Immediate and long-term consequences of COVID-19 infections for the development of neurological disease

Heneka, Michael T.; Golenbock, Douglas T.; Latz, Eicke; Morgan, Dave; Brown, Robert H.

doi:10.1186/s13195-020-00640-3

Cited by 439 publications

(466 citation statements)

References 27 publications

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“…The underlying causes for these symptoms related to COVID-19 and the mechanisms involved in potential long-lasting impairments are currently not fully understood but are probably multifactorial. These factors include direct viral infection of the nervous system, the systemic inflammatory response to the virus, cerebrovascular ischemia due to endothelial dysfunction or severe coagulopathy, the ARDS presented in severe cases, the use of invasive ventilation and sedation along with side effects of drugs used to treat COVID-19, and peripheral organ dysfunction (see Figure 1; Sasannejad et al, 2019;Heneka et al, 2020;Ogier et al, 2020). SARS-CoV-2, similarly to other coronaviruses, shows certain neurotropism.…”

Section: Mechanisms Involved In Cognitive and Neuropsychiatric Manifementioning

confidence: 99%

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Alonso‐Lana

Marquié

Ruiz

et al. 2020

Front. Aging Neurosci.

150

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The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread worldwide and has had unprecedented effects in healthcare systems, economies and society. COVID-19 clinical presentation primarily affects the respiratory system causing bilateral pneumonia, but it is increasingly being recognized as a systemic disease, with neurologic manifestations reported in patients with mild symptoms but, most frequently, in those in a severe condition. Elderly individuals are at high risk of developing severe forms of COVID-19 due to factors associated with aging and a higher prevalence of medical comorbidities and, therefore, they are more vulnerable to possible lasting neuropsychiatric and cognitive impairments. Several reports have described insomnia, depressed mood, anxiety, post-traumatic stress disorder and cognitive impairment in a proportion of patients after discharge from the hospital. The potential mechanisms underlying these symptoms are not fully understood but are probably multifactorial, involving direct neurotrophic effect of SARS-CoV-2, consequences of long intensive care unit stays, the use of mechanical ventilation and sedative drugs, brain hypoxia, systemic inflammation, secondary effects of medications used to treat COVID-19 and dysfunction of peripheral organs. Chronic diseases such as dementia are a particular concern not only because they are associated with higher rates of hospitalization and mortality but also because COVID-19 further exacerbates the vulnerability of those with cognitive impairment. In patients with dementia, COVID-19 frequently has an atypical presentation with mental status changes complicating the early identification of cases. COVID-19 has had a dramatical impact in long-term care facilities, where rates of infection and mortality have been very high. Community measures implemented to slow the spread of the virus have forced to social distancing and cancelation of cognitive stimulation programs, which may have contributed to generate loneliness, behavioral symptoms and worsening of cognition in patients with dementia. COVID-19 has impacted the functioning of Memory Clinics, research programs and clinical trials in the Alzheimer's field, triggering the

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Section: Mechanisms Involved In Cognitive and Neuropsychiatric Manifementioning

confidence: 99%

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Alonso‐Lana

Marquié

Ruiz

et al. 2020

Front. Aging Neurosci.

150

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“…SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm and hyperinflammation with potential effects on the central nervous system [ 7 ]. Such pathogenetical progress of the acute immune reaction, along with acute respiratory dysfunction, may cause the immediate and long-term consequences on cognitive and neuropsychological function [ 7 , 8 ]. Furthermore, such emerging infectious diseases and the responding measures (i.e., isolation, quarantine, and social distancing) have tremendously impacted on people’s lifestyles and aroused psychological distress of high level [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 in pregnancy on mother’s psychological status and infant’s neurobehavioral development: a longitudinal cohort study in China

Wang

Chen

et al. 2020

BMC Med

100

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Background Evidence concerning the long-term impact of Covid-19 in pregnancy on mother’s psychological disorder and infant’s developmental delay is unknown. Methods This study is a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020. Seventy-two pregnant patients with Covid-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). We collected data from medical records regarding Covid-19, delivery or abortion, testing results of maternal and neonatal specimens, and questionnaires of quarantine, mother–baby separation, feeding, and measuring of mothers’ mental disorders and infants’ neurobehavioral disorders. Results All cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy. 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion. Among 57 live births, only one neonate was positive of nucleic acid testing for throat swab, but negative in repeated tests subsequently. The median duration of mother–baby separation was 35 days (interquartile range 16 to 52 days). After the termination of maternal quarantine, 49.1% of mothers chose to prolong the mother–baby separation (median 8 days; IQR 5 to 23 days). The breastfeeding rate was 8.8% at 1 week after birth, 19.3% at the age of 1 month, and 36.8% at the age of 3 months, respectively. The proportion of “monitoring” and “risk” in the social–emotional developmental domain at the age of 3 months was 22.7% and 63.6%, respectively. After the adjustment of preterm, neonatal sex, admitted to NICU, and the mother’s Covid-19 condition, the negative associations were significantly identified (p < 0.05) between mother–baby separation days and three developmental domains: communication, gross motor, and personal–social. Conclusions There is no definite evidence on vertical transmission of SARS-CoV-2. In addition to control infection risk, researchers and healthcare providers should pay more attention to maternal mental health and infant’s feeding, closeness with parents, and early development.

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“…Various parameters have been proposed to predict prognosis and outcomes among patients with COVID, including the neutrophil to lymphocyte ratio (NLR) (27)(28)(29)(30). A metanalysis of six studies involving 1,141 patients has demonstrated that an elevated NLR is associated with severe disease manifestation (28).…”

Section: Introductionmentioning

confidence: 99%

Acute Ischemic Stroke in COVID-19: A Case-Based Systematic Review

2020

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Corona virus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is recognized as a global pandemic by WHO 2020 with 5,934 936 infections, 367,166 deaths and affecting over 200 countries as of 30th May 2020. Acute Ischemic Stroke (AIS) in brain is also emerging as an important neurovascular/neurological complication of COVID-19, associated with extreme immune responses leading to dysregulated coagulation system and generalized thrombo-embolic status and increased risk of AIS especially among usually less vulnerable younger adults in this cohort. Thus, in early June 2020, we aimed to review the clinical data on all published cases of COVID-19 and concomitant AIS, with a view to understanding the pertinent clinical, laboratory and imaging features. The neutrophil-lymphocyte ratio (NLR) at time of hospital admission for COVID infection correlates positively with the duration of time before onset of clinical features of AIS. Higher NLR, C-Reactive protein, serum ferritin, D-dimer and fibrinogen levels are associated with poor prognosis of AIS in COVID-19 with 75% of patients dying or being severely disabled at present. Currently it is too early to comment on the long-term outcomes for survivors.

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Immediate and long-term consequences of COVID-19 infections for the development of neurological disease

Cited by 439 publications

References 27 publications

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia

Impact of Covid-19 in pregnancy on mother’s psychological status and infant’s neurobehavioral development: a longitudinal cohort study in China

Acute Ischemic Stroke in COVID-19: A Case-Based Systematic Review

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