Novel coronavirus and the central nervous system

Sun, Tong; Guan, Junwen

doi:10.1111/ene.14227

Cited by 74 publications

(75 citation statements)

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“…As these receptors turnover as rapidly as every 24 hours, inhibition of these secretions inhibits receptor growth causing loss of smell and taste. 24,49,52,55,[114][115][116][117][118] Reports in both mouse and human datasets demonstrate that olfactory sensory neurons do not express two key genes involved in CoV-2 entry, ACE2 and TMPRSS2. In contrast, olfactory epithelial support cells and stem cells express both of these genes, as do cells in the nasal respiratory epithelium.…”

Section: Diagnosis Of Smell and Taste Lossmentioning

confidence: 99%

Anosmia and Ageusia as Initial or Unique Symptoms after SARS-COV-2 Virus Infection

Machado¹,

Gutierrez²

2020

Preprint

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SARS-CoV-2 (CoV-2) is a coronavirus which is causing the actual COVID-19 pandemic. The disease caused by 2019 new coronavirus (2019-nCoV) was named coronavirus disease-19 (COVID-19) by the World Health Organization in February 2020. Primary non-specific reported symptoms of 2019-nCoV infection at the prodromal phase are malaise, fever, and dry cough. The most commonly reported signs and symptoms are fever (98%), cough (76%), dyspnea (55%), and myalgia or fatigue (44%). Nonetheless, recent reports suggest an association between COVID-19 and altered olfactory and taste functions, although smell seems to be more affected than taste. These associations of smell and taste dysfunctions and CoV-2 are consistent with case reports describing a patient with SARS with long term anosmia after recovery from respiratory distress, with the observation that olfactory function is commonly altered after infection with endemic coronaviruses, and with data demonstrating that intentional experimental infection of humans with CoV-299 raises the thresholds at which odors can be detected. Post-viral anosmia and is one of the leading causes of loss of sense of smell in adults, accounting for up to 40% cases of anosmia. Viruses that give rise to the common cold are well known to cause post-infectious loss, and over 200 different viruses are known to cause upper respiratory tract infections. I reviewed the possible mechanisms of smell and taste loss in COVID-19. I concluded that since the existence of such a relationship is likely, it is highly recommended that those patients who experience complications such as smell and/or taste loss, even as unique symptoms, should be considered as potential SARS-CoV-2 virus carriers.

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Section: Diagnosis Of Smell and Taste Lossmentioning

confidence: 99%

Anosmia and Ageusia as Initial or Unique Symptoms after SARS-COV-2 Virus Infection

Machado¹,

Gutierrez²

2020

Preprint

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“…Of the 26 articles (Table 1) included in this study for the discussion, data was pooled from 25 (excluding Mao et al due to assumption of overlapping cohort with Li et al) and generated 1520 patients. In all patients, COVID-19 was diagnosed based on nasopharyngeal reverse transcriptase polymerase chain reaction (RT-PCR) except two where diagnosis was made based on cerebrospinal uid RT-PCR [12,18]. Of the 1520, 56 patients quali ed as having signi cant neurological manifestations (Table 1, Fig.…”

mentioning

confidence: 99%

“…Thirty-one patients experienced a cerebrovascular complication, with 27 ischemic strokes [11,[19][20][21][22][23], 3 hemorrhagic strokes [11,15,23] and 1 cerebral venous sinus thrombosis [11]. There were 15 patients with GBS [13,14,[24][25][26][27][28][29][30] or its variants, 6 reported as encephalitis [12,18,[31][32][33], one with seizures [34], one with acute hemorrhagic necrotizing encephalopathy [16] one reported as transverse myelitis [35], and one reported as ADEM [36]. Nine of these cases were reported as fatal.…”

mentioning

confidence: 99%

“…The neurological diagnosis in these reported fatal cases were stroke -ischemic and hemorrhagic, encephalitis and GBS. CSF was reportedly tested by RT-PCR for SARS-CoV-2 in 13 and out of these 2 were positive [12,18]. 57-91), were more likely to present with severe disease (per American Thoracic Society guidelines for pneumonia) [37], and were more likely to have cardiovascular risk factors such as hypertension and diabetes.…”

mentioning

confidence: 99%

“…All had severe disease per ATS criteria for pneumonia [37] [34], one of acute hemorrhagic necrotizing encephalopathy [16], one transverse myelitis and one of ADEM [35,36]. Of the six patients reported as having encephalitis, CSF pleocytosis was reported in 4/6, elevated CSF protein in 3/6, CSF RT-PCR was tested in 5/6 and was positive in 2/5 [12,18]. The one patient reported as having seizures had multiple generalized tonic-clonic seizures in the setting of fever, fatigue, and shortness of breath.…”

mentioning

confidence: 99%

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Neurological Complications of COVID-19: A Systematic Review of Literature

Sriwastava

Srivastava

Kataria

et al. 2020

Preprint

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Abstract Background: To study the nature and frequency of occurrence of “significant” neurological complications in coronavirus disease-2019 (COVID-19) via a systematic review of the literature.Methods: We screened all articles resulting from a search of PubMed, Cochrane, Google Scholar and Scopus, using the keywords "COVID-19 and CNS", "SARS-CoV-2 and CNS”, “COVID-19 and neurological manifestation”, “SARS2 and neurological manifestation” and “COVID-19 and Brain” looking for reports of significant neurological manifestations that would potentially have an impact on the outcome.Results: Twenty-six articles met the inclusion criteria. The significant neurological diagnoses reported were stroke, Guillain Barre Syndrome (GBS) and its variants, encephalitis, seizures, acute hemorrhagic necrotizing encephalopathy, acute disseminated encephalomyelitis (ADEM) and transverse myelitis. Although stroke, predominantly ischemic, was observed in ~ 6% of COVID-19 patients from Wuhan, China, mortality in this cohort was 38%. Of the 24 pooled patients with reports of etiology, 17 had large vessel occlusions. GBS occurred in 5/1200 (0.4%) of the COVID-19 cohort from Italy. One of the six reported encephalitis cases, the ADEM case and the report of transverse myelitis do not have data for conclusive diagnosis.Conclusion: The most frequent significant neurological association with COVID-19 is stroke, predominantly ischemic. In a cohort from Wuhan, China, this was as frequent as ~ 6%, with a 38% mortality. Most common reported etiology is large vessel occlusion. Other reported significant neurological complications are GBS/variants, encephalitis, seizures and acute hemorrhagic necrotizing encephalopathy. The reports of ADEM and transverse myelitis lacked diagnostically conclusive data.

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