters, i.e., partial pressure of oxygen in arterial blood (PaO2), oxygen saturation (SpO2), ratio between arterial partial pressure of oxygen (PaO2), and fraction of inspired oxygen (PaO2/FiO2); (b) outcome parameters, i.e., duration of hospitalization and number of pharmacological treatments used during the hospitalization. We investigated between-group differences and the relationships between severity of delirium/depression and the dependent variables. Duration of hospitalization was longer for DEL than for either DEP or CONT and for DEP compared to CONT. NEECHAM and HAM-D scores predicted lower PaO2 and PaO2/FiO2 levels in the DEL and DEP groups, respectively. In DEP, BPRS scores positively correlated with duration of hospitalization. Delirium impacted the course of COVID-19 more severely than depression. The mechanisms by which delirium and depression worsen respiratory parameters differ.

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Section: Discussionmentioning

confidence: 99%

Association of Delirium and Depression with Respiratory and Outcome Measures in COVID-19 Inpatients

Simonetti

Pais

Savoia

et al. 2023

JPM

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“…Platelet mitochondrial respiratory chain function, oxidative phosphorylation, and endogenous CoQ10 levels were reduced in patients after COVID-19 (Sumbalova et al, 2022). Sepsis is a leading cause of morbidity and mortality and often contributes to acute brain dysfunction (Tong et al, 2021). PLTmitos membrane depolarization is significantly correlated with the severity of sepsis (Gründler et al, 2014).…”

Section: Plt-mitos Dysfunction In Cns Infectionmentioning

confidence: 99%

Platelet mitochondria, a potent immune mediator in neurological diseases

Ma,

Jiang,

Yang

et al. 2023

Front. Physiol.

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Dysfunction of the immune response is regarded as a prominent feature of neurological diseases, including neurodegenerative diseases, malignant tumors, acute neurotraumatic insult, and cerebral ischemic/hemorrhagic diseases. Platelets play a fundamental role in normal hemostasis and thrombosis. Beyond those normal functions, platelets are hyperactivated and contribute crucially to inflammation and immune responses in the central nervous system (CNS). Mitochondria are pivotal organelles in platelets and are responsible for generating most of the ATP that is used for platelet activation and aggregation (clumping). Notably, platelet mitochondria show marked morphological and functional alterations under heightened inflammatory/oxidative stimulation. Mitochondrial dysfunction not only leads to platelet damage and apoptosis but also further aggravates immune responses. Improving mitochondrial function is hopefully an effective strategy for treating neurological diseases. In this review, the authors discuss the immunomodulatory roles of platelet-derived mitochondria (PLT-mitos) in neurological diseases and summarize the neuroprotective effects of platelet mitochondria transplantation.

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“…The most characteristic neurological finding associated with COVID-19 is “brain fog,” a broad term that describes fatigue, confusion, delirium and an impaired ability to concentrate, leading to decreased memory, cognition and executive function [ 5 ]. This phenomenon appears distinct from acutely altered cognition in the setting of severe diseases, such as those experienced by hospitalized patients with or without respiratory compromise [ 6 ]. It is of major concern that symptoms of brain fog may persist several months after the initial resolution of symptoms [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Biomedical Perspectives of Acute and Chronic Neurological and Neuropsychiatric Sequelae of COVID-19

Stefano

Büttiker

Weissenberger

et al. 2022

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: The incidence of infections from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent for coronavirus disease 2019 (COVID-19), has dramatically escalated following the initial outbreak in China in late 2019, resulting in a global pandemic with millions of deaths. Although the majority of infected patients survive, and the rapid advent and deployment of vaccines have afforded increased immunity against SARS-CoV-2, long term sequelae of SARS-CoV-2 infection have become increasingly recognized. These include, but are not limited to, chronic pulmonary disease, cardiovascular disorders, and proinflammatory-associated neurological dysfunction that may lead to psychological and neurocognitive impairment. A major component of cognitive dysfunction is operationally categorized as “brain fog” which comprises difficulty with concentration, forgetfulness, confusion, depression, and fatigue. Multiple parameters associated with long-term neuropsychiatric sequelae of SARS-CoV-2 infection have been detailed in clinical studies. Empirically elucidated mechanisms associated with the neuropsychiatric manifestations of COVID-19 are by nature complex, but broad based working models have focused on mitochondrial dysregulation leading to systemic reductions of metabolic activity and cellular bioenergetics within CNS structures. Multiple factors underlying the expression of brain fog may facilitate future pathogenic insults leading to repetitive cycles of viral and bacterial propagation. Interestingly, diverse neurocognitive sequelae associated with COVID-19 are not dissimilar from those observed in other historical pandemics, thereby providing a broad and integrative perspective on potential common mechanisms of CNS dysfunction subsequent to viral infection. Poor mental health status may be reciprocally linked to compromised immune processes and enhanced susceptibility to infection by diverse pathogens. By extrapolation, we contend that COVID-19 may potentiate the severity of neurological/neurocognitive deficits in patients afflicted by well-studied neurodegenerative disorders such as Alzheimer's disease and Parkinson’s disease. Accordingly, the prevention, diagnosis, and management of sustained neuropsychiatric manifestations of COVID-19 are pivotal health care directives and provide a compelling rationale for careful monitoring of infected patients, as early mitigation efforts may reduce short- and long-term complications.

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COVID-19-Associated Acute Brain Dysfunction Related to Sepsis

Cited by 5 publications

References 116 publications

Association of Delirium and Depression with Respiratory and Outcome Measures in COVID-19 Inpatients

Association of Delirium and Depression with Respiratory and Outcome Measures in COVID-19 Inpatients

Platelet mitochondria, a potent immune mediator in neurological diseases

Biomedical Perspectives of Acute and Chronic Neurological and Neuropsychiatric Sequelae of COVID-19

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