Cranial Nerve Impairment Associated With COVID-19 Infections: A Systematic Review

Tonkal, Albaraa; Alamri, Abdullah A; AlMaghrabi, Sahar J; Mozahim, Naif F; Mozahim, Sarah F; Alsubaie, Shahad A.; Alsehly, Areej A; Alshuaibi, Razan O; Alotaibi, Leena A; Qashgari, Fadi S

doi:10.7759/cureus.31997

Cited by 6 publications

(5 citation statements)

References 47 publications

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“…The facial nerve (cranial nerve VII), the glossopharyngeal nerve (cranial nerve IX), and the vagus nerve (cranial nerve X) innervate the anterior two-thirds of the tongue, the posterior one-third of the tongue, and the epiglottis region, respectively, to transmit information on tastants. Among them, the facial nerve is most commonly affected by COVID-19, followed by the glossopharyngeal nerve and the vagus nerve [ 64 ]. A possible link has been indicated between COVID-19 and facial nerve paralysis [ 65 ].…”

Section: Resultsmentioning

confidence: 99%

Treatments of COVID-19-Associated Taste and Saliva Secretory Disorders

Tsuchiya

2023

Dentistry Journal

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Since the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, treating taste and saliva secretory disorders associated with coronavirus disease 2019 (COVID-19) has become a critical issue. The aim of the present study was to update information on treatments applicable to such oral symptoms and discuss their pathogenic mechanisms. The literature search indicated that different treatments using tetracycline, corticosteroids, zinc, stellate ganglion block, phytochemical curcumin, traditional herbal medicine, nutraceutical vitamin D, photobiomodulation, antiviral drugs, malic acid sialagogue, chewing gum, acupuncture, and/or moxibustion have potential effects on COVID-19-associated ageusia/dysgeusia/hypogeusia and xerostomia/dry mouth/hyposalivation. These treatments have multiple modes of action on viral cellular entry and replication, cell proliferation and differentiation, immunity, and/or SARS-CoV-2 infection-induced pathological conditions such as inflammation, cytokine storm, pyroptosis, neuropathy, zinc dyshomeostasis, and dysautonomia. An understanding of currently available treatment options is required for dental professionals because they may treat patients who were infected with SARS-CoV-2 or who recovered from COVID-19, and become aware of their abnormal taste and salivary secretion. By doing so, dentists and dental hygienists could play a crucial role in managing COVID-19 oral symptoms and contribute to improving the oral health-related quality of life of the relevant patients.

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Section: Resultsmentioning

confidence: 99%

Treatments of COVID-19-Associated Taste and Saliva Secretory Disorders

Tsuchiya

2023

Dentistry Journal

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“…Previous studies have reported cases of cranial nerve infections following COVID-19, as well as cognitive impairment due to diffuse white matter damage [23,24]. Symptoms such as loss of smell and Bell's palsy also result from olfactory and facial nerve involvement [25,26].…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Prevalence of Dysphagia in Patients with Mild COVID-19 and Those with Aspiration Pneumonia Alone: Findings of the Videofluoroscopic Swallowing Study

Kim,

Ryu,

Kim

et al. 2023

Medicina

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Background and Objectives: Patients recovering from mild coronavirus disease (COVID-19) reportedly have dysphagia or difficulty in swallowing. We compared the prevalence of dysphagia between patients diagnosed with mild COVID-19 and those diagnosed with aspiration pneumonia alone. Materials and Methods: A retrospective study was conducted from January 2020 to June 2023 in 160 patients referred for a videofluoroscopic swallowing study (VFSS) to assess for dysphagia. The cohort included 24 patients with mild COVID-19 and aspiration pneumonia, 30 with mild COVID-19 without aspiration pneumonia, and 106 with aspiration pneumonia alone. We reviewed the demographic data, comorbidities, and VFSS results using the penetration–aspiration scale (PAS) and functional dysphagia scale (FDS). Results: In a study comparing patients with mild COVID-19 (Group A) and those with aspiration pneumonia alone (Group B), no significant differences were observed in the baseline characteristics, including the prevalence of dysphagia-related comorbidities between the groups. Group A showed milder dysphagia, as evidenced by lower PAS and FDS scores, shorter oral and pharyngeal transit times (p = 0.001 and p = 0.003, respectively), and fewer residues in the vallecula and pyriform sinuses (p < 0.001 and p < 0.03, respectively). When Group A was subdivided into those with COVID-19 with (Group A1) and without aspiration pneumonia (Group A2), both subgroups outperformed Group B in terms of specific VFSS metrics, such as oral transit time (p = 0.01), pharyngeal transit time (p = 0.04 and p = 0.02, respectively), and residue in the vallecula (p = 0.04 and p = 0.02, respectively). However, Group B showed improved triggering of the pharyngeal swallowing reflex compared with Group A2 (p = 0.02). Conclusion: Mild COVID-19 patients showed less severe dysphagia than those with aspiration pneumonia alone. This finding was consistent across VFSS parameters, even when the COVID-19 group was subdivided based on the status of aspiration pneumonia.

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“…One patient presented with peripheral nerve palsy that remitted soon after antiviral and glucocorticoid treatment, during hospitalization, and two patients presented with polyneuritis cranialis, one of them died during hospitalization because of COVID-19 complications and the other one was discharged with sequelae. In a systematic review, the most commonly affected nerves were the facial and abducens nerves ( 41 ). The mechanism of PNS involvement continues to be a subject of debate as there are theories in favor of direct viral invasion, but inflammation also plays an important role ( 5 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

The outcome and risk factors associated with central and peripheral nervous system involvement in hospitalized COVID-19 patients: a retrospective cohort study

Hanganu,

Niculae,

Dulămea

et al. 2024

Front. Neurol.

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IntroductionSARS-CoV-2 infection can affect any organ, including both the central nervous system (CNS) and peripheral nervous system (PNS). The aim of this study was to explore the outcome and risk factors associated with the involvement of either CNS or PNS in a cohort of hospitalized COVID-19 patients.MethodsWe performed a retrospective observational cohort study of hospitalized adult patients with COVID-19, between May 2020 and December 2022, presenting with new onset neurological disabilities any time after admission.ResultsWe included 115 patients, 72 with CNS manifestations and 43 with PNS involvement. The CNS manifestations were COVID-19-associated encephalopathy, headache, neurovascular events, and seizures in 80.5, 43, 31.9, and 11.1% of patients, respectively. The neurovascular events were ischemic stroke in 17 (23.6%) patients, hemorrhagic stroke in 6 (8.3%) patients, venous thrombosis in 1 (1.4%) patient, and subarachnoid hemorrhage in 1 (1.4%) patient. Cranial nerve involvement was the most frequent PNS manifestation in 34 (79%) cases, followed by mononeuritis in 5 (11.6%) patients and polyneuropathy in 4 (9.3%) patients. The affected cranial nerves were the vestibulocochlear nerve in 26 (60.5%) patients, the olfactory nerve in 24 (55.8%) patients, the oculomotor nerves in 5 (11.6%) patients, and the facial nerve in 1 (2.3%) patient. Two patients (9.3%) presented with polyneuritis cranialis. Older age (HR = 1.02, 95% CI: 1.003–1.037, p = 0.01), COVID severity (HR = 2.53, 95% CI: 1.42–4.5, p = 0.002), ischemic cardiac disease (HR = 2.42, 95% CI: 1.05–5.6, p = 0.03), and increased D-dimers (HR = 1.00, 95% CI: 1.00–1.00, p = 0.02) were independently associated with the development of CNS manifestations. The factors associated with in-hospital mortality were age (HR = 1.059, 95% CI: 1.024–1.096, p = 0.001), C-reactive protein (HR = 1.006, 95% CI: 1.00–1.011, p = 0.03), CNS involvement (HR = 9.155, 95% CI: 1.185–70.74, p = 0.03), and leucocyte number (HR = 1.053, 95% CI: 1.026–1.081, p < 0.001).ConclusionCOVID-19-associated encephalopathy was the most common CNS manifestation in our study, but neurovascular events are also important considering the overlap between inflammatory and prothrombotic pathways, especially in severe cases. CNS involvement was associated with in-hospital all-cause mortality. PNS findings were various, involving mostly the cranial nerves, especially the vestibulocochlear nerve.

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Cranial Nerve Impairment Associated With COVID-19 Infections: A Systematic Review

Cited by 6 publications

References 47 publications

Treatments of COVID-19-Associated Taste and Saliva Secretory Disorders

Treatments of COVID-19-Associated Taste and Saliva Secretory Disorders

Comparative Analysis of the Prevalence of Dysphagia in Patients with Mild COVID-19 and Those with Aspiration Pneumonia Alone: Findings of the Videofluoroscopic Swallowing Study

The outcome and risk factors associated with central and peripheral nervous system involvement in hospitalized COVID-19 patients: a retrospective cohort study

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