Potential neurological manifestations of COVID-19: a narrative review

Pergolizzi, J. V.; Raffa, Robert B.; Varrassi, Giustino; Magnusson, Peter; LeQuang, Jo Ann; Paladini, Antonella; Taylor, Robert; Wollmuth, Charles; Breve, Frank; Chopra, Maninder; Nalamasu, Rohit; Christo, Paul J.

doi:10.1080/00325481.2020.1837503

Cited by 28 publications

(21 citation statements)

References 116 publications

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“… 24 The known mechanisms of neuropathology are direct viral infection, severe systemic inflammation, neuroinflammation, microvascular thrombosis, and neurodegeneration. 25 …”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 conditions in Ecuadorian patients: an observational study

González-Andrade

2022

The Lancet Regional Health - Americas

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“… 24 The known mechanisms of neuropathology are direct viral infection, severe systemic inflammation, neuroinflammation, microvascular thrombosis, and neurodegeneration. 25 …”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 conditions in Ecuadorian patients: an observational study

González-Andrade

2022

The Lancet Regional Health - Americas

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“…Clinicians must first differentiate between Long COVID which can be managed with at-home care and relatively benign interventions versus life-threatening illness. Following acute COVID, some patients may develop potentially fatal cases of pulmonary embolism, heart failure, lung fibrosis, stroke as well as severe neurological impairment and mental breakdown [62,63]. Acute COVID disrupts the body's immune and endocrine systems, which can exacerbate comorbid conditions and patients may have to deal with this long after the acute COVID resolves.…”

Section: Clinical Implications Of Long Covidmentioning

confidence: 99%

It's not over till it's over: a narrative review of Long COVID

Pergolizzi¹,

LeQuang²,

Magnusson³

et al. 2021

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Viral persistence following acute COVID infection is increasingly being reported by patients and gradually being recognized as a medical syndrome. Like much about COVID, this so-called Long COVID is perplexing. It is associated with numerous symptoms, foremost among them profound fatigue, and often occurs in a relapsing/remitting pattern. There is one “living” guideline for managing Long COVID and even terminology and definitions of the syndrome are in flux. Long COVID occurs in patients who have recovered from the acute infection and this may be viral persistence, a form of autoimmunity, or the long-term results of organ damage sustained during the acute infection. Symptoms have been reported up to six months after acute infection with no clear association between the severity of the acute infection and the presence or absence of Long COVID. The symptoms of the acute illness do not necessarily align with the symptoms of Long COVID. Disruptions to the autonomic function in Long COVID are particularly puzzling, including orthostatic intolerance syndrome (which may not have occurred during the acute infection). Loss of the sense of smell and taste is one symptom that appears common in both acute and Long COVID; on the other hand, fever is more prevalent in acute than Long COVID. Research is urgently needed to better understand Long COVID, for example: what is the role of elevated biomarkers such as D-dimer and C-reactive protein in Long COVID? Is Long COVID one or more than one syndrome? How can patients with Long COVID be appropriately treated?

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“…SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the cause of coronavirus disease 2019 (COVID-19 or COVID), has-as of 13 May 2021-infected >160 million people worldwide and has contributed to >3.3 million deaths [1]. COVID has multiple distinguishing features which contribute to its virulence including, but not limited to asymptomatic transmission via respiratory droplets, an unpredictable incubation period ranging from 2-14 days, multiorgan failure [2], cytokine storm, hemophagocytic lymphohistiocytosis, respiratory failure/acute respiratory distress syndrome [3], and neurological symptoms [4]. These factors considered, COVID has been declared as of 13 May 2021 to have a case-fatality ratio ranging from 0.1% (Singapore) to 19.7% (Yemen) depending on country, with a median case-fatality ratio of 1.7% based on data from 179 countries [5].…”

Section: Introductionmentioning

confidence: 99%

Vaping and subsequent comorbidities potentially associated with increased mortality and more severe illness in COVID-19: a narrative review

2021

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Introduction: COVID-19 (or COVID) is a highly virulent viral disease which more frequently presents severe infection in specific populations, such as the elderly, patients with hypertension, patients with respiratory disease, and patients who smoke. The effects vaping (i.e., an electronic cigarette or JUUL device) has on COVID progression remains unclear, because there is an information paucity correlating e-cigarette use and COVID. This review sought to identify links between vape use and COVID severity via literature review. Additionally, because there is more widespread information about cigarette smoking than about vaping, this review sought to illustrate commonalities between smoking and vaping. If smoking and vaping are deemed near-identical practices, then it is possible the effects of smoking on human health and on COVID disease could be comparable in vaping. Methods: Several searches were performed on PubMed with MeSH headings and JSTOR between 17 December 2020 and 22 December 2020. Search results were excluded if they were not trials or controlled clinical trials, if the articles were not about COVID, if the articles were about smoking behaviors or habits, or if the articles were not related to vaping or smoking. Key findings were summarized and tabled based on relevance, substantiability, and applicability to COVID. Results: Multiple sources viewed smoking and vaping as equal risk factors for COVID disease, whereas other sources viewed the two as unique risk factors. Because of this controversy, it is challenging to view the two practices as similar enough to pose equivalent risks for COVID. Both practices pose significant health risks to its users, but these health risks are unique to each practice. Discussion: There are several limitations which exacerbate ambiguity—(1) it is unclear how harmful smoking is for COVID patients, because several publications found smoking may have protective effects; (2) few older patients vape, but yet most severe COVID cases occur in older populations; (3) older patients and impoverished patients show a statistically significant risk for severe COVID disease independent of other factors; (4) vaping is a relatively new practice, and there are few patients who self-report long-term e-cigarette use or long-term adverse effects as a result thereof. Conclusion: Although vaping may present serious health risks, clinically, it is uncertain how significantly vaping affects COVID disease, especially when compared against cigarette smoking. More research is needed on both the effects of vaping on COVID and the likeness of vaping versus smoking.

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Potential neurological manifestations of COVID-19: a narrative review

Cited by 28 publications

References 116 publications

Post-COVID-19 conditions in Ecuadorian patients: an observational study

Post-COVID-19 conditions in Ecuadorian patients: an observational study

It's not over till it's over: a narrative review of Long COVID

Vaping and subsequent comorbidities potentially associated with increased mortality and more severe illness in COVID-19: a narrative review

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