Lack of dyspnea in patients with Covid‐19: another neurological conundrum?

Recasens, B. Bertran; Martínez‐Llorens, Juana; Rodríguez‐Sevilla, Juan José; Rubio, Miguel Ángel

doi:10.1111/ene.14265

Cited by 43 publications

(43 citation statements)

References 6 publications

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“…A similar pattern of brain invasion was demonstrated in human brains from patients with SARS-CoV-1 infection [42,79]. It has been proposed that viral neurotropism could explain the severity of respiratory failure in COVID-19 [75] and the absence of dyspnea [80]. Mutations of the S protein of the coronavirus [81] or variations in population genetics for expression of ACE2 [82] could determine the divergences in the pattern of respiratory problems in COVID-19.…”

Section: Alterations Of Smell and Tastementioning

confidence: 61%

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

Román

Spencer

Reis

et al. 2020

Journal of the Neurological Sciences

234

249

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A comprehensive review of the neurological disorders reported during the current COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. CNS manifestations include: headache and decreased responsiveness considered initial indicators of potential neurological involvement; anosmia, hyposmia, hypogeusia, and dysgeusia are frequent early symptoms of coronavirus infection. Respiratory failure, the lethal manifestation of COVID-19, responsible for 264,679 deaths worldwide, is probably neurogenic in origin and may result from the viral invasion of cranial nerve I, progressing into rhinencephalon and brainstem respiratory centers. Cerebrovascular disease, in particular large-vessel ischemic strokes, and less frequently cerebral venous thrombosis, intracerebral hemorrhage and subarachnoid hemorrhage, usually occur as part of a thrombotic state induced by viral attachment to ACE2 receptors in endothelium causing widespread endotheliitis, coagulopathy, arterial and venous thromboses. Acute hemorrhagic necrotizing encephalopathy is associated to the cytokine storm. A frontal hypoperfusion syndrome has been identified. There are isolated reports of seizures, encephalopathy, meningitis, encephalitis, and myelitis. The neurological diseases affecting the PNS and muscle in COVID-19 are less frequent and include Guillain-Barré syndrome; Miller Fisher syndrome; polyneuritis cranialis; and rare instances of viral myopathy with rhabdomyolysis. The main conclusion of this review is the pressing need to define the neurology of COVID-19, its frequency, manifestations, neuropathology and pathogenesis. On behalf of the World Federation of Neurology we invite national and regional neurological associations to create local databases to report cases with neurological manifestations observed during the ongoing pandemic. International neuroepidemiological collaboration may help define the natural history of this worldwide problem.

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Section: Alterations Of Smell and Tastementioning

confidence: 61%

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

Román

Spencer

Reis

et al. 2020

Journal of the Neurological Sciences

234

249

View full text Add to dashboard Cite

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“…Nevertheless, since brainstem conveys information to higher CNS structures involved in breathing control, its dysfunction can affect this integrated system and contribute to the respiratory symptoms (or their absence) of COVID‐19 patients. Interestingly, peripheral afferents could also play a role: virus‐induced C fibers dysfunction could contribute to the absence of dyspnea in COVID‐19 pneumonia 5 …”

mentioning

confidence: 99%

Hypoxemia in COVID‐19; Comment on: “The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients”

Coen

Allali

Adler³

et al. 2020

Journal of Medical Virology

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“… 114 Potentially, this viral neurotropism could partially explain the respiratory failure severity in the absence of dyspnea seen during the current pandemic, but autopsy studies are warranted to confirm this theory of pathogenesis and to target treatment protocols. 49 , 115 …”

Section: Disorders Of Control Of Breathing and The Neuromuscular Breamentioning

confidence: 99%

COVID-19 and Respiratory System Disorders

Brosnahan

Jonkman

Kugler

et al. 2020

ATVB

135

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The severe acute respiratory syndrome coronavirus-2 emerged as a serious human pathogen in late 2019, causing the disease coronavirus disease 2019 (COVID-19). The most common clinical presentation of severe COVID-19 is acute respiratory failure consistent with the acute respiratory distress syndrome. Airway, lung parenchymal, pulmonary vascular, and respiratory neuromuscular disorders all feature in COVID-19. This article reviews what is known about the effects of severe acute respiratory syndrome coronavirus-2 infection on different parts of the respiratory system, clues to understanding the underlying biology of respiratory disease, and highlights current and future translation and clinical research questions.

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Lack of dyspnea in patients with Covid‐19: another neurological conundrum?

Cited by 43 publications

References 6 publications

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries

Hypoxemia in COVID‐19; Comment on: “The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients”

COVID-19 and Respiratory System Disorders

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