The neurological manifestations of COVID-19: a review article

Niazkar, Hamid Reza; Zibaee, Behdad; Nasimi, Ali; Bahri, Narjes

doi:10.1007/s10072-020-04486-3

Cited by 259 publications

(311 citation statements)

References 41 publications

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“…One of our patients had a similar finding in his brain imaging/pathology studies. Other scenarios for acute symptomatic seizures in critically ill patients with COVID-19 have also been reported before [18][19][20][21]. All of our patients were admitted to intensive care unit (ICU) and had hypoxemia, two patients had metabolic derangements, and one child suffered from febrile status epilepticus.…”

Section: Discussionsupporting

confidence: 66%

Seizure in patients with COVID-19

et al. 2020

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Objective The purpose of the current study was to collect the data on the occurrence of seizures in patients with COVID-19 and to clarify the circumstances of the occurrence of seizures in these patients. Methods All consecutive patients who referred to healthcare facilities anywhere in Fars province (located in South Iran with a population of 4.851 million people) from February 19 until June 2, 2020, and had confirmed COVID-19 by positive result on polymerase chain reaction testing and seizure were included. Results During the study period, 6,147 people had confirmed COVID-19 in Fars province, Iran; 110 people died from the illness (case fatality rate 1.79%). During this time period, five people had seizures (seizure rate 0.08%). In four patients, seizure was one of the presenting manifestations, and in one person, it happened during the course of hospital admission. Two patients had status epilepticus. All patients experienced hypoxemia and four of them needed respirator. Two patients had related metabolic derangements and one had cerebrospinal fluid (CSF) lymphocytic pleocytosis. Brain imaging was abnormal in three patients. Four patients died. Conclusion New-onset seizures in critically ill patients with COVID-19 should be considered as acute symptomatic seizures and the treating physician should try to determine the etiology of the seizure and manage the cause immediately and appropriately. Detailed clinical, neurological, imaging, and electrophysiological investigations and attempts to isolate SARS-CoV-2 from CSF may clarify the role played by this virus in causing seizures in these patients.

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Section: Discussionsupporting

confidence: 66%

Seizure in patients with COVID-19

et al. 2020

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“…For example, chloroquine and hydroxychloroquine may be associated with neuropsychiatric adverse effects, retinopathy, ataxia, seizures, and limbic encephalitis [149] while ribavirin and interferons are linked to retinopathy and neuropsychiatric consequences [150]. Seizures a reported symptom of SARS-CoV-2 infection, even in patients with no past medical history of epilepsy; however, an increased occurrence of seizures may be an adverse effect of anti-viral medications (e.g., lopinavir, ritonavir, ribavirin) [151]. Thus, further research to distinguish the deleterious neurological consequences of SARS-CoV-2 from the neurological side effects of COVID-19 therapies is necessary to advance clinical care.…”

Section: Challenges For the Clinical Management Of Covid-19mentioning

confidence: 99%

Neurological consequences of COVID-19: what have we learned and where do we go from here?

Jarrahi

Ahluwalia

Khodadadi

et al. 2020

J Neuroinflammation

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The coronavirus disease-19 (COVID-19) pandemic is an unprecedented worldwide health crisis. COVID-19 is caused by SARS-CoV-2, a highly infectious pathogen that is genetically similar to SARS-CoV. Similar to other recent coronavirus outbreaks, including SARS and MERS, SARS-CoV-2 infected patients typically present with fever, dry cough, fatigue, and lower respiratory system dysfunction, including high rates of pneumonia and acute respiratory distress syndrome (ARDS); however, a rapidly accumulating set of clinical studies revealed atypical symptoms of COVID-19 that involve neurological signs, including headaches, anosmia, nausea, dysgeusia, damage to respiratory centers, and cerebral infarction. These unexpected findings may provide important clues regarding the pathological sequela of SARS-CoV-2 infection. Moreover, no efficacious therapies or vaccines are currently available, complicating the clinical management of COVID-19 patients and emphasizing the public health need for controlled, hypothesis-driven experimental studies to provide a framework for therapeutic development. In this mini-review, we summarize the current body of literature regarding the central nervous system (CNS) effects of SARS-CoV-2 and discuss several potential targets for therapeutic development to reduce neurological consequences in COVID-19 patients.

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“…COVID-19 is a rapidly emerging RNA virus since its first reported case in Wuhan, China, in December 2019 [1,2].…”

Section: Introductionmentioning

confidence: 99%

The Neurological Complexities and Prognosis of COVID-19

Padda

Khehra

Jaferi

et al. 2020

SN Compr. Clin. Med.

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Several neurological manifestations and complications linked to SARS-CoV-2 have been reported along with well-known respiratory pathology. The global active transmission of SARS-CoV-2 and its unexplained characteristics has led to a pandemic. Since its rapid emergence from Wuhan, China, in December 2019, several studies have reported the impacts of COVID-19 on the CNS and PNS and its implications. This comprehensive review article comprises case reports, case series, metaanalysis, cohort studies, retrospective studies, and narrative reviews focusing on COVID-19-associated CNS and PNS complexities. The authors searched for over 200 articles and used 52 publications related to the neurological complexities of COVID-19 affecting the CNS and PNS as part of the literature review process. The predominant CNS symptoms noted in COVID-19 patients were headaches and dizziness, and the most common PNS symptoms were alterations in smell and taste. Case reports on headache/dizziness, intracerebral hemorrhage, acute hemorrhagic necrotizing encephalopathy, meningitis/encephalitis, encephalopathy, cerebrovascular events, chemosensory dysfunction, Guillain-Barre syndrome, and acute transverse myelitis/acute necrotizing myelitis in PCR-confirmed SARS-CoV-2 subjects are also reported. New-onset neurological symptoms were also observed in children with PCR-confirmed SARS-CoV-2 that developed pediatric multisystem inflammatory syndrome (PIMS). This comprehensive review article will assist the clinicians and researchers to gain information about the neurological manifestations and complications associated with COVID-19 and develop planning to treat these symptoms in concerned patients of all ages. However, it is unclear whether SARS-CoV2-associated neurological effects are due to primary infections or secondary response to the possible mechanisms discussed in this review.

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The neurological manifestations of COVID-19: a review article

Cited by 259 publications

References 41 publications

Seizure in patients with COVID-19

Seizure in patients with COVID-19

Neurological consequences of COVID-19: what have we learned and where do we go from here?

The Neurological Complexities and Prognosis of COVID-19

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