Neurological Complications of Novel Influenza A (H1N1) pdm09 Infection: Report of Two Cases and a Systematic Review of the Literature

Algahtani, Hussein; Shirah, Bader; Alkhashan, Sulaiman; Ahmad, Raafat

doi:10.4172/2314-7326.1000201

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…This theory is supported by significantly elevated levels of serum cytokines IL‐6, TNF‐alpha, and IL‐10 in patients with IAE compared to those with no neurological disorders or not infected with influenza virus. The correlation between the severity of neurological complications and serum levels of pro‐inflammatory cytokines also supports the hypothesis of a cytokine driven mechanism (Algahtani & Shirah, 2016; Hasegawa et al., 2011; Kawada et al., 2003; Sellers et al., 2017). Pro‐inflammatory cytokines may increase the permeability of hematoencephalic barrier, trigger an injury of vascular endothelium as well as apoptosis of neurons and glia cells, and provoke acute brain edema and necrosis.…”

Section: Discussionsupporting

confidence: 71%

“…Up to 50%–55% of patients with IAE present normal CT scans. CT or MRI usually show lesions in the corpus callosum, white matter basal ganglia, and occasionally in the cortical and subcortical regions (Algahtani & Shirah, 2016; Ferrari et al., 2009; Goenka et al., 2014). The limitation of our study is that we did not test CSF for influenza RNR, as this method has not yet been standardized in Lithuania.…”

Section: Discussionmentioning

confidence: 99%

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Neurological complications of pandemic A(H1N1)2009pdm, postpandemic A(H1N1)v, and seasonal influenza A

et al. 2020

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Objectives Not much is known about influenza‐associated neurological complications. We aimed to describe the case series of hospitalized patients who were confirmed with influenza A and presented with neurological symptoms in order to capture the broad spectrum of influenza clinical manifestation and suggest including influenza diagnostic in some neurological conditions. Materials and methods The inclusion criteria were age ≥ 18 and laboratory‐confirmed influenza presenting with neurological symptoms. Influenza‐associated neurological complication was described as a development of neurological symptom with no other origin. The outcomes were classified into 5 categories: 1. recovery with no significant disability; 2. minor disability (able to manage on their own); 3. moderate disability (requiring some help but able to walk without assistance); 4. severe disability (unable to walk without assistance and perform daily activities); 5. death. Results In total, 12 patients (five women and seven men) were enrolled, with age range 18–71 years old. Neurological complications of pandemic A(H 1 N 1 )2009pdm influenza developed in seven out of 69 (10.1%) hospitalized patients. The most common neurological complication was encephalopathy. Neurological complications developed in two out of 24 (8.3%) hospitalized patients during postpandemic (H 1 N 1 ) V period. One patient presented with encephalopathy, another with meningoencephalitis. During the 2018 influenza season, there was one patient who has developed influenza A neurological complications. Overall, two out of 104 (1.9%) influenza A patients developed influenza‐associated neurological complications in 2019. Conclusions Every patient with unexplained neurological symptoms and signs similar to aseptic and septic meningitis/encephalitis has to be tested for influenza virus during epidemics and pandemics.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Neurological complications of pandemic A(H1N1)2009pdm, postpandemic A(H1N1)v, and seasonal influenza A

et al. 2020

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“…This immune response that participates in induction or exacerbation of neuropathologies occurs specifically in genetically susceptible individuals [ 16 ]. This theory is predominant in explaining the neurological complications of other viruses such as the pandemic influenza A H1N1 pdm09 [ 17 ]. This has therapeutic implications which include the possible improvement with the early use of pulse steroid therapy and intravenous immunoglobulin before tissue damage occurs.…”

Section: Discussionmentioning

confidence: 99%

Neurological Complications of Middle East Respiratory Syndrome Coronavirus: A Report of Two Cases and Review of the Literature

Algahtani

Subahi

Shirah

2016

Case Reports in Neurological Medicine

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160

190

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Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first discovered in September 2012 in Saudi Arabia. Since then, it caused more than 1600 laboratory-confirmed cases and more than 580 deaths among them. The clinical course of the disease ranges from asymptomatic infection to severe lower respiratory tract illness with multiorgan involvement and death. The disease can cause pulmonary, renal, hematological, and gastrointestinal complications. In this paper, we report neurological complications of MERS-CoV in two adult patients, and we hypothesize the pathophysiology. The first patient had an intracerebral hemorrhage as a result of thrombocytopenia, disseminated intravascular coagulation, and platelet dysfunction. The second case was a case of critical illness polyneuropathy complicating a long ICU stay. In these cases, the neurological complications were secondary to systemic complications and long ICU stay. Autopsy studies are needed to further understand the pathological mechanism.

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“…This theory could provide an explanation to the mystery behind the albeit rare neuroinvasive capability of MERS‐CoV. This hypothesis has previously been used to explain the resultant neurological complications observed over the course of infection with the H1N1 pdm09 influenza strain [42].…”

Section: Coronaviruses (Covs)mentioning

confidence: 99%

Neurological pathophysiology of SARS‐CoV‐2 and pandemic potential RNA viruses: a comparative analysis

et al. 2021

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SARS‐CoV‐2 has infected hundreds of millions of people with over four million dead, resulting in one of the worst global pandemics in recent history. Neurological symptoms associated with COVID‐19 include anosmia, ageusia, headaches, confusion, delirium, and strokes. These may manifest due to viral entry into the central nervous system (CNS) through the blood–brain barrier (BBB) by means of ill‐defined mechanisms. Here, we summarize the abilities of SARS‐CoV‐2 and other neurotropic RNA viruses, including Zika virus and Nipah virus, to cross the BBB into the CNS, highlighting the role of magnetic resonance imaging (MRI) in assessing presence and severity of brain structural changes in COVID‐19 patients. We present new insight into key mutations in SARS‐CoV‐2 variants B.1.1.7 (P681H) and B.1.617.2 (P681R), which may impact on neuropilin 1 (NRP1) binding and CNS invasion. We postulate that SARS‐CoV‐2 may infect both peripheral cells capable of crossing the BBB and brain endothelial cells to traverse the BBB and spread into the brain. COVID‐19 patients can be followed up with MRI modalities to better understand the long‐term effects of COVID‐19 on the brain.

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Neurological Complications of Novel Influenza A (H1N1) pdm09 Infection: Report of Two Cases and a Systematic Review of the Literature

Cited by 4 publications

References 20 publications

Neurological complications of pandemic A(H1N1)2009pdm, postpandemic A(H1N1)v, and seasonal influenza A

Neurological complications of pandemic A(H1N1)2009pdm, postpandemic A(H1N1)v, and seasonal influenza A

Neurological Complications of Middle East Respiratory Syndrome Coronavirus: A Report of Two Cases and Review of the Literature

Neurological pathophysiology of SARS‐CoV‐2 and pandemic potential RNA viruses: a comparative analysis

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