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Poloni S, Hamani A, Kassis V, Escoffier P, Hagenkotter B, Gendrin V, Zayet S, Klopfenstein T. Acute Cerebellitis Following COVID-19: Alarming Clinical Presentation Challenged by Normal Paraclinical Findings. Infect Dis Ther 2024:10.1007/s40121-024-01048-4. [PMID: 39316326 DOI: 10.1007/s40121-024-01048-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 09/09/2024] [Indexed: 09/25/2024] Open
Abstract
We report the case of an acute cerebellitis following COVID-19 in 32-year-old man who presented with a life-threatening critical cerebellar syndrome contrasting with normal paraclinical findings. Despite this fulminant critical presentation, the patient fully recovered in 37 days after early treatment with high-dose steroids and intravenous immunoglobulins. This case highlights the need for clinicians to be aware of acute cerebellitis following COVID-19, despite normal laboratory, imaging and electroencephalography findings and the importance to start appropriate treatment as soon as possible.
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Affiliation(s)
- Samantha Poloni
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Abdoulaye Hamani
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Valentine Kassis
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Pauline Escoffier
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Beate Hagenkotter
- Department of Neurology, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Vincent Gendrin
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Souheil Zayet
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France
| | - Timothée Klopfenstein
- Department of Infectious and Tropical Diseases, Nord Franche-Comté Hospital, 90400, Trévenans, France.
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Li J, Kong X, Liu T, Xian M, Wei J. The Role of ACE2 in Neurological Disorders: From Underlying Mechanisms to the Neurological Impact of COVID-19. Int J Mol Sci 2024; 25:9960. [PMID: 39337446 PMCID: PMC11431863 DOI: 10.3390/ijms25189960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/06/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
Angiotensin-converting enzyme 2 (ACE2) has become a hot topic in neuroscience research in recent years, especially in the context of the global COVID-19 pandemic, where its role in neurological diseases has received widespread attention. ACE2, as a multifunctional metalloprotease, not only plays a critical role in the cardiovascular system but also plays an important role in the protection, development, and inflammation regulation of the nervous system. The COVID-19 pandemic further highlights the importance of ACE2 in the nervous system. SARS-CoV-2 enters host cells by binding to ACE2, which may directly or indirectly affect the nervous system, leading to a range of neurological symptoms. This review aims to explore the function of ACE2 in the nervous system as well as its potential impact and therapeutic potential in various neurological diseases, providing a new perspective for the treatment of neurological disorders.
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Affiliation(s)
- Jingwen Li
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
- Institute for Sports and Brain Health, School of Physical Education, Henan University, Kaifeng 475004, China
| | - Xiangrui Kong
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
- Institute for Sports and Brain Health, School of Physical Education, Henan University, Kaifeng 475004, China
| | - Tingting Liu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Meiyan Xian
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Jianshe Wei
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
- Institute for Sports and Brain Health, School of Physical Education, Henan University, Kaifeng 475004, China
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Wang YC, Hsu HC, Shih HI. Invasive Listeriosis After Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Infection. J Acute Med 2024; 14:130-133. [PMID: 39229357 PMCID: PMC11366690 DOI: 10.6705/j.jacme.202409_14(3).0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 09/05/2024]
Abstract
Acute deteriorated consciousness is commonly reported in elderly COVID-19 patients. Secondary bacterial infection is common in critically ill COVID-19 patients. Listeria monocytogenes is a gram-positive, facultatively intracellular rod-shaped bacterium ubiquitously distributed in the environment and is an opportunistic and foodborne pathogen. Pregnant women and their newborns, adults aged 65 years or older, and immunocompromised people are more vulnerable to Listeria -related invasive disease. A 74-year-old man with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with initial presentations of headache and acute disorientation, which was finally diagnosed with L . monocytogenes bacteremia and meningitis. Multiplex polymerase chain reaction (Multiplex PCR) assay was used to rapidly diagnose it in the emergency department.
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Affiliation(s)
- Yu Ching Wang
- National Cheng Kung University Hospital Department of Emergency Medicine Tainan Taiwan
- College of Medicine School of Medicine National Cheng Kung University, Tainan Taiwan
| | - Hsiang-Chin Hsu
- National Cheng Kung University Hospital Department of Emergency Medicine Tainan Taiwan
- College of Medicine School of Medicine National Cheng Kung University, Tainan Taiwan
| | - Hsin-I Shih
- National Cheng Kung University Hospital Department of Emergency Medicine Tainan Taiwan
- College of Medicine School of Medicine National Cheng Kung University, Tainan Taiwan
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Wang X, Guo Q, Huang K, Ma G, Zhai L, Lin B, Ren H, Yang Z. Impact of the COVID-19 pandemic on risk of sarcopenia: From lockdown and infection perspectives: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e39257. [PMID: 39121262 PMCID: PMC11315480 DOI: 10.1097/md.0000000000039257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 07/19/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND During the new coronavirus disease 2019 (COVID-19) pandemic, there are numerous symptoms in the skeletal muscular system, such as decreased skeletal muscle mass, strength, and muscle function, which are the main manifestations of sarcopenia. To investigate the impact of the COVID-19 pandemic on sarcopenia from the perspectives of COVID-19 pandemic lockdown and COVID-19 infection, we conducted this study. METHODS We searched for literature related to COVID-19 and sarcopenia published in PubMed, Embase, Cochrane Library, and Web of Science. Two researchers independently searched and screened the articles, extracted data, and assessed the quality of the final included literature. RevMan 5.4 was used for meta-analysis. RESULTS A total of 8 articles with a total of 1145 patients were included. There was a significant difference in SARC-F scores (MD = 0.67, 95%CI = [0.41, 0.93], Z = 5.00, P < .00001), handgrip (MD = -1.57, 95%CI = [-2.41, -0.73], Z = 3.66, P = .0002), body weight (MD = -1.87, 95%CI = [-3.69, -0.05], Z = 2.01, P = .04), and skeletal muscle mass index (MD = -0.28, 95%CI = [-0.54, -0.02], Z = 2.13, P = .03) between the time before the COVID-19 pandemic and during the COVID-19 pandemic. However, the results showed that there was no significant difference in muscle mass between the 2 groups (MD = -1.72, 95%CI = [-4.39, 0.94], Z = 1.27, P = .21). CONCLUSION The COVID-19 pandemic has had an impact on sarcopenia. Both infection with COVID-19 and lockdown during the COVID-19 pandemic increase the risk of sarcopenia. Research should pay more attention to this disease during the COVID-19 pandemic and adopt effective interventions to minimize adverse outcomes.
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Affiliation(s)
- Xiang Wang
- The Second School of Clinical Medicine, Zhejiang Traditional Chinese Medical University, Hangzhou, Zhejiang, China
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Qiaofeng Guo
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Kai Huang
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Gouping Ma
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lifeng Zhai
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Bingyuan Lin
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Haiyong Ren
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ze Yang
- The Second School of Clinical Medicine, Zhejiang Traditional Chinese Medical University, Hangzhou, Zhejiang, China
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Granja López J, Estebas Armas C, Lorenzo Dieguez M, Puertas Muñoz I, De Celis Ruiz E, Rigual R, Fernández-Fournier M, Torres Iglesias G, Sánchez Velasco S, Tallón Barranco A, Rogozina O, Ramírez E, González-Muñoz M, Lacruz Ballester L. Neurological manifestations of immune origin after COVID-19 vaccination: retrospective case study. Front Pharmacol 2024; 15:1376474. [PMID: 39175548 PMCID: PMC11338880 DOI: 10.3389/fphar.2024.1376474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/19/2024] [Indexed: 08/24/2024] Open
Abstract
Objectives: To know the frequency and characteristics of neurological manifestations of probable immune origin occurring after exposure to COVID-19 vaccination. In addition, to pre-study the usefulness of the Spanish pharmacovigilance system and lymphocyte transformation test in establishing causality. Methods: Retrospective case study, including patients admitted to the Neurology department from January 2021 to May 2022 with a probable neuroimmune disorder. Demographic, clinical and COVID-19 vaccination antecedent data were collected from medical records. Results: From a total of 108 patients, 30 were excluded due to a different etiological diagnosis after follow-up. Thirty-six patients (46.2%) had received the COVID-19 vaccine in the previous 3 months (21.8% during the previous month). BioNTech-Pfizer vaccine was the most frequent in this group (63.9%). 69/108 were female and mean age 51.2 years (SD 22.59), with no significant difference with not recently-vaccinated (U-Mann Whitney, p = 0.256). The neurological syndromes found were (vaccinated/total): polyradiculoneuropathy (8/16), encephalitis (5/11), multiple sclerosis relapse (5/16), optic neuritis (1/4), myelitis (3/6), cranial neuropathy (6/10), aseptic meningitis (1/3) and others (7/11). Acute immunosuppressive treatment was administered in 61.1% of cases and 47.2% presented complete clinical improvement, without significant differences with non-vaccinated patients (chi-square, p = 0.570). Eleven vaccinated patients were studied in the pharmacovigilance office for possible adverse drug reaction. Causality according to the Spanish pharmacovigilance system (SPVS) algorithm was "Related" to COVID-19 vaccine (score ≥ 4) in 11 cases with positive in vitro study (lymphocyte transformation test) to polyethylene glycol-2000 and polysorbate-80 in 4 cases. Conclusion: Neuroimmune disorders appearing after administration of COVID-19 vaccine do not seem to present important differentiating clinical and/or evolutive features. Delayed hypersensitivity to vaccine excipients could be one of the pathophysiological mechanisms, and lymphocyte transformation test is a useful tool to identify it.
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Affiliation(s)
- Juan Granja López
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Carlos Estebas Armas
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Manuel Lorenzo Dieguez
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Inmaculada Puertas Muñoz
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Elena De Celis Ruiz
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Ricardo Rigual
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Mireya Fernández-Fournier
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Gabriel Torres Iglesias
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Sara Sánchez Velasco
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Antonio Tallón Barranco
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
| | - Olga Rogozina
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Elena Ramírez
- Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Laura Lacruz Ballester
- Neurology Department and Stroke Center, Laboratory of Neurological and Cerebrovascular Sciences, Hospital La Paz Institute for Health Research Institute-IdiPAZ (La Paz University Hospital—Universidad Autónoma de Madrid), Madrid, Spain
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Ma HY, Chiang NT, Kao RH, Lee CY. Health Workers' Mindfulness-Based Stress Reduction and Resilience During COVID-19 Pandemic. J Multidiscip Healthc 2024; 17:3691-3713. [PMID: 39114858 PMCID: PMC11303674 DOI: 10.2147/jmdh.s464285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/25/2024] [Indexed: 08/10/2024] Open
Abstract
Background Research indicates that a significant number of healthcare workers accounted for all confirmed Coronavirus disease 2019 (COVID-19) cases, and many of the infected healthcare workers were asymptomatic. During the COVID-19 outbreak, a considerable number of people in Taiwan contracted the disease. Therefore, health workers in Taiwan often experienced lack of medical resources, and this problem is worse for outer island areas. In terms of stress and mental health, this study investigated the effect of poor healthcare capacity and high workload on health workers during the COVID-19 pandemic. This study also explored mindfulness-based stress reduction and resilience in health workers. Methods This study conducted an in-depth interview to investigate stress perceived by health workers in a hospital located on an outer island of Taiwan as well as their mental health and stress relieving strategies. Results It was found that during the COVID-19 outbreak, some common sources of stress for health workers included exposure to infectious diseases, heavy workloads, facing ethical dilemma in clinical decision-making, and unfamiliar problems from the pandemic. These types of stress cause worries, anxiety, and depression in health workers, which affects their mental and physical health as well as their patient-care performance. Conclusion This study proposed that mindfulness-based stress reduction and protecting mental health are important for health workers.
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Affiliation(s)
- Hsiang-Yu Ma
- Department of Ocean and Border Management, National Quemoy University, Kinmen, Taiwan
| | - Nein-Tsu Chiang
- Department of Ocean and Border Management, National Quemoy University, Kinmen, Taiwan
| | - Rui-Hsin Kao
- Department of Ocean and Border Management, National Quemoy University, Kinmen, Taiwan
| | - Chih-Ying Lee
- Department of Ocean and Border Management, National Quemoy University, Kinmen, Taiwan
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Szalai E, Nagy K, Kolkedi Z, Csutak A. Corneal nerve fiber morphology following COVID-19 infection in vaccinated and non-vaccinated population. Sci Rep 2024; 14:16801. [PMID: 39039160 PMCID: PMC11263336 DOI: 10.1038/s41598-024-67967-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/18/2024] [Indexed: 07/24/2024] Open
Abstract
To examine corneal subbasal nerve changes in patients who received vaccination against SARS-CoV-2 virus and underwent COVID-19 infection compared to infected non-vaccinated patients and healthy controls. Twenty-nine eyes of 29 vaccinated patients (mean age: 36.66 ± 12.25 years) within six months after PCR or Ag test proven COVID-19 infection and twenty-eight eyes of 28 age-matched infected, non-vaccinated patients (mean age: 42.14 ± 14.17 years) were enrolled. Twenty-five age-matched healthy individuals (mean age: 47.52 ± 18.45 years) served as controls. In vivo confocal microscopy (Heidelberg Retina Tomograph II Rostock Cornea Module, Germany) was performed in each group. Corneal subbasal nerve plexus morphology and corneal dendritic cells (DC) were evaluated. Significantly higher corneal nerve fiber density (P < 0.001), nerve branch density (P < 0.001), nerve fiber length (P < 0.001), total branch density (P = 0.007), nerve fiber area (P = 0.001) and fractal dimension (P < 0.001) values were observed in vaccinated patients after COVID-19 infection compared to the non-vaccinated group. Significantly higher DC density was observed in the non-vaccinated group compared to the control group (P = 0.05). There was a statistically significant difference in the size of mature DCs (P < 0.0001) but the size of immature DCs did not differ significantly among the 3 groups (P = 0.132). Our results suggest that SARS-CoV-2 vaccination may have a protective effect against the complications of COVID-19 disease on the corneal subbasal nerve fibers.
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Affiliation(s)
- Eszter Szalai
- Department of Ophthalmology, University of Pécs Medical School, Rákóczi U. 2, Pécs, 7623, Hungary.
| | - Katalin Nagy
- Department of Ophthalmology, University of Pécs Medical School, Rákóczi U. 2, Pécs, 7623, Hungary
| | - Zsofia Kolkedi
- Department of Ophthalmology, University of Pécs Medical School, Rákóczi U. 2, Pécs, 7623, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, University of Pécs Medical School, Rákóczi U. 2, Pécs, 7623, Hungary
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Mrabet S, Jaziri A, Araoud M, Zellama D, Naija S, Ben Amor S, Souissi A, Jemni H. Coronavirus disease-19 encephalitis as a differential diagnosis of a cyclosporine related posterior leukoencephalopathy syndrome: A case report. LA TUNISIE MEDICALE 2024; 102:429-432. [PMID: 38982969 PMCID: PMC11358812 DOI: 10.62438/tunismed.v102i7.5027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 05/07/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Posterior leukoencephalopathy syndrome (PRES) is a rare neurological disease possibly associated with the use of calcineurin inhibitors like cyclosporine A (CSA). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for the outbreak of coronavirus disease 19 (COVID-19) can cause neurological manifestations. We described a case of CSA-related PRES whose diagnosis was difficult due to a concurrent infection with SARS-CoV-2. OBSERVATION The 16-year-old patient was known to have corticosteroid-resistant nephrotic syndrome secondary to minimal change disease. CSA was introduced, and on the fifth day of treatment, the patient presented with seizures followed by fever. Biological and magnetic resonance imaging data were in favor of SARS-CoV-2 encephalitis. Relief of immunosuppression by discontinuation of CSA was decided and the patient was put on anticonvulsants. After being declared cured of COVID-19, which was without other clinical signs, the CSA was reintroduced but the patient presented with seizures the next day. This allowed the physicians to rectify the diagnosis and relate the seizures to a CSA-related PRES. CONCLUSION Infection with SARS-CoV-2 could be a differential diagnosis of a PRES related to calcineurin inhibitors.
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Affiliation(s)
- Sanda Mrabet
- Department of Nephrology, Dialysis, and Transplantation. Sahloul University Hospital. Sousse. Tunisia
| | - Achraf Jaziri
- Department of Nephrology, Dialysis, and Transplantation. Sahloul University Hospital. Sousse. Tunisia
| | - Maha Araoud
- Department of Nephrology, Dialysis, and Transplantation. Sahloul University Hospital. Sousse. Tunisia
| | - Dorsaf Zellama
- Department of Nephrology, Dialysis, and Transplantation. Sahloul University Hospital. Sousse. Tunisia
| | - Salma Naija
- Department of Neurology. Sahloul University Hospital. Sousse. Tunisia
| | - Sana Ben Amor
- Department of Neurology. Sahloul University Hospital. Sousse. Tunisia
| | - Alaa Souissi
- Department of Radiology. Sahloul University Hospital. Sousse. Tunisia
| | - Héla Jemni
- Department of Radiology. Sahloul University Hospital. Sousse. Tunisia
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Hinds Ii SR, Cifu DX. LIMBIC-CENC: Successfully conducting longitudinal mTBI research during the COVID-19 pandemic. NeuroRehabilitation 2024:NRE230272. [PMID: 38995806 DOI: 10.3233/nre-230272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
BACKGROUND Conducting mild traumatic brain injury (mTBI) longitudinal studies across multiple sites is a challenging endeavor which has been made more challenging because of COVID-19. OBJECTIVE This article briefly describes several concerns that need to be addressed during the conduct of research to account for COVID-19's impact. METHODS The recent actions and steps taken by the Long-term Impact of Military-relevant Brain Injury Consortium (LIMBIC)-Chronic Effects of Neurotrauma Consortium (CENC) researchers are reviewed. RESULTS COVID-19's effects on the conduct of LIMBIC-CENC for the short-term and long-term were considered to ensure the study continued safely for participants and researchers. COVID-19 may have long-lasting health and especially neurological effects which may confound the quantitative and qualitative measures of this any comparable longitudinal studies. CONCLUSION The recognition, understanding, and preparation of COVID-19's impact on a longitudinal military and veteran mTBI population is crucial to successfully conducting LIMBIC-CENC and similar neurological research studies. Developing a plan based on the best available information while remaining agile as new information about COVID-19 emerge, is essential. Research presented in this special issue underscores the complexity of studying long-term effects of mTBI, in a population exposed to and symptomatic from COVID-19.
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Affiliation(s)
| | - David X Cifu
- Virginia Commonwealth University, Richmond, VA, USA
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10
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Avorio F, Russelli G, Panarello G, Alduino R, Conaldi PG, Lo Re V. Neurological complications of SARS-CoV-2 infection among solid organ transplanted patients: does immunosuppression matter? Front Neurol 2024; 15:1393104. [PMID: 39026584 PMCID: PMC11254845 DOI: 10.3389/fneur.2024.1393104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/24/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction SARS-CoV-2 infection can lead to a broad range of neurological manifestations such as olfactory and gustative disorders, myalgias, headache, and fatigue but also more rare and severe neurological pictures such seizures, encephalitis, and cerebrovascular diseases. It is still unknown if the underlying pathophysiological mechanism is the direct cytotoxic effect of the virus on central nervous system or if the related systemic inflammation leads to cerebral suffering and neurological symptoms. Studying neurological manifestations of SARS-CoV-2 infection among solid organ transplant recipients, who take immunosuppressive drugs, may help to shed light on this topic. Methods We enrolled a total of 73 solid organ transplantation recipients (kidney, liver, lung, heart and combined) with a history of SARS-CoV-2 infection (in the period between July 2020 and June 2021). We collected all demographic and clinical general information and, through phone interviews, we registered retrospectively the occurrence of neurological symptoms during the acute phase of infection and within the next 6 months. Results Approximately 27.4% (20/73) of patients needed hospitalization during the infection, 25.3% (18/73) were treated with oxygen therapy, and only one patient was admitted to the Intensive Care Unit for mechanical ventilation. Almost 74% (54/73) of patients reported at least one neurological symptom/disease. The most frequent neurological complications were myalgia (57.5%), headache (37%), and hyposmia/hypogeusia (37%). Need of oxygen therapy during the SARS-CoV-2 infection was statistically significantly associated to neurological complications (p= 0.0344). Pre-infection neurological comorbidities and immunosuppression levels (higher levels of tacrolimus and also being on steroids) did not modify the probability to have neurological manifestations. Discussion Frequency of headache was comparable with the same self-reported symptom in the general population, while hyposmia/hypogeusia was more frequent in our cohort of transplant recipients. Higher level of tacrolimus as well as being on steroids did not result protective against neurological manifestation. Lastly neurological symptoms occurred more frequent in more severe cases of infection.
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Affiliation(s)
- Federica Avorio
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center Italy (UPMCI), Palermo, Italy
| | | | - Giovanna Panarello
- Department of Anesthesiology and Intensive Care, IRCCS ISMETT, UPMCI, Palermo, Italy
| | | | | | - Vincenzina Lo Re
- Neurology Service, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), University of Pittsburgh Medical Center Italy (UPMCI), Palermo, Italy
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11
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Neu F, Nay S, Schuchardt S, Klawonn F, Skripuletz T, Suehs KW, Pessler F. Targeted metabolomics identifies accurate CSF metabolite biomarkers for the differentiation between COVID-19 with neurological involvement and CNS infections with neurotropic viral pathogens. J Transl Med 2024; 22:620. [PMID: 38961383 PMCID: PMC11223383 DOI: 10.1186/s12967-024-05422-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND COVID-19 is primarily considered a respiratory tract infection, but it can also affect the central nervous system (CNS), which can result in long-term sequelae. In contrast to CNS infections by classic neurotropic viruses, SARS-CoV-2 is usually not detected in cerebrospinal fluid (CSF) from patients with COVID-19 with neurological involvement (neuro-COVID), suggesting fundamental differences in pathogenesis. METHODS To assess differences in CNS metabolism in neuro-COVID compared to CNS infections with classic neurotropic viruses, we applied a targeted metabolomic analysis of 630 metabolites to CSF from patients with (i) COVID-19 with neurological involvement [n = 16, comprising acute (n = 13) and post-COVID-19 (n = 3)], (ii) viral meningitis, encephalitis, or myelitis (n = 10) due to herpes simplex virus (n = 2), varicella zoster virus (n = 6), enterovirus (n = 1) and tick-borne encephalitis virus (n = 1), and (iii) aseptic neuroinflammation (meningitis, encephalitis, or myelitis) of unknown etiology (n = 21) as additional disease controls. RESULTS Standard CSF parameters indicated absent or low neuroinflammation in neuro-COVID. Indeed, CSF cell count was low in neuro-COVID (median 1 cell/µL, range 0-12) and discriminated it accurately from viral CNS infections (AUC = 0.99) and aseptic neuroinflammation (AUC = 0.98). 32 CSF metabolites passed quality assessment and were included in the analysis. Concentrations of differentially abundant (fold change ≥|1.5|, FDR ≤ 0.05) metabolites were both higher (9 and 5 metabolites) and lower (2 metabolites) in neuro-COVID than in the other two groups. Concentrations of citrulline, ceramide (d18:1/18:0), and methionine were most significantly elevated in neuro-COVID. Remarkably, triglyceride TG(20:1_32:3) was much lower (mean fold change = 0.09 and 0.11) in neuro-COVID than in all viral CNS infections and most aseptic neuroinflammation samples, identifying it as highly accurate biomarker with AUC = 1 and 0.93, respectively. Across all samples, TG(20:1_32:3) concentration correlated only moderately with CSF cell count (ρ = 0.65), protein concentration (ρ = 0.64), and Q-albumin (ρ = 0.48), suggesting that its low levels in neuro-COVID CSF are only partially explained by less pronounced neuroinflammation. CONCLUSIONS The results suggest that CNS metabolite responses in neuro-COVID differ fundamentally from viral CNS infections and aseptic neuroinflammation and may be used to discover accurate diagnostic biomarkers in CSF and to gain insights into differences in pathophysiology between neuro-COVID, viral CNS infections and aseptic neuroinflammation.
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Affiliation(s)
- Frieder Neu
- Research Group Biomarkers for Infectious Diseases, TWINCORE Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Str. 7, 30625, Hannover, Germany
- Study Programme Medicine, Riga Stradins University, Riga, Latvia
| | - Sandra Nay
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Sven Schuchardt
- Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany
| | - Frank Klawonn
- Biostatistics, Helmholtz Centre for Infection Research, Brunswick, Germany
| | | | | | - Frank Pessler
- Research Group Biomarkers for Infectious Diseases, TWINCORE Centre for Experimental and Clinical Infection Research, Feodor-Lynen-Str. 7, 30625, Hannover, Germany.
- Centre for Individualised Infection Medicine, Hannover, Germany.
- Research Group Biomarkers for Infectious Diseases, Helmholtz Centre for Infection Research, Brunswick, Germany.
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12
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Brauer T, Paika S, Kotwani R, Khanna D. Neurological Complications of COVID-19 Infection: A Comprehensive Review. Cureus 2024; 16:e65192. [PMID: 39176347 PMCID: PMC11341106 DOI: 10.7759/cureus.65192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/19/2024] [Indexed: 08/24/2024] Open
Abstract
The COVID-19 pandemic is well on its way to reaching endemic status across the globe. While the medical community's understanding of the respiratory complications induced by COVID-19 is improving, there is still much to be learned about the neurological manifestations associated with COVID-19 infection. This review aimed to compile relevant, available evidence of COVID-19-induced neurological complications and to provide information for each complication regarding symptomology, progression patterns, demographic risk factors, treatment, and causative mechanism of action when available. Data for this review was collected using a confined search on PubMed using the keywords ["COVID-19" OR "SARS-CoV-2"] AND ["neurological complications" OR "olfactory symptoms" OR "gustatory symptoms" OR "myalgia" OR "headache" OR "dizziness" OR "stroke" OR "seizures" OR "meningoencephalitis" OR "cerebellar ataxia" OR "acute myelitis" OR "Guillain Barré Syndrome" OR "Miller Fisher Syndrome" OR "Posterior Reversible Encephalopathy Syndrome"] between 2019 and 2023. A wide range of neurological manifestations impact a significant percentage of COVID-19 patients, and a deeper understanding of these manifestations is necessary to ensure adequate management. The most common neurological complications identified consist of olfactory and gustatory dysfunctions, myalgia, headache, and dizziness, while the most severe complications include stroke, seizures, meningoencephalitis, Guillain-Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome. While this review effectively provides a roadmap of the neurological risks posed to COVID-19 patients, further research is needed to clarify the precise incidence of these complications and to elucidate the mechanisms responsible for their manifestation.
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Affiliation(s)
- Travis Brauer
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Sulaiman Paika
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Roshni Kotwani
- Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Deepesh Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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13
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Chen J, Gao X, Liang J, Wu Q, Shen L, Zheng Y, Ma Y, Peng Y, He Y, Yin J. Association between gut microbiota dysbiosis and poor functional outcomes in acute ischemic stroke patients with COVID-19 infection. mSystems 2024; 9:e0018524. [PMID: 38700338 PMCID: PMC11237522 DOI: 10.1128/msystems.00185-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Acute ischemic stroke (AIS) patients with active COVID-19 infection often have more severe symptoms and worse recovery. COVID-19 infection can cause gut microbiota dysbiosis, which is also a risk factor for poor outcomes in AIS patients. However, the association between gut microbiota and functional outcomes among AIS patients with COVID-19 infection has not been fully clarified yet. In this study, we performed 16S rRNA gene sequencing to characterize the gut microbial community among AIS patients with acute COVID-19 infection, AIS patients with post-acute COVID-19 infection, and AIS patients without COVID-19 infection. We found that AIS patients with acute COVID-19 experienced poorer recovery and significant gut dysbiosis, characterized by higher levels of Enterobacteriaceae and lower levels of Ruminococcaceae and Lachnospiraceae. Furthermore, a shorter time window (less than 28 days) between COVID-19 infection and stroke was identified as a risk factor for poor functional outcomes in AIS patients with COVID-19, and the enrichment of Enterobacteriaceae was indicated as a mediator in the relationship between infection time window and poor stroke outcomes. Our findings highlight the importance of early intervention after COVID-19 infection, especially by regulating the gut microbiota, which plays a role in the prognosis of AIS patients with COVID-19 infection.IMPORTANCEThe gut microbiota plays an important role in the association between respiratory system and cerebrovascular system through the gut-lung axis and gut-brain axis. However, the specific connection between gut bacteria and the functional outcomes of acute ischemic stroke (AIS) patients with COVID-19 is not fully understood yet. In our study, we observed a significant decrease in bacterial diversity and shifts in the abundance of key bacterial families in AIS patients with acute COVID-19 infection. Furthermore, we identified that the time window was a critical influence factor for stroke outcomes, and the enrichment of Enterobacteriaceae acted as a mediator in the relationship between the infection time window and poor stroke outcomes. Our research provides a new perspective on the complex interplay among AIS, COVID-19 infection, and gut microbiota dysbiosis. Moreover, recognizing Enterobacteriaceae as a potential mediator of poor stroke prognosis offers a novel avenue for future exploration and therapeutic interventions.
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Affiliation(s)
- Jiaying Chen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Comprehensive Medical Treatment Ward, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuxuan Gao
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingru Liang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiheng Wu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Linlin Shen
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yifeng Zheng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu Ma
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuping Peng
- Department of Neurosurgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yan He
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Laboratory Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Mental Health of the Ministry of Education, Guangzhou, Guangdong, China
| | - Jia Yin
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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14
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Jamora RDG, Jalipa FGU, Villanueva III EQ, Sy MCC, Espiritu AI, Anlacan VMM. Clinical outcomes of patients with seizure admitted for COVID-19: Findings from the Philippine CORONA study. Heliyon 2024; 10:e32461. [PMID: 38933946 PMCID: PMC11201110 DOI: 10.1016/j.heliyon.2024.e32461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 06/04/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Objective Seizure is one of the neurologic manifestations of coronavirus disease 2019 (COVID-19) infection. There are few studies focused on the outcome of hospitalized patients with COVID-19 and seizure. Methods This was a subgroup analysis of patients with seizure based on a nationwide, multicenter, retrospective study of COVID-19 patients admitted in 37 hospitals in the Philippines. Results A total of 10,881 patients with COVID-19 infection were included. Among these, 27 (0.2 %) patients had pre-existing seizure/epilepsy and 125 (1.1 %) had new-onset seizure. The patients with pre-existing seizure/epilepsy had a mean age of 49 years and majority were males (63.0 %). The patients with new-onset seizure had a mean age of 57 years and majority were males (60.5 %). Among patients with pre-existing seizure/epilepsy, there were no significant differences in the proportion of severe/critical COVID-19 (p = 0.131), all-cause mortality (p = 0.177), full/partial neurologic recovery (p = 0.190), ventilator use (p = 0.106), length of intensive care unit stay (p = 0.276), and length of hospitalization (p = 0.591). Patients with new-onset seizure were 2.65 times more likely to have severe/critical COVID-19 infection (p < 0.001), 3.12 times more likely to die (p < 0.001), and 3.51 times more likely to require a ventilator (p < 0.001) than those without new-onset seizure. New-onset seizure, however, was not significantly associated with full/partial neurologic recovery (p = 0.184) and prolonged length of hospitalization (p = 0.050). Conclusion Severe/critical COVID-19 infection, higher mortality rate, and use of a ventilator were significantly higher among patients with new-onset seizure but not among patients with pre-existing seizure/epilepsy.
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Affiliation(s)
- Roland Dominic G. Jamora
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Section of Neurology, Department of Internal Medicine, Cardinal Santos Medical Center, San Juan City, Philippines
| | - Francis Gerwin U. Jalipa
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Emilio Q. Villanueva III
- Department of Pathology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Marie Charmaine C. Sy
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Adrian I. Espiritu
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Veeda Michelle M. Anlacan
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
- Section of Neurology, Department of Internal Medicine, Cardinal Santos Medical Center, San Juan City, Philippines
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15
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Jachman-Kapułka J, Zińczuk A, Szymański W, Simon K, Rorat M. Complexity and Diversity of the Neurological Spectrum of SARS-CoV-2 over Three Waves of COVID-19. J Clin Med 2024; 13:3477. [PMID: 38930003 PMCID: PMC11204600 DOI: 10.3390/jcm13123477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objectives: SARS-CoV-2 continually mutates, with five identified variants. Many neurological manifestations were observed during the COVID-19 pandemic, with differences between virus variants. The aim of this study is to assess the frequency and characteristics of neurological manifestations during COVID-19 in hospitalized patients over three waves in Poland with comparison and analysis correlation with the course of infection. Methods: This retrospective single-center study included 600 consecutive adults with confirmed COVID-19, hospitalized during 3 waves (pre-Delta, Delta and Omicron) in Poland. Demographic and clinical information and neurological manifestations were collected and compared across three periods. Results: The median age of the study group was 68, lower during the Delta wave. In the Omicron period, the disease severity at admission and inflammatory markers concentration were the lowest. Neurological manifestations were observed in 49%. The most common were altered mentation, headache, myalgia, mood disorder, ischemic stroke and encephalopathy. Smell and taste disturbances (STDs) were less frequent in the Omicron period. Neurological complications were predominant in the pre-Delta and Omicron periods. Ischemic stroke was observed more often in pre-Delta period. Altered mentation was related to higher severity at admission, worse lab test results, higher admission to ICU and mortality, while headache reduced mortality. Pre-existing dementia was related to higher mortality. Conclusions: Neurological manifestations of COVID-19 are frequent, with a lower rate of STDs in the Omicron period and more often cerebrovascular diseases in the pre-Delta period. Headache improves the course of COVID-19, while altered mentation, stroke and neurological comorbidities increase severity and mortality.
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Affiliation(s)
- Justyna Jachman-Kapułka
- 6th Department of Internal Medicine and Rheumatology, J. Gromkowski Specialist Regional Hospital, 51-149 Wroclaw, Poland
| | - Aleksander Zińczuk
- 1st Department of Infectious Diseases, J. Gromkowski Specialist Regional Hospital, 51-149 Wroclaw, Poland; (A.Z.); (W.S.); (K.S.)
| | - Wojciech Szymański
- 1st Department of Infectious Diseases, J. Gromkowski Specialist Regional Hospital, 51-149 Wroclaw, Poland; (A.Z.); (W.S.); (K.S.)
- Clinical Department of Infectious Diseases and Hepatology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Krzysztof Simon
- 1st Department of Infectious Diseases, J. Gromkowski Specialist Regional Hospital, 51-149 Wroclaw, Poland; (A.Z.); (W.S.); (K.S.)
- Clinical Department of Infectious Diseases and Hepatology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Marta Rorat
- Department of Social Sciences and Infectious Diseases, Medical Faculty, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland;
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16
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van der Knaap N, de Vreeze F, van Rosmalen F, Wintjens MSJN, van Santen S, Linden DEJ, Staals J, van Mook WNKA, Jansen JFA, van der Horst ICC, van Bussel BCT, Ariës MJH. The incidence of neurological complications in mechanically ventilated COVID-19 ICU patients: An observational single-center cohort study in three COVID-19 periods. Clin Neurol Neurosurg 2024; 241:108311. [PMID: 38704879 DOI: 10.1016/j.clineuro.2024.108311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/07/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Neurological complications in COVID-19 patients admitted to an intensive care unit (ICU) have been previously reported. As the pandemic progressed, therapeutic strategies were tailored to new insights. This study describes the incidence, outcome, and types of reported neurological complications in invasively mechanically ventilated (IMV) COVID-19 patients in relation to three periods during the pandemic. METHODS IMV COVID-19 ICU patients from the Dutch Maastricht Intensive Care COVID (MaastrICCht) cohort were included in a single-center study (March 2020 - October 2021). Demographic, clinical, and follow-up data were collected. Electronic medical records were screened for neurological complications during hospitalization. Three distinct periods (P1, P2, P3) were defined, corresponding to periods with high hospitalization rates. ICU survivors with and without reported neurological complications were compared in an exploratory analysis. RESULTS IMV COVID-19 ICU patients (n=324; median age 64 [IQR 57-72] years; 238 males (73.5%)) were stratified into P1 (n=94), P2 (n=138), and P3 (n=92). ICU mortality did not significantly change over time (P1=38.3%; P2=41.3%; P3=37.0%; p=.787). The incidence of reported neurological complications during ICU admission gradually decreased over the periods (P1=29.8%; P2=24.6%; P3=18.5%; p=.028). Encephalopathy/delirium (48/324 (14.8%)) and ICU-acquired weakness (32/324 (9.9%)) were most frequently reported and associated with ICU treatment intensity. ICU survivors with neurological complications (n=53) were older (p=.025), predominantly male (p=.037), and had a longer duration of IMV (p<.001) and ICU stay (p<.001), compared to survivors without neurological complications (n=132). A multivariable analysis revealed that only age was independently associated with the occurrence of neurological complications (ORadj=1.0541; 95% CI=1.0171-1.0925; p=.004). Health-related quality-of-life at follow-up was not significantly different between survivors with and without neurological complications (n = 82, p=.054). CONCLUSIONS A high but decreasing incidence of neurological complications was reported during three consecutive COVID-19 periods in IMV COVID-19 patients. Neurological complications were related to the intensity of ICU support and treatment, and associated with prolonged ICU stay, but did not lead to significantly worse reported health-related quality-of-life at follow-up.
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Affiliation(s)
- Noa van der Knaap
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Fleur de Vreeze
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Frank van Rosmalen
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Marieke S J N Wintjens
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Susanne van Santen
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - David E J Linden
- Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Julie Staals
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Walther N K A van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Bas C T van Bussel
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Marcel J H Ariës
- Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Research Institute of Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands.
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17
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Zhang H, Zhang A, Lin Y, Li C, Yang Y, Dong R, Lin X, Wang B, Bi Y. COVID-19 vaccination may prevent postoperative delirium in elderly patients undergoing elective non-cardiac surgery: The PNDRFAP and PNDABLE studies. Heliyon 2024; 10:e30414. [PMID: 38818170 PMCID: PMC11137356 DOI: 10.1016/j.heliyon.2024.e30414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 06/01/2024] Open
Abstract
Background Postoperative delirium (POD) often occurs in elderly patients after surgery. We conducted two clinical studies to determine whether COVID-19 vaccination has a protective effect on POD and to explore the role of CSF biomarkers in this process. Methods We conducted two clinical studies, Perioperative Neurocognitive Disorder Risk Factor and Prognosis (PNDRFAP) and Perioperative Neurocognitive Disorder and Biomarker Lifestyle (PNDABLE), in which patients more than or equal to 65 years old who have had elective non-cardiac surgery were enrolled. The preoperative cognitive status of patients were evaluated by Mini-Mental State Examination (MMSE) one day preoperatively. Confusion Assessment Method (CAM) was used to diagnose POD. We used the mediation model to analyze the relationship between CSF biomarkers, COVID-19 vaccination and POD, as well as Dynamic Nomogram to calculate the incidence of Non-Postoperative Delirium (NPOD). The main outcome of these studies was the incidence of POD during seven days postoperatively or before discharge, which was assessed by CAM. Results In the final, 705 participants were enrolled in the PNDRFAP study, and 638 patients in the PNDABLE. In both studies, we found that the occurrence of POD was lower in patients who had injected COVID-19 vaccination before surgery compared with those without vaccination (PNDRFAP: 10.20 % [21/205] vs 25.80 % [129/500], P < 0.001; PNDABLE: 2.40 % [4/164] vs 34.60 % [164/474], P < 0.001). Mediation analysis showed that the protective effect of preoperative COVID-19 vaccine on POD was significantly mediated by CSF Aβ42 (proportion = 17.56 %), T-tau (proportion = 19.64 %), Aβ42/T-tau (proportion = 29.67 %), and Aβ42/P-tau (proportion = 12.26 %). Conclusions COVID-19 vaccine is a protective factor for POD in old patients, which is associated with CSF biomarkers.
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Affiliation(s)
- Haoran Zhang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Aihua Zhang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Yanan Lin
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Chuan Li
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Yunchao Yang
- Department of Anesthesiology, Qingdao University Medical College, Qingdao, Shandong, China
| | - Rui Dong
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Xu Lin
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Bin Wang
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Yanlin Bi
- Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao, Shandong, China
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18
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Granholm ACE, Englund E, Gilmore A, Head E, Yong WH, Perez SE, Guzman SJ, Hamlett ED, Mufson EJ. Neuropathological findings in Down syndrome, Alzheimer's disease and control patients with and without SARS-COV-2: preliminary findings. Acta Neuropathol 2024; 147:92. [PMID: 38801558 PMCID: PMC11130011 DOI: 10.1007/s00401-024-02743-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/11/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024]
Abstract
The SARS-CoV-2 virus that led to COVID-19 is associated with significant and long-lasting neurologic symptoms in many patients, with an increased mortality risk for people with Alzheimer's disease (AD) and/or Down syndrome (DS). However, few studies have evaluated the neuropathological and inflammatory sequelae in postmortem brain tissue obtained from AD and people with DS with severe SARS-CoV-2 infections. We examined tau, beta-amyloid (Aβ), inflammatory markers and SARS-CoV-2 nucleoprotein in DS, AD, and healthy non-demented controls with COVID-19 and compared with non-infected brain tissue from each disease group (total n = 24). A nested ANOVA was used to determine regional effects of the COVID-19 infection on arborization of astrocytes (Sholl analysis) and percent-stained area of Iba-1 and TMEM 119. SARS-CoV-2 antibodies labeled neurons and glial cells in the frontal cortex of all subjects with COVID-19, and in the hippocampus of two of the three DS COVID-19 cases. SARS-CoV-2-related alterations were observed in peri-vascular astrocytes and microglial cells in the gray matter of the frontal cortex, hippocampus, and para-hippocampal gyrus. Bright field microscopy revealed scattered intracellular and diffuse extracellular Aβ deposits in the hippocampus of controls with confirmed SARS-CoV-2 infections. Overall, the present preliminary findings suggest that SARS-CoV-2 infections induce abnormal inflammatory responses in Down syndrome.
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Affiliation(s)
- Ann-Charlotte E Granholm
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Research Complex II, Aurora, CO, USA.
| | - Elisabet Englund
- Division of Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anah Gilmore
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Research Complex II, Aurora, CO, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California Irvine, Irvine, CA, USA
- Department of Neurology, University of California Irvine, Irvine, CA, USA
| | - William H Yong
- Department of Pathology and Laboratory Medicine, University of California Irvine, Irvine, CA, USA
| | - Sylvia E Perez
- Department of Translational Neuroscience and Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Samuel J Guzman
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Eric D Hamlett
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Elliott J Mufson
- Department of Translational Neuroscience and Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
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Molino C, Bergantini L, Santucci S, Pitinca MT, d'Alessandro M, Cameli P, Taddei S, Bargagli E. SARS-CoV-2 and Dysphagia: A Retrospective Analysis of COVID-19 Patients with Swallowing Disorders. Dysphagia 2024:10.1007/s00455-024-10715-0. [PMID: 38782803 DOI: 10.1007/s00455-024-10715-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/25/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND COVID-19 can lead to impairment of neural networks involved in swallowing, since the act of swallowing is coordinated and performed by a diffuse brain network involving peripheral nerves and muscles. Dysphagia has been identified as a risk and predictive factor for the severest form of SARS-CoV-2 infection. OBJECTIVES To investigate the association between swallowing disorders and COVID-19 in patients hospitalized for COVID-19. METHODS We collected demographic data, medical information specific to dysphagia and data on medical treatments of patients with COVID-19. RESULTS A total of 43 hospitalized COVID-19 patients were enrolled in the study. Twenty (46%) were evaluated positive for dysphagia and 23 (54%) were evaluated negative. Neurocognitive disorders and diabetes were mostly associated with patients who resulted positive for dysphagia. Respiratory impairment caused by COVID-19 seems to be a cause of dysphagia, since all patients who needed oxygen-therapy developed symptoms of dysphagia, unlike patients who did not. In the dysphagic group, alteration of the swallowing trigger resulted in the severest form of dysphagia. An association was found between the severest form of COVID-19 and dysphagia. This group consisted predominantly of males with longer hospitalization. CONCLUSIONS Identification of COVID-19 patients at risk for dysphagia is crucial for better patient management.
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Affiliation(s)
- Christopher Molino
- Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS), Siena University, Viale Bracci, Siena, 53100, Italy
| | - Laura Bergantini
- Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS), Siena University, Viale Bracci, Siena, 53100, Italy.
| | | | | | - Miriana d'Alessandro
- Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS), Siena University, Viale Bracci, Siena, 53100, Italy
| | - Paolo Cameli
- Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS), Siena University, Viale Bracci, Siena, 53100, Italy
| | | | - Elena Bargagli
- Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS), Siena University, Viale Bracci, Siena, 53100, Italy
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20
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Zhu Y, Cao X, Ying R, Liu K, Chai Y, Luo M, Huang Q, Gao P, Zhang C. Mapping the vast landscape of multisystem complications of COVID-19: Bibliometric analysis. Heliyon 2024; 10:e30760. [PMID: 38765136 PMCID: PMC11098853 DOI: 10.1016/j.heliyon.2024.e30760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/16/2024] [Accepted: 05/03/2024] [Indexed: 05/21/2024] Open
Abstract
Background With the rapid global spread of COVID-19, it has become evident that the virus can lead to multisystem complications, leading to a significant increase in related publications. Bibliometrics serves as a valuable tool for identifying highly cited literature and research hotspots within specific areas. Objective The aim of this study is to identify current research hotspots and future trends in COVID-19 complications. Methods The dataset was obtained from the Web of Science Core Collection, covering COVID-19 complications from December 8, 2019, to October 31, 2022. Various aspects, including publication general information, authors, journals, co-cited authors, co-cited references, research hotspots, and future trends, were subjected to analysis. Visual analysis was conducted using VOSviewer, The Online Analysis Platform of Literature Metrology, and Charticulator. Results There were 4597 articles in the study. The top three countries with the most published articles are the USA (n = 1350, 29.4 %), China (n = 765, 16.6 %), and Italy (n = 623, 13.6 %). USA and China have the closest collaborative relationship. The institute with the largest number of publications is Huazhong University of Science and Technology, followed by Harvard Medical School. Nevertheless, half of the top 10 institutes belong to the USA. "Rezaei, Nima" published 13 articles and ranked first, followed by "Yaghi, Shadi" with 12 articles and "Frontera, Jennifer" with 12 articles. The journal with the largest number of publications is "Journal of Clinical Medicine". The top 3 co-cited authors are "Zhou, Fei", "Guan, Wei-Jie", "Huang, Chaolin". The top 3 co-cited references addressed COVID-19's clinical features in China and noticed that COVID-19 patients had a wide range of complications. We also list four research hotspots. Conclusions This study conducted a bibliometric visual analysis of the literature on COVID-19 complications and summarized the current research hotspots. This study may provide valuable insights into the complications of COVID-19.
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Affiliation(s)
- Yi Zhu
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiyu Cao
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rongtao Ying
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ke Liu
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yilu Chai
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Maocai Luo
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qingsong Huang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peiyang Gao
- Department of Critical Care Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chuantao Zhang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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21
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Bobowik P, Gajewski J, Wiszomirska I, Maciejewska-Skrendo A, Leźnicka K, Kaczmarczyk K. The Impact of Resistance Training on Equilibrium Abilities and Quality of Life in Older Adults after SARS-CoV-2 Survival. J Clin Med 2024; 13:2747. [PMID: 38792288 PMCID: PMC11121851 DOI: 10.3390/jcm13102747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The scientific literature on COVID-19 and its long-term impacts on all-body systems and their treatments is still limited. The aim of the study was to create a safe protocol-based intervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. Methods: This study used a sample of 46 people (intervention group: n = 26; control group: n = 20). Resistance training (RT) was held twice a week, with 60 min per session for 8 weeks. The postural stability and quality of life questionnaire (WHQOOL) was completed during pre- and post-testing. Results: The results indicated significant differences in overall stability index (OSI) with eyes open (EO), anterior-posterior stability index (APSI) EO, fall-risk index 6-2 (FRI6-2) values in males (p < 0.05), and APSI EO (p < 0.05) values in females compared to control groups, respectively. In the training, a significant improvement was reported in OSI EO and APSI EO (p < 0.05) female groups compared to baseline results and in FRI6-2 values in both gender groups (p < 0.01-men, p < 0.05-women). The effect of the intervention was recorded in the intervention group in the OSI EO (Z = -3.12, p < 0.01, R = 0.533) and FRI6-2 (Z = -2.06, p < 0.05, R = 0.354). Additionally, significantly different reactions between the groups were observed in the psychological domain (DOM2) (Z = 2.194, p < 0.028, R = 0.389), social relationship domain (DOM3) (Z = 2.051, p < 0.0403, R = 0.361), and in question 2 concerning general health (Z = 3.309, p < 0.0009, R = 0.535). Conclusions: The findings indicate that RT had a positive effect on older adults affected by COVID-19, led to a significant improvement in their postural stability, and had a significant impact on elements of psychological well-being and quality of life.
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Affiliation(s)
- Patrycja Bobowik
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland; (I.W.); (K.K.)
| | - Jan Gajewski
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland;
| | - Ida Wiszomirska
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland; (I.W.); (K.K.)
| | - Agnieszka Maciejewska-Skrendo
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (A.M.-S.); (K.L.)
- Institute of Physical Culture Sciences, University of Szczecin, 70-453 Szczecin, Poland
| | - Katarzyna Leźnicka
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland; (A.M.-S.); (K.L.)
- Institute of Physical Culture Sciences, University of Szczecin, 70-453 Szczecin, Poland
| | - Katarzyna Kaczmarczyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland; (I.W.); (K.K.)
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22
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Akanchise T, Angelov B, Angelova A. Nanomedicine-mediated recovery of antioxidant glutathione peroxidase activity after oxidative-stress cellular damage: Insights for neurological long COVID. J Med Virol 2024; 96:e29680. [PMID: 38767144 DOI: 10.1002/jmv.29680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/15/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
Nanomedicine for treating post-viral infectious disease syndrome is at an emerging stage. Despite promising results from preclinical studies on conventional antioxidants, their clinical translation as a therapy for treating post-COVID conditions remains challenging. The limitations are due to their low bioavailability, instability, limited transport to the target tissues, and short half-life, requiring frequent and high doses. Activating the immune system during coronavirus (SARS-CoV-2) infection can lead to increased production of reactive oxygen species (ROS), depleted antioxidant reserve, and finally, oxidative stress and neuroinflammation. To tackle this problem, we developed an antioxidant nanotherapy based on lipid (vesicular and cubosomal types) nanoparticles (LNPs) co-encapsulating ginkgolide B and quercetin. The antioxidant-loaded nanocarriers were prepared by a self-assembly method via hydration of a lyophilized mixed thin lipid film. We evaluated the LNPs in a new in vitro model for studying neuronal dysfunction caused by oxidative stress in coronavirus infection. We examined the key downstream signaling pathways that are triggered in response to potassium persulfate (KPS) causing oxidative stress-mediated neurotoxicity. Treatment of neuronally-derived cells (SH-SY5Y) with KPS (50 mM) for 30 min markedly increased mitochondrial dysfunction while depleting the levels of both glutathione peroxidase (GSH-Px) and tyrosine hydroxylase (TH). This led to the sequential activation of apoptotic and necrotic cell death processes, which corroborates with the crucial implication of the two proteins (GSH-Px and TH) in the long-COVID syndrome. Nanomedicine-mediated treatment with ginkgolide B-loaded cubosomes and vesicular LNPs showed minimal cytotoxicity and completely attenuated the KPS-induced cell death process, decreasing apoptosis from 32.6% (KPS) to 19.0% (MO-GB), 12.8% (MO-GB-Quer), 14.8% (DMPC-PEG-GB), and 23.6% (DMPC-PEG-GB-Quer) via free radical scavenging and replenished GSH-Px levels. These findings indicated that GB-LNPs-based nanomedicines may protect against KPS-induced apoptosis by regulating intracellular redox homeostasis.
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Affiliation(s)
- Thelma Akanchise
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, Orsay, France
| | - Borislav Angelov
- Extreme Light Infrastructure ERIC, Department of Structural Dynamics, Dolni Brezany, Czech Republic
| | - Angelina Angelova
- Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, Orsay, France
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23
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Tang L, Guo Y, Shu C, Peng X, Qiu S, Li R, Liu P, Wei H, Liao S, Du Y, Guo D, Gao N, Zeng QL, Liu X, Ji F. Neurological manifestations and risk factors associated with poor prognosis in hospitalized children with Omicron variant infection. Eur J Pediatr 2024; 183:2353-2363. [PMID: 38429545 DOI: 10.1007/s00431-024-05495-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
There are increasing reports of neurological manifestation in children with coronavirus disease 2019 (COVID-19). However, the frequency and clinical outcomes of in hospitalized children infected with the Omicron variant are unknown. The aim of this study was to describe the clinical characteristics, neurological manifestations, and risk factor associated with poor prognosis of hospitalized children suffering from COVID-19 due to the Omicron variant. Participants included children older than 28 days and younger than 18 years. Patients were recruited from December 10, 2022 through January 5, 2023. They were followed up for 30 days. A total of 509 pediatric patients hospitalized with the Omicron variant infection were recruited into the study. Among them, 167 (32.81%) patients had neurological manifestations. The most common manifestations were febrile convulsions (n = 90, 53.89%), viral encephalitis (n = 34, 20.36%), epilepsy (n = 23, 13.77%), hypoxic-ischemic encephalopathy (n = 9, 5.39%), and acute necrotizing encephalopathy (n = 6, 3.59%). At discharge, 92.81% of patients had a good prognosis according to the Glasgow Outcome Scale (scores ≥ 4). However, 7.19% had a poor prognosis. Eight patients died during the follow-up period with a cumulative 30-day mortality rate of 4.8% (95% confidence interval (CI) 1.5-8.1). Multivariate analysis revealed that albumin (odds ratio 0.711, 95% CI 0.556-0.910) and creatine kinase MB (CK-MB) levels (odds ratio 1.033, 95% CI 1.004-1.063) were independent risk factors of poor prognosis due to neurological manifestations. The area under the curve for the prediction of poor prognosis with albumin and CK-MB was 0.915 (95%CI 0.799-1.000), indicating that these factors can accurately predict a poor prognosis. Conclusion: In this study, 32.8% of hospitalized children suffering from COVID-19 due to the Omicron variant infection experienced neurological manifestations. Baseline albumin and CK-MB levels could accurately predict poor prognosis in this patient population. What is Known: • Neurological injury has been reported in SARS-CoV-2 infection; compared with other strains, the Omicron strain is more likely to cause neurological manifestations in adults. • Neurologic injury in adults such as cerebral hemorrhage and epilepsy has been reported in patients with Omicron variant infection. What is New: • One-third hospitalized children with Omicron infection experience neurological manifestations, including central nervous system manifestations and peripheral nervous system manifestations. • Albumin and CK-MB combined can accurately predict poor prognosis (AUC 0.915), and the 30-day mortality rate of children with Omicron variant infection and neurological manifestations was 4.8%.
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Affiliation(s)
- Li Tang
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Yuxin Guo
- Department of Infectious Diseases, the Second Affiliated Hospital Xi'an Jiaotong University, No.157 Xi Wu Road, Xi'an, 710004, Shaanxi, China
| | - Chang Shu
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Xiaokang Peng
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Sikai Qiu
- Department of Infectious Diseases, the Second Affiliated Hospital Xi'an Jiaotong University, No.157 Xi Wu Road, Xi'an, 710004, Shaanxi, China
| | - Ruina Li
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Pan Liu
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Huijing Wei
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Shan Liao
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Yali Du
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Dandan Guo
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China
| | - Ning Gao
- Department of Infectious Diseases, the Second Affiliated Hospital Xi'an Jiaotong University, No.157 Xi Wu Road, Xi'an, 710004, Shaanxi, China
| | - Qing-Lei Zeng
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, No. 1, Eastern Jianshe Road, Zhengzhou, 450052, Henan, China.
| | - Xiaoguai Liu
- Department of Infectious Diseases, Xi'an Jiaotong University Affiliated Children's Hospital, No. 69 Xi Ju Yuan Alley, Xi'an, 710003, Shaanxi, China.
| | - Fanpu Ji
- Department of Infectious Diseases, the Second Affiliated Hospital Xi'an Jiaotong University, No.157 Xi Wu Road, Xi'an, 710004, Shaanxi, China.
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University) Ministry of Education of China, Xi'an, China.
- National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
- Shaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Xi'an, Shaanxi, China.
- Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education, Shaanxi, China.
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24
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Sun M, Manson ML, Guo T, de Lange ECM. CNS Viral Infections-What to Consider for Improving Drug Treatment: A Plea for Using Mathematical Modeling Approaches. CNS Drugs 2024; 38:349-373. [PMID: 38580795 PMCID: PMC11026214 DOI: 10.1007/s40263-024-01082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/07/2024]
Abstract
Neurotropic viruses may cause meningitis, myelitis, encephalitis, or meningoencephalitis. These inflammatory conditions of the central nervous system (CNS) may have serious and devastating consequences if not treated adequately. In this review, we first summarize how neurotropic viruses can enter the CNS by (1) crossing the blood-brain barrier or blood-cerebrospinal fluid barrier; (2) invading the nose via the olfactory route; or (3) invading the peripheral nervous system. Neurotropic viruses may then enter the intracellular space of brain cells via endocytosis and/or membrane fusion. Antiviral drugs are currently used for different viral CNS infections, even though their use and dosing regimens within the CNS, with the exception of acyclovir, are minimally supported by clinical evidence. We therefore provide considerations to optimize drug treatment(s) for these neurotropic viruses. Antiviral drugs should cross the blood-brain barrier/blood cerebrospinal fluid barrier and pass the brain cellular membrane to inhibit these viruses inside the brain cells. Some antiviral drugs may also require intracellular conversion into their active metabolite(s). This illustrates the need to better understand these mechanisms because these processes dictate drug exposure within the CNS that ultimately determine the success of antiviral drugs for CNS infections. Finally, we discuss mathematical model-based approaches for optimizing antiviral treatments. Thereby emphasizing the potential of CNS physiologically based pharmacokinetic models because direct measurement of brain intracellular exposure in living humans faces ethical restrictions. Existing physiologically based pharmacokinetic models combined with in vitro pharmacokinetic/pharmacodynamic information can be used to predict drug exposure and evaluate efficacy of antiviral drugs within the CNS, to ultimately optimize the treatments of CNS viral infections.
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Affiliation(s)
- Ming Sun
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Martijn L Manson
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Tingjie Guo
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Elizabeth C M de Lange
- Division of Systems Pharmacology and Pharmacy, Leiden Academic Center for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands.
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25
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Zheng Q, Cheng YR, Wang M, Ma X, Ye L, Xu Z, Feng Z. COVID-19 vaccinations for patients with epilepsy in Guizhou Province, China: A cross-sectional study. Heliyon 2024; 10:e29354. [PMID: 38623193 PMCID: PMC11016729 DOI: 10.1016/j.heliyon.2024.e29354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
Several COVID-19 vaccines have been approved for emergency use according to China's immunization programs. These vaccines has created hope for patients with epilepsy, because the vaccines can help to reduce their risk of becoming infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to investigate the COVID-19 vaccine safety in patients with epilepsy. Here, we assessed the time of symptom control and the features of adverse events of seizure patients following their COVID-19 vaccinations. The results showed that adverse events of COVID-19 vaccinations for epilepsy patients included local pain at the injection site, dizziness and headache, epileptic attack, somnolence, limb weakness, limb pain, allergy, and fever. In addition, the average recovery time of the adverse events was approximately 42 h. More importantly, our study showed that it was relatively safe to vaccinate epilepsy patients who did not experience seizures for approximately 12 months prior to the immunization date.
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Affiliation(s)
- Qian Zheng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- School of clinical medicine, Guizhou Medical University, Guiyang, China
| | - Yong-Ran Cheng
- School of Public Health, Hangzhou Medical College, Hangzhou, China
| | - Mingwei Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xuntai Ma
- Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Lan Ye
- School of Basic Medicine, Guizhou Medical University, Guiyang, China
| | - Zucai Xu
- Department of Neurology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhanhui Feng
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
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26
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Yamada S, Hashita T, Yanagida S, Sato H, Yasuhiko Y, Okabe K, Noda T, Nishida M, Matsunaga T, Kanda Y. SARS-CoV-2 causes dysfunction in human iPSC-derived brain microvascular endothelial cells potentially by modulating the Wnt signaling pathway. Fluids Barriers CNS 2024; 21:32. [PMID: 38584257 PMCID: PMC11000354 DOI: 10.1186/s12987-024-00533-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which is associated with various neurological symptoms, including nausea, dizziness, headache, encephalitis, and epileptic seizures. SARS-CoV-2 is considered to affect the central nervous system (CNS) by interacting with the blood-brain barrier (BBB), which is defined by tight junctions that seal paracellular gaps between brain microvascular endothelial cells (BMECs). Although SARS-CoV-2 infection of BMECs has been reported, the detailed mechanism has not been fully elucidated. METHODS Using the original strain of SARS-CoV-2, the infection in BMECs was confirmed by a detection of intracellular RNA copy number and localization of viral particles. BMEC functions were evaluated by measuring transendothelial electrical resistance (TEER), which evaluates the integrity of tight junction dynamics, and expression levels of proinflammatory genes. BMEC signaling pathway was examined by comprehensive RNA-seq analysis. RESULTS We observed that iPSC derived brain microvascular endothelial like cells (iPSC-BMELCs) were infected with SARS-CoV-2. SARS-CoV-2 infection resulted in decreased TEER. In addition, SARS-CoV-2 infection decreased expression levels of tight junction markers CLDN3 and CLDN11. SARS-CoV-2 infection also increased expression levels of proinflammatory genes, which are known to be elevated in patients with COVID-19. Furthermore, RNA-seq analysis revealed that SARS-CoV-2 dysregulated the canonical Wnt signaling pathway in iPSC-BMELCs. Modulation of the Wnt signaling by CHIR99021 partially inhibited the infection and the subsequent inflammatory responses. CONCLUSION These findings suggest that SARS-CoV-2 infection causes BBB dysfunction via Wnt signaling. Thus, iPSC-BMELCs are a useful in vitro model for elucidating COVID-19 neuropathology and drug development.
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Affiliation(s)
- Shigeru Yamada
- Division of Pharmacology, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-Ku, Kawasaki, 210-9501, Japan
| | - Tadahiro Hashita
- Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi, Japan
| | - Shota Yanagida
- Division of Pharmacology, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-Ku, Kawasaki, 210-9501, Japan
| | - Hiroyuki Sato
- Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi, Japan
| | - Yukuto Yasuhiko
- Division of Pharmacology, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-Ku, Kawasaki, 210-9501, Japan
| | - Kaori Okabe
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takamasa Noda
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Brain Bioregulatory Science, The Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Motohiro Nishida
- Department of Physiology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cardiocirculatory Signaling, National Institute for Physiological Sciences and Exploratory Research Center on Life and Living Systems, National Institutes of Natural Sciences, Okazaki, Aichi, Japan
| | - Tamihide Matsunaga
- Department of Clinical Pharmacy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Aichi, Japan
| | - Yasunari Kanda
- Division of Pharmacology, National Institute of Health Sciences, 3-25-26, Tonomachi, Kawasaki-Ku, Kawasaki, 210-9501, Japan.
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Clemente-Suárez VJ, Redondo-Flórez L, Beltrán-Velasco AI, Belinchón-deMiguel P, Ramos-Campo DJ, Curiel-Regueros A, Martín-Rodríguez A, Tornero-Aguilera JF. The Interplay of Sports and Nutrition in Neurological Health and Recovery. J Clin Med 2024; 13:2065. [PMID: 38610829 PMCID: PMC11012304 DOI: 10.3390/jcm13072065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
This comprehensive review explores the dynamic relationship between sports, nutrition, and neurological health. Focusing on recent clinical advancements, it examines how physical activity and dietary practices influence the prevention, treatment, and rehabilitation of various neurological conditions. The review highlights the role of neuroimaging in understanding these interactions, discusses emerging technologies in neurotherapeutic interventions, and evaluates the efficacy of sports and nutritional strategies in enhancing neurological recovery. This synthesis of current knowledge aims to provide a deeper understanding of how lifestyle factors can be integrated into clinical practices to improve neurological outcomes.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain;
| | | | - Pedro Belinchón-deMiguel
- Department of Nursing and Nutrition, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Agustín Curiel-Regueros
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (A.C.-R.); (J.F.T.-A.)
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Tan L, Wang F, Huang Y, Fu C, Zhang H, Feng J, Xu Y, Ye X, Tang R, Chen Y, Mou L, Li R, Chen J, Xian J. The Impact of SARS-CoV-2 Infection on the Length of Stay in the Neuro-ICU:A Prospective Multicenter Cohort Study in Eight Neuro-ICU, China Between February and April 2023. Neuropsychiatr Dis Treat 2024; 20:765-775. [PMID: 38577632 PMCID: PMC10992672 DOI: 10.2147/ndt.s447887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/21/2024] [Indexed: 04/06/2024] Open
Abstract
Purpose The SARS-CoV-2 infection cases are increasing rapidly in neuro-intensive care units (neuro-ICUs) at the beginning of 2023 in China. We aimed to characterize the prevalence, risk factors, and prognosis of critically ill patients treated in neuro-ICUs. Materials and Methods In the prospective, multicenter, observational registry study, critically ill patients with intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI) admitted to eight Chinese neuro-ICUs between Feb 16, 2023, to Apr 30, 2023 were enrolled for the study. Mortality and ICU stay day were used as the primary outcomes. Results 131 patients were finally included and analyzed (mean age 60.36 years [SD 13.81], 64.12% male, 39.69% SARS-CoV-2 infected). The mortality is higher in the SARS-CoV-2 infection group without statistical signification (7.69% vs 5.06%, p>0.05). The length of stay (LOS) in neuro-ICUs was significantly longer among the SARS-CoV-2 infection patients (7(1-12) vs 4(1-8), p<0.01), with increased viral pneumonia occurrence (58.54% vs 7.32%, p<0.01). SARS-CoV-2 infection, surgery, and low GCS scores were independent risk factors for prolonged LOS, and respiratory/renal failure were independent risk factors for death. Conclusion Based on the present neuro-ICU cohort, SARS-CoV-2 infection was a significant risk for the prolonged LOS of neuro-critically ill patients. Trial Registration Registered with Chictr.org.cn (ChiCTR2300068355) at 16 February 2023, Prospective registration. https://www.chictr.org.cn/showproj.html?proj=188252.
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Affiliation(s)
- Liang Tan
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Feilong Wang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Yi Huang
- Department of Neurosurgery, The Ninth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Chuhua Fu
- Department of Neurosurgery, Xiangyang No.1 People’s Hospital, University of Medicine, Xiangyang, Hubei, People’s Republic of China
| | - Haijun Zhang
- Department of Neurosurgery, Kaifeng Central Hospital, Kaifeng, Henan, People’s Republic of China
| | - Jianfei Feng
- Department of Encephalopathy, Beibei Traditional Chinese Medical Hospital, Chongqing, People’s Republic of China
| | - Yincai Xu
- Department of Neurosurgery, Zheng Coal General Hospital, Zhengzhou, Henan Province, People’s Republic of China
| | - Xinzhen Ye
- Department of Neurosurgery, Songshan General Hospital, Chongqing, People’s Republic of China
| | - Rongrui Tang
- Department of Neurosurgery, University-Town Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yinglian Chen
- Zhuhai Brainlightning Research Institute, Zhuhai City, Guangdong, People’s Republic of China
| | - Liansheng Mou
- Department of Neurosurgery, Liangping District People’s Hospital, Chongqing, People’s Republic of China
| | - Ronghao Li
- Department of Basic Medicine, Army Medical University, Chongqing, People’s Republic of China
| | - Jingyu Chen
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Jishu Xian
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
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Hanani M. Satellite Glial Cells in Human Disease. Cells 2024; 13:566. [PMID: 38607005 PMCID: PMC11011452 DOI: 10.3390/cells13070566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
Satellite glial cells (SGCs) are the main type of glial cells in sensory ganglia. Animal studies have shown that these cells play essential roles in both normal and disease states. In a large number of pain models, SGCs were activated and contributed to the pain behavior. Much less is known about SGCs in humans, but there is emerging recognition that SGCs in humans are altered in a variety of clinical states. The available data show that human SGCs share some essential features with SGCs in rodents, but many differences do exist. SGCs in DRG from patients suffering from common painful diseases, such as rheumatoid arthritis and fibromyalgia, may contribute to the pain phenotype. It was found that immunoglobulins G (IgG) from fibromyalgia patients can induce pain-like behavior in mice. Moreover, these IgGs bind preferentially to SGCs and activate them, which can sensitize the sensory neurons, causing nociception. In other human diseases, the evidence is not as direct as in fibromyalgia, but it has been found that an antibody from a patient with rheumatoid arthritis binds to mouse SGCs, which leads to the release of pronociceptive factors from them. Herpes zoster is another painful disease, and it appears that the zoster virus resides in SGCs, which acquire an abnormal morphology and may participate in the infection and pain generation. More work needs to be undertaken on SGCs in humans, and this review points to several promising avenues for better understanding disease mechanisms and developing effective pain therapies.
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Affiliation(s)
- Menachem Hanani
- Laboratory of Experimental Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem 91240, Israel; ; Tel.: +972-2-5844721
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
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Kim JH, Yoon D, Ko HY, Jung K, Sunwoo JS, Shin WC, Byun JI, Shin JY. Risk of encephalitis and meningitis after COVID-19 vaccination in South Korea: a self-controlled case series analysis. BMC Med 2024; 22:123. [PMID: 38486297 PMCID: PMC10941581 DOI: 10.1186/s12916-024-03347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/07/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Several neurological manifestations shortly after a receipt of coronavirus infectious disease 2019 (COVID-19) vaccine have been described in the recent case reports. Among those, we sought to evaluate the risk of encephalitis and meningitis after COVID-19 vaccination in the entire South Korean population. METHODS We conducted self-controlled case series (SCCS) analysis using the COVID-19 immunization record data from the Korea Disease Control Agency between February 2021 and March 2022, linked with the National Health Insurance Database between January 2021 and October 2022. We retrieved all medical claims of adults aged 18 years or older who received at least one dose of COVID-19 vaccines (BNT162b2, mRNA-1273, ChAdOx1-S, or Ad26.COV2.S), and included only those who had a diagnosis record for encephalitis or meningitis within the 240-day post-vaccination period. With day 0 defined as the date of vaccination, risk window was defined as days 1-28 and the control window as the remainder period excluding the risk windows within the 240-day period. We used conditional Poisson regression to estimate the incidence rate ratios (IRR) with 95% confidence intervals (CI), stratified by dose and vaccine type. RESULTS From 129,956,027 COVID-19 vaccine doses administered to 44,564,345 individuals, there were 251 and 398 cases of encephalitis and meningitis during the risk window, corresponding to 1.9 and 3.1 cases per 1 million doses, respectively. Overall, there was an increased risk of encephalitis in the first 28 days of COVID-19 vaccination (IRR 1.26; 95% CI 1.08-1.47), which was only significant after a receipt of ChAdOx1-S (1.49; 1.03-2.15). For meningitis, no increased risk was observed after any dose of COVID-19 vaccine (IRR 1.03; 95% CI 0.91-1.16). CONCLUSIONS Our findings suggest an overall increased risk of encephalitis after COVID-19 vaccination. However, the absolute risk was small and should not impede COVID-19 vaccine confidence. No significant association was found between the risk of meningitis and COVID-19 vaccination.
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Affiliation(s)
- Ju Hwan Kim
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Dongwon Yoon
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Hwa Yeon Ko
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Kyungyeon Jung
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, South Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea.
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Nielsen NM, Spiliopoulos L, Hansen JV, Videbech P, Hviid A. SARS-CoV-2 Infection and Risk of Postacute Psychiatric and Neurologic Diagnoses: A Nationwide Danish Cohort Study. Neurology 2024; 102:e208113. [PMID: 38382013 DOI: 10.1212/wnl.0000000000208113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/16/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The extent and burden of postacute psychiatric and neurologic manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not yet fully understood. To evaluate the association between SARS-CoV-2 infection and postacute manifestations of psychiatric and neurologic disorders, we conducted a nationwide cohort study including the entire Danish population aged 12 years or older on March 1, 2020. METHODS Individuals were followed up for SARS-CoV-2 infection and diagnosis of subsequent psychiatric and neurologic disorders from March 1, 2020, to January 31, 2023, using the Danish nationwide coronavirus disease 2019 (COVID-19) test surveillance database and the Danish National Patient Registry. The main period of interest was 1-12 months after infection. Incidence rate ratios (IRRs) of new onset of 11 psychiatric and 30 neurologic disorders were calculated by comparing incidence rates of disorders between SARS-CoV-2-positive individuals and individuals without a positive test (nonpositive individuals). Stratified analyses were conducted according to COVID-19 vaccination status, variant period, age, sex, and severity of infection. RESULTS Overall, 1,775,639 individuals in the study cohort (n = 3,239,008) were tested SARS-CoV-2 positive during follow-up. SARS-CoV-2-positive individuals compared with nonpositive individuals were at 24% reduced risk of any psychiatric disease (IRR 0.76, 95% CI 0.74-0.78) in the postacute period. The risk of any neurologic disorder was slightly higher among SARS-CoV-2-positive individuals than among those without a positive test (IRR 1.05, 95% CI 1.04-1.07). IRRs for specific disorders varied considerably from a 3.9-fold increased risk of change in sense of smell or taste (IRR 3.91, 95% CI 2.77-5.53) to a 29% reduced risk of dementia (IRR 0.71, 95% CI 0.65-0.78). The severity of infection and vaccination status, more so than age, sex, and variant, were found to significantly influence the stratified IRRs. Compared with nonpositive individuals, hospitalized patients with COVID-19 were at a 2.1-fold (IRR 2.05, 95% CI 1.78-2.37) increased risk of psychiatric disorders and at a 2.4-fold increased risk of neurologic disorders (IRR 2.44, 95% CI 2.29-2.60). DISCUSSION Our study does not support previous findings of substantial postacute neurologic and psychiatric morbidities among the general population of SARS-CoV-2-infected individuals, but does corroborate an elevated risk among the most severe cases with COVID-19.
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Affiliation(s)
- Nete M Nielsen
- From the Department of Epidemiology Research (N.M.N., L.S., J.V.H., A.H.), Statens Serum Institut, Copenhagen; Focused Research Unit in Neurology (N.M.N.), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa; Center for Neuropsychiatric Depression Research (P.V.), Mental Health Center Glostrup and University of Copenhagen, Glostrup; Clinical Institute (P.V.), University of Copenhagen, and Pharmacovigilance Research Center (A.H.), Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Lampros Spiliopoulos
- From the Department of Epidemiology Research (N.M.N., L.S., J.V.H., A.H.), Statens Serum Institut, Copenhagen; Focused Research Unit in Neurology (N.M.N.), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa; Center for Neuropsychiatric Depression Research (P.V.), Mental Health Center Glostrup and University of Copenhagen, Glostrup; Clinical Institute (P.V.), University of Copenhagen, and Pharmacovigilance Research Center (A.H.), Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Jørgen V Hansen
- From the Department of Epidemiology Research (N.M.N., L.S., J.V.H., A.H.), Statens Serum Institut, Copenhagen; Focused Research Unit in Neurology (N.M.N.), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa; Center for Neuropsychiatric Depression Research (P.V.), Mental Health Center Glostrup and University of Copenhagen, Glostrup; Clinical Institute (P.V.), University of Copenhagen, and Pharmacovigilance Research Center (A.H.), Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Poul Videbech
- From the Department of Epidemiology Research (N.M.N., L.S., J.V.H., A.H.), Statens Serum Institut, Copenhagen; Focused Research Unit in Neurology (N.M.N.), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa; Center for Neuropsychiatric Depression Research (P.V.), Mental Health Center Glostrup and University of Copenhagen, Glostrup; Clinical Institute (P.V.), University of Copenhagen, and Pharmacovigilance Research Center (A.H.), Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
| | - Anders Hviid
- From the Department of Epidemiology Research (N.M.N., L.S., J.V.H., A.H.), Statens Serum Institut, Copenhagen; Focused Research Unit in Neurology (N.M.N.), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa; Center for Neuropsychiatric Depression Research (P.V.), Mental Health Center Glostrup and University of Copenhagen, Glostrup; Clinical Institute (P.V.), University of Copenhagen, and Pharmacovigilance Research Center (A.H.), Department of Drug Design and Pharmacology, University of Copenhagen, Denmark
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Balduz M, Fidancı H. Visual evoked potential abnormalities in patients with COVID-19. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231061. [PMID: 38451579 PMCID: PMC10913780 DOI: 10.1590/1806-9282.20231061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVE It has been suggested that diseases that may cause visual evoked potential abnormality, such as optic neuritis, may be associated with the coronavirus disease 2019. This study aimed to find out whether there are visual evoked potential abnormalities in coronavirus disease 2019 patients using pattern reversal visual evoked potential and flash visual evoked potential. METHODS Patients with a history of coronavirus disease 2019 (coronavirus disease 2019 patients) and controls were included in this prospective case-control study. This study was conducted in the Clinical Neurophysiology Laboratory of Adana City Training and Research Hospital. Individuals without visual impairment were included. Coronavirus disease 2019 patients were required to have clinical features consistent with previous acute infection and a positive nose swab polymerase chain reaction test. Visual evoked potential was applied to coronavirus disease 2019 patients between July 2020 and July 2021. Controls consisted of patients without a history of chronic disease who underwent a visual evoked potential study between June 2017 and June 2018 due to headache or dizziness. Pattern reversal visual evoked potential and flash visual evoked potential were applied to all participants. N75, P100, and N135 waves obtained from pattern reversal visual evoked potential and P1, N1, P2, N2, P3, and N3 waves obtained from flash visual evoked potential were analyzed. RESULTS A total of 44 coronavirus disease 2019 patients and 40 controls were included in the study. Age and gender were not different between the two groups. Pattern reversal visual evoked potential parameters were not different between the two groups. Right P2 latency was 114.4±21.1 and 105.5±14.7 ms in coronavirus disease 2019 patients and controls, respectively (p=0.031). Patients with P100 and P2 wave abnormalities were 6 (13.6%) and 13 (29.6%), respectively. CONCLUSION This study showed that there may be visual evoked potential abnormalities in coronavirus disease 2019 patients.
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Affiliation(s)
- Metin Balduz
- Adana City Training and Research Hospital, Department of Neurology – Adana, Turkey
| | - Halit Fidancı
- Adana City Training and Research Hospital, Division of Clinical Neurophysiology, Department of Neurology – Adana, Turkey
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Ku YS, Joa KL, Kim MO, Kim CH, Jung HY. Quadriplegia, Dysphagia and Ataxia Manifested in a Child With COVID-19 Related Acute Necrotizing Encephalopathy: A Case Report. BRAIN & NEUROREHABILITATION 2024; 17:e2. [PMID: 38585028 PMCID: PMC10990845 DOI: 10.12786/bn.2024.17.e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 04/09/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, presents primarily with respiratory symptoms. However, children with COVID-19 are usually asymptomatic or mild acute symptoms and also neurological manifestations have also been observed. We report the case of a 7-year-old girl who presented with high fever and altered mental status, leading to a diagnosis of COVID-19 and acute necrotizing encephalopathy (ANE). The patient received intensive medical care in the intensive care unit and subsequently underwent rehabilitation programs due to neurological functional sequelae. Neurological complications in COVID-19, including ANE, may result from potential viral nerve involvement, cytokine storms, and the blood-brain barrier disruption. Early rehabilitation plays a pivotal role in managing COVID-19-related neurological complications and enhancing patients' functional outcomes. Further research is essential to gain a better understanding of the mechanisms and treatment strategies for neurological manifestations in pediatric COVID-19 patients, particularly those with multisystem inflammatory syndrome in child.
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Affiliation(s)
- Young-Su Ku
- Department of Physical and Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
| | - Kyung-Lim Joa
- Department of Physical and Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
| | - Myeong-Ok Kim
- Department of Physical and Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
| | - Chang-Hwan Kim
- Department of Physical and Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
| | - Han-Young Jung
- Department of Physical and Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
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Tramonti C, Graziani F, Pasqualone E, Ricci E, Moncini C, Lombardi B. Outpatient rehabilitation in post-acute COVID-19 patients: a combined progressive treatment protocol. Disabil Rehabil 2024:1-11. [PMID: 38407196 DOI: 10.1080/09638288.2024.2316797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE to investigate the effectiveness of a 4-week combined progressive program on functional abilities, disability status and quality of life (QoL) in COVID-19 recovered patients. MATERIALS & METHODS 18 COVID-19 recovered patients performed a combined rehabilitation treatment accounting for 12 sessions, including both respiratory and motor training sessions. A careful monitoring of exercise intensity, duration and progression to tailor complexity evolution on patients' competencies was carried out. Patients were monitored with different functional scales and self-reported questionnaires before (T0) and after (T1) rehabilitation. RESULTS 6-Minutes Walk Test, Timed Up and Go Test and Short Physical Performance Battery significantly improved, while Physiological Cost Index presented a significant reduction after rehabilitation. Moreover, Barthel Index significantly improved and patients presented significantly increased upper and lower limbs strength at T1. Furthermore, mMRC Dyspnoea Scale presented a significant reduction after training. Finally, physical and psychological well-being scales improved according to Short-Form 36; while, self-reported questionnaires related to mood and depression showed no significant modification after rehabilitation. CONCLUSIONS results evidenced the efficacy of the combined progressive intervention in COVID-19 recovered patients. The specific customization on patients' needs and the careful exercise monitoring promoted improvements on functional abilities and disability status, with positive impact on QoL.
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Affiliation(s)
- Caterina Tramonti
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
- Levante Ligure Rehabilitation Center, Fondazione Don C. Gnocchi Onlus, La Spezia, Italy
| | | | | | - Eleonora Ricci
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
| | - Cristina Moncini
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
| | - Bruna Lombardi
- Department of Physical and Rehabilitation Medicine, Firenze, Italy
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Gajurel BP, Yadav SK, Nepal G, Pant S, Yadav M, Shah R, Shah S. Neurological manifestations and complications of COVID-19 in patients admitted to a tertiary care center in Nepal during the second wave. Medicine (Baltimore) 2024; 103:e36017. [PMID: 38363915 PMCID: PMC10869060 DOI: 10.1097/md.0000000000036017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/18/2023] [Indexed: 02/18/2024] Open
Abstract
Neurological symptoms and signs of Coronavirus disease-19 (COVID-19) can accompany, follow, or precede respiratory symptoms and signs; hence, they are important in the diagnosis and management of COVID-19 patients. In this retrospective study conducted during the second wave of COVID-19, we included all patients diagnosed with COVID-19 using real-time polymerase chain reaction and admitted to the Tribhuvan University Teaching Hospital between June 2021 and October 2021. The patients were categorized into 2 groups: group A (with neurological manifestations or complications) and Group-B (without neurological manifestations or complications). The 2 groups were compared in terms of intensive care unit (ICU) admission, need for ventilatory support, length of hospital stay, and various outcomes. The study included 235 participants ranging in age from 13 to 102 years (mean age = 54 years, standard deviation = 18). Among the participants, 54.50% were male. The proportion of individuals in group A was higher (59.15%, N = 139) than that in Group-B (40.85%, N = 96). Notably, a significantly greater number of patients were admitted to the ICU in Group B than in Group A. However, there were no statistically significant differences in the need for ventilatory support or hospital stay between the 2 groups. Interestingly, group A showed a higher rate of improvement (Z = -3.1145, P = .00188, 95% CI), while Group-B had a higher rate of mortality (Z = 4.5562, P < .00001, 95% CI). Altered mental status and stroke have been specifically linked to poorer outcomes, whereas typical neurological manifestations, such as hyposmia, hypogeusia, dizziness, headache, and myalgia, are associated with better outcomes.
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Affiliation(s)
- Bikram Prasad Gajurel
- Department of Neurology Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sushil Kumar Yadav
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
| | - Gaurav Nepal
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
| | - Sobin Pant
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
| | - Manish Yadav
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
| | - Ravi Shah
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
| | - Sumit Shah
- Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal
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Wang L, Wang Z, Huang R, Li W, Zheng D. SARS-CoV-2 may play a direct role in the pathogenesis of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19: A CARE-compliant case report and literature review. Medicine (Baltimore) 2024; 103:e37192. [PMID: 38306528 PMCID: PMC10843456 DOI: 10.1097/md.0000000000037192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
RATIONALE During the past 3 years of the corona virus disease 2019 (COVID-19) pandemic, COVID-19 has been recognized to cause various neurological complications, including rare posterior reversible encephalopathy syndrome (PRES). In previously reported cases of PRES associated with COVID-19, the majority of patients had severe COVID-19 infection and known predisposing factors for PRES, such as uncontrolled hypertension, renal dysfunction, and use of immunosuppressants. It remains unclear whether these risk factors or infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributes to the development of PRES in these patients. Here we report a special case of PRES associated with COVID-19 without any known risk factors for PRES, indicating the SARS-CoV-2's direct role in the pathogenesis of PRES associated with COVID-19. PATIENT CONCERNS An 18-year-old female patient presented to the emergency department with abdominal pain. Preliminary investigations showed no abnormalities, except for positive results in novel coronavirus nucleic acid tests using oropharyngeal swabs. However, the patient subsequently developed tonic-clonic seizures, headaches, and vomiting on the second day. Extensive investigations have been performed, including brain MRI and lumbar puncture. Brain MRI showed hypointense T1-weighted and hyperintense T2-weighted lesions in the bilateral occipital, frontal, and parietal cortices without enhancement effect. Blood and cerebrospinal fluid analyses yielded negative results. The patient had no hypertension, renal insufficiency, autoimmune disease, or the use of immunosuppressants or cytotoxic drugs. DIAGNOSES PRES was diagnosed based on the clinical features and typical MRI findings of PRES. INTERVENTIONS Symptomatic treatments such as anticonvulsants were administered to the patients. OUTCOMES The patient fully recovered within 1 week. The initial MRI abnormalities also disappeared completely on a second MR examination performed 11 days later, supporting the diagnosis of PRES. The patient was followed up for 6 months and remained in a normal state. LESSONS The current case had no classical risk factors for PRES, indicating that although the cause of PRES in COVID-19 patients may be multifactorial, the infection of SARS-CoV-2 may play a direct role in the pathogenesis of PRES associated with COVID-19.
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Affiliation(s)
- Lishen Wang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhihan Wang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Rui Huang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weishuai Li
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dongming Zheng
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
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Błażejewski G, Witkoś J, Hartman-Petrycka M. Changes in sensitivity and hedonic rating to transcutaneous electrical nerve stimulation following COVID-19. Sci Rep 2024; 14:1233. [PMID: 38216666 PMCID: PMC10786926 DOI: 10.1038/s41598-024-51596-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
COVID-19 affects not only the respiratory system but also other biological systems such as the nervous system. Usually, these changes are reported based on the patient's subjective description. The aim of our study, therefore, was to objectively determine the effect that the SARS-CoV-2 virus and COVID-19 disease has on sensory threshold and the hedonic and subjective perception of an electrical stimulus. The sensory threshold was tested on the inner forearm by applying non-invasive transcutaneous electrical nerve stimulation (TENS) with 100 Hz and 100 µs parameters and a biphasic current waveform. The study involved 211 participants, aged 22-79 years, with a mean age of 56.9 ± 12.1 years. There were 131 subjects in the COVID group, while the NON-COVID group, the control group, was matched to the COVID group in terms of gender, age, body mass index and presence of chronic diseases. The research was carried out in 2022. Sensory sensitivity was highest in the group that had suffered with COVID-19. The median sensory sensitivity was 11 mA in the COVID group and 14 mA (p < 0.001) in the NON-COVID group, however, the current sensitivity threshold decreased over time (R = 0.52, p < 0.001). Post COVID-19, the electrical stimulus was more often perceived as unpleasant: COVID versus NON-COVID (23% vs. 3%, p < 0.001) and as a different sensation to tingling (27% vs. 2%, p < 0.001). Post-COVID-19 patients have a lower sensory threshold, the electrical stimulus is more often described as unpleasant and in subjective feelings it is more often described as pinching. The differences between COVID and NON-COVID decrease with time since the onset of COVID symptoms.
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Affiliation(s)
- Grzegorz Błażejewski
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland.
| | - Joanna Witkoś
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Magdalena Hartman-Petrycka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
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Hanganu AR, Niculae CM, Dulămea AO, Moisă E, Constantin R, Neagu G, Hristea A. The outcome and risk factors associated with central and peripheral nervous system involvement in hospitalized COVID-19 patients: a retrospective cohort study. Front Neurol 2024; 14:1338593. [PMID: 38274890 PMCID: PMC10808716 DOI: 10.3389/fneur.2023.1338593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction SARS-CoV-2 infection can affect any organ, including both the central nervous system (CNS) and peripheral nervous system (PNS). The aim of this study was to explore the outcome and risk factors associated with the involvement of either CNS or PNS in a cohort of hospitalized COVID-19 patients. Methods We performed a retrospective observational cohort study of hospitalized adult patients with COVID-19, between May 2020 and December 2022, presenting with new onset neurological disabilities any time after admission. Results We included 115 patients, 72 with CNS manifestations and 43 with PNS involvement. The CNS manifestations were COVID-19-associated encephalopathy, headache, neurovascular events, and seizures in 80.5, 43, 31.9, and 11.1% of patients, respectively. The neurovascular events were ischemic stroke in 17 (23.6%) patients, hemorrhagic stroke in 6 (8.3%) patients, venous thrombosis in 1 (1.4%) patient, and subarachnoid hemorrhage in 1 (1.4%) patient. Cranial nerve involvement was the most frequent PNS manifestation in 34 (79%) cases, followed by mononeuritis in 5 (11.6%) patients and polyneuropathy in 4 (9.3%) patients. The affected cranial nerves were the vestibulocochlear nerve in 26 (60.5%) patients, the olfactory nerve in 24 (55.8%) patients, the oculomotor nerves in 5 (11.6%) patients, and the facial nerve in 1 (2.3%) patient. Two patients (9.3%) presented with polyneuritis cranialis. Older age (HR = 1.02, 95% CI: 1.003-1.037, p = 0.01), COVID severity (HR = 2.53, 95% CI: 1.42-4.5, p = 0.002), ischemic cardiac disease (HR = 2.42, 95% CI: 1.05-5.6, p = 0.03), and increased D-dimers (HR = 1.00, 95% CI: 1.00-1.00, p = 0.02) were independently associated with the development of CNS manifestations. The factors associated with in-hospital mortality were age (HR = 1.059, 95% CI: 1.024-1.096, p = 0.001), C-reactive protein (HR = 1.006, 95% CI: 1.00-1.011, p = 0.03), CNS involvement (HR = 9.155, 95% CI: 1.185-70.74, p = 0.03), and leucocyte number (HR = 1.053, 95% CI: 1.026-1.081, p < 0.001). Conclusion COVID-19-associated encephalopathy was the most common CNS manifestation in our study, but neurovascular events are also important considering the overlap between inflammatory and prothrombotic pathways, especially in severe cases. CNS involvement was associated with in-hospital all-cause mortality. PNS findings were various, involving mostly the cranial nerves, especially the vestibulocochlear nerve.
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Affiliation(s)
- Andreea Raluca Hanganu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania
- Fundeni Clinical Institute, Bucharest, Romania
| | - Cristian-Mihail Niculae
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania
| | - Adriana Octaviana Dulămea
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Fundeni Clinical Institute, Bucharest, Romania
| | - Emanuel Moisă
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Elias University Emergency Hospital, Bucharest, Romania
| | - Rareș Constantin
- National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania
| | - Georgiana Neagu
- National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania
| | - Adriana Hristea
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- National Institute for Infectious Diseases “Prof. Dr. Matei Bals”, Bucharest, Romania
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Gavilán E, Medina-Guzman R, Bahatyrevich-Kharitonik B, Ruano D. Protein Quality Control Systems and ER Stress as Key Players in SARS-CoV-2-Induced Neurodegeneration. Cells 2024; 13:123. [PMID: 38247815 PMCID: PMC10814689 DOI: 10.3390/cells13020123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
The COVID-19 pandemic has brought to the forefront the intricate relationship between SARS-CoV-2 and its impact on neurological complications, including potential links to neurodegenerative processes, characterized by a dysfunction of the protein quality control systems and ER stress. This review article explores the role of protein quality control systems, such as the Unfolded Protein Response (UPR), the Endoplasmic Reticulum-Associated Degradation (ERAD), the Ubiquitin-Proteasome System (UPS), autophagy and the molecular chaperones, in SARS-CoV-2 infection. Our hypothesis suggests that SARS-CoV-2 produces ER stress and exploits the protein quality control systems, leading to a disruption in proteostasis that cannot be solved by the host cell. This disruption culminates in cell death and may represent a link between SARS-CoV-2 and neurodegeneration.
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Affiliation(s)
- Elena Gavilán
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla (US), 41012 Sevilla, Spain; (R.M.-G.); (B.B.-K.); (D.R.)
- Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Junta de Andalucía, CSIC, University of Seville (US), 41013 Sevilla, Spain
| | - Rafael Medina-Guzman
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla (US), 41012 Sevilla, Spain; (R.M.-G.); (B.B.-K.); (D.R.)
| | - Bazhena Bahatyrevich-Kharitonik
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla (US), 41012 Sevilla, Spain; (R.M.-G.); (B.B.-K.); (D.R.)
- Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Junta de Andalucía, CSIC, University of Seville (US), 41013 Sevilla, Spain
| | - Diego Ruano
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Sevilla (US), 41012 Sevilla, Spain; (R.M.-G.); (B.B.-K.); (D.R.)
- Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Junta de Andalucía, CSIC, University of Seville (US), 41013 Sevilla, Spain
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Mikheeva AG, Topuzova MP, Malko VA, Zhilina ES, Mikhailova AA, Lagutina DI, Karonova TL, Alekseeva TM. Mood Disorders After COVID-19. ANNALS OF CLINICAL AND EXPERIMENTAL NEUROLOGY 2024; 17:17-27. [DOI: 10.54101/acen.2023.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
Introduction. The COVID-19 pandemic has led to a high prevalence of post-COVID-19 syndrome (PCS), with mood disorders being the most common manifestations.
Objective: To study the prevalence of PCS-associated mood disorders and their features.
Materials and methods. We examined patients after COVID-19 (n = 91; age: 24-84 years; median time to recovery: 7 months) using the following tools: the BDI and HADS (screening for anxiety and depression); the Starkstein Apathy Scale; FIS and FSS (fatigue assessment); the MoCA, MMSE, and FAB (cognitive assessment); the FIRST, ESS, PSQI, and ISI (sleep disorders evaluation); the EQ5D (quality of life measurement). We designed a special questionnaire to collect data related to a history of COVID-19 and patients' condition after discharge. In addition, we analyzed electronic medical records and discharge summaries and performed neurological examination.
Results. Of all the examined patients, 65 (71.4%) participants had signs and symptoms of PCS. Mood disorders were observed in 33 (50.8%) cases, with apathy (78.7%), anxiety (66.7%), and fatigue (60.6%) being the most common. Depressive disorders were found in 12 (36.3%) patients. Cognitive functions were impaired in 7 (21.2%) patients; sleep disorders were observed in 16 (48.5%) cases. We found a positive correlation between depressive disorders and fatigue based on the BDI, FIS, and FSS scores (rS = 0.711; rS = 0.453), depressive disorders and anxiety (rS = 0.366), fatigue and apathy (rS = 0.350). Anxiety increased the risk of sleep disorders (rS = 0.683). Quality of life has been shown to decrease in patients with mood disorders due to the negative effect of long-term fatigue and depressive disorders.
Conclusions. There is a close connection between different types of mood disorders that develop after COVID-19 and exacerbate symptoms of each other. Early diagnosis and treatment of these disorders can improve patients' quality of life and preserve their ability to work.
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Chen S, Liang J, Chen D, Huang Q, Sun K, Zhong Y, Lin B, Kong J, Sun J, Gong C, Wang J, Gao Y, Zhang Q, Sun H. Cerebrospinal fluid metabolomic and proteomic characterization of neurologic post-acute sequelae of SARS-CoV-2 infection. Brain Behav Immun 2024; 115:209-222. [PMID: 37858739 DOI: 10.1016/j.bbi.2023.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/08/2023] [Accepted: 10/14/2023] [Indexed: 10/21/2023] Open
Abstract
The mechanism by which SARS-CoV-2 causes neurological post-acute sequelae of SARS-CoV-2 (neuro-PASC) remains unclear. Herein, we conducted proteomic and metabolomic analyses of cerebrospinal fluid (CSF) samples from 21 neuro-PASC patients, 45 healthy volunteers, and 26 inflammatory neurological diseases patients. Our data showed 69 differentially expressed metabolites and six differentially expressed proteins between neuro-PASC patients and healthy individuals. Elevated sphinganine and ST1A1, sphingolipid metabolism disorder, and attenuated inflammatory responses may contribute to the occurrence of neuro-PASC, whereas decreased levels of 7,8-dihydropterin and activation of steroid hormone biosynthesis may play a role in the repair process. Additionally, a biomarker cohort consisting of sphinganine, 7,8-dihydroneopterin, and ST1A1 was preliminarily demonstrated to have high value in diagnosing neuro-PASC. In summary, our study represents the first attempt to integrate the diagnostic benefits of CSF with the methodological advantages of multi-omics, thereby offering valuable insights into the pathogenesis of neuro-PASC and facilitating the work of neuroscientists in disclosing different neurological dimensions associated with COVID-19.
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Affiliation(s)
- Shilan Chen
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Jianhao Liang
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Dingqiang Chen
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Qiyuan Huang
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Kaijian Sun
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Yuxia Zhong
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Baojia Lin
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Jingjing Kong
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Jiaduo Sun
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China
| | - Chengfang Gong
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Jun Wang
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
| | - Ya Gao
- Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
| | - Qingguo Zhang
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China.
| | - Haitao Sun
- Clinical Biobank Center, Microbiome Medicine Center, Department of Laboratory Medicine, Guangdong Provincial Clinical Research Center for Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China; Key Laboratory of Mental Health of the Ministry of Education, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, China.
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Guo J, Zhang Y, Gao Y, Li S, Xu G, Tian Z, Xu Q, Li X, Li Y, Zhang Y. Systematical analyses of large-scale transcriptome reveal viral infection-related genes and disease comorbidities. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2023; 51:453-465. [PMID: 37651591 DOI: 10.1080/21691401.2023.2252477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
Perturbation of transcriptome in viral infection patients is a recurrent theme impacting symptoms and mortality, yet a detailed understanding of pertinent transcriptome and identification of robust biomarkers is not complete. In this study, we manually collected 23 datasets related to 6,197 blood transcriptomes across 16 types of respiratory virus infections. We applied a comprehensive systems biology approach starting with whole-blood transcriptomes combined with multilevel bioinformatics analyses to characterize the expression, functional pathways, and protein-protein interaction (PPI) networks to identify robust biomarkers and disease comorbidities. Robust gene markers of infection with different viruses were identified, which can accurately classify the normal and infected patients in train and validation cohorts. The biological processes (BP) of different viruses showed great similarity and enriched in infection and immune response pathways. Network-based analyses revealed that a variety of viral infections were associated with nervous system diseases, neoplasms and metabolic diseases, and significantly correlated with brain tissues. In summary, our manually collected transcriptomes and comprehensive analyses reveal key molecular markers and disease comorbidities in the process of viral infection, which could provide a valuable theoretical basis for the prevention of subsequent public health events for respiratory virus infections.
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Affiliation(s)
- Jing Guo
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Ya Zhang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Yueying Gao
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Si Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Gang Xu
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Zhanyu Tian
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Qi Xu
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Xia Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Yongsheng Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, College of Biomedical Information and Engineering, Hainan Women and Children's Medical Center, Hainan Medical University, Haikou, Hainan, China
| | - Yunpeng Zhang
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
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Wang P, Wang Y, Qin J. Multi-organ microphysiological system: A new paradigm for COVID-19 research. ORGANS-ON-A-CHIP 2023; 5:100029. [PMID: 37206997 PMCID: PMC10181865 DOI: 10.1016/j.ooc.2023.100029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/29/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, is a systemic disease with a broad spectrum of manifestations in multiple organs. Till now, it remains unclear whether these multi-organ dysfunctions arise from direct viral infection, or indirect injuries. There is an urgent need to evaluate the impacts of SARS-CoV-2 infection on human bodies and explore the pathogenesis of extrapulmonary organ injuries at a systemic level. Multi-organ microphysiological systems, which can model whole-body physiology with engineered tissues and physiological communications between different organs, serve as powerful platforms to model COVID-19 in a multi-organ manner. In this perspective, we summarize the recent advancement in multi-organ microphysiological system-based researches, discuss the remaining challenges, and proposed some prospects in the application of multi-organ model system for COVID-19 research.
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Affiliation(s)
- Peng Wang
- University of Science and Technology of China, Hefei, 230026, China
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215123, China
| | - Yaqing Wang
- University of Science and Technology of China, Hefei, 230026, China
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215123, China
| | - Jianhua Qin
- University of Science and Technology of China, Hefei, 230026, China
- Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, 215123, China
- Division of Biotechnology, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, China
- Beijing Institute for Stem Cell and Regenerative Medicine, Chinese Academy of Sciences, Beijing, China
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Nicotra A, Masserini F, Calcaterra F, Di Vito C, Doneddu PE, Pomati S, Nobile-Orazio E, Riva A, Mavilio D, Pantoni L. What do we mean by long COVID? A scoping review of the cognitive sequelae of SARS-CoV-2 infection. Eur J Neurol 2023; 30:3968-3978. [PMID: 37540896 DOI: 10.1111/ene.16027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND AND PURPOSE Many COVID-19 patients report persistent symptoms, including cognitive disturbances. We performed a scoping review on this topic, focusing primarily on cognitive manifestations. METHODS Abstracts and full texts of studies published on PubMed (until May 2023) addressing cognitive involvement persisting after SARS-CoV-2 infection were reviewed, focusing on terms used to name the cognitive syndrome, reported symptoms, their onset time and duration, and testing batteries employed. Reported psychiatric symptoms, their assessment tools, and more general manifestations were also extracted. RESULTS Among the 947 records identified, 180 studies were included. Only one third of them used a label to define the syndrome. A minority of studies included patients according to stringent temporal criteria of syndrome onset (34%), whereas more studies reported a minimum required symptom duration (77%). The most frequently reported cognitive symptoms were memory and attentional-executive disturbances, and among psychiatric complaints, the most frequent were anxiety symptoms, depression, and sleep disturbances. Most studies reported fatigue among general symptoms. Thirty-six studies employed cognitive measures: screening tests alone (n = 19), full neuropsychological batteries (n = 25), or both (n = 29); 30 studies performed psychiatric testing. Cognitive deficits were demonstrated in 39% of subjects, the most frequently affected domains being attention/executive functions (90%) and memory (67%). CONCLUSIONS Currently, no agreement exists on a label for post-COVID-19 cognitive syndrome. The time of symptom onset after acute infection and symptom duration are still discussed. Memory and attention-executive complaints and deficits, together with fatigue, anxiety, and depression symptoms, are consistently reported, but the objective evaluation of these symptoms is not standardized.
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Affiliation(s)
- Alessia Nicotra
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Federico Masserini
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Francesca Calcaterra
- Unit of Clinical and Experimental Immunology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Clara Di Vito
- Unit of Clinical and Experimental Immunology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Pietro Emiliano Doneddu
- Neuromuscular and Neuroimmunology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Simone Pomati
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Eduardo Nobile-Orazio
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
- Neuromuscular and Neuroimmunology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Italy
| | - Agostino Riva
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Domenico Mavilio
- Unit of Clinical and Experimental Immunology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Rozzano, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Leonardo Pantoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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45
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Wei D, Xie Y, Liu X, Chen R, Zhou M, Zhang X, Qu J. Pathogen evolution, prevention/control strategy and clinical features of COVID-19: experiences from China. Front Med 2023; 17:1030-1046. [PMID: 38157194 DOI: 10.1007/s11684-023-1043-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.
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Affiliation(s)
- Dong Wei
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yusang Xie
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, 200025, China
| | - Xuefei Liu
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, 200025, China
| | - Rong Chen
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, 200025, China
| | - Min Zhou
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, 200025, China
| | - Xinxin Zhang
- Department of Infectious Diseases, Research Laboratory of Clinical Virology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jieming Qu
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, 200025, China.
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Harapan BN, Harapan T, Theodora L, Anantama NA. From Archipelago to Pandemic Battleground: Unveiling Indonesia's COVID-19 Crisis. J Epidemiol Glob Health 2023; 13:591-603. [PMID: 37707715 PMCID: PMC10686963 DOI: 10.1007/s44197-023-00148-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to countries worldwide, including Indonesia. With its unique archipelagic geography consisting of more than 17,000 thousand islands, Indonesia faces unique complexities in managing the spread of the virus. Based on existing literature, this review article elaborates on key issues that have shaped Indonesia's COVID-19 response. The article begins by examining the early stages of the COVID-19 pandemic in Indonesia, along with the implementation of various preventive measures and the impact of the virus on public health. This article examines how Indonesia's socio-economic factors have generally influenced its healthcare system and further delves into the COVID-19 response strategies implemented by the Indonesian government and public health authorities as well as overall crisis preparedness. It discusses the actions taken to control the spread of the virus, including testing strategies and vaccination efforts. The difficulties encountered in implementing these measures are presented. In conclusion, this review article provides a comprehensive understanding of the COVID-19 crisis in Indonesia, covering facts on multiple dimensions ranging from the timeline of the pandemic to vaccination efforts, epidemiology, socio-economic implications, testing strategies, mobility patterns, public holidays, the impact of working from home, and the utilization of complementary and alternative medicine in addition to the standard of care for COVID-19. The insights gained from this article can complement future strategies for pandemic management and response in Indonesia and other countries facing similar challenges.
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Affiliation(s)
| | - Triswan Harapan
- Complementary Cardiovascular Clinic (CCV Clinic), Tangerang Selatan, Indonesia
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Melgarejo L, Caronna E, Rosell-Mirmi J, Elosua-Bayés I, Alpuente A, Torres-Ferrus M, Gallardo VJ, Pozo-Rosich P. Migraine worsening after COVID-19 and COVID-19 vaccination: Are we facing a nocebo effect? Eur J Neurol 2023; 30:3877-3885. [PMID: 37791410 DOI: 10.1111/ene.16058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND PURPOSE In clinical practice patients may report migraine worsening as a consequence of COVID-19 (either infection or vaccines), however, data in this area are lacking. We aimed to investigate the link between COVID-19 and COVID-19 vaccination with migraine worsening and its associated factors. METHODS An online survey was sent to migraine patients followed up in a Spanish Headache Clinic, collecting demographic data, and information regarding SARS-CoV-2 infection and vaccination. We asked patients if they had noticed worsening of their migraine after these events and assessed concerns about infection, vaccination and migraine worsening. We also extracted data from participants' own electronic diaries (e-diaries), including 1-month data before and after their reported infection and/or vaccination. We compared participants who self-reported migraine worsening since infection or vaccination with those who did not. RESULTS Of 550 participants, 44.9% (247/550) reported having had COVID-19 at least once and 83.3% (458/550) had been vaccinated. Sixty-one patients reported migraine worsening since COVID-19 and 52 since the vaccination. Among the risk factors for perceived migraine worsening in the two settings (infection and vaccination) was concern about migraine worsening itself (infection: odds ratio [OR] 2.498 [95% CI: 1.02-6.273], p = 0.046; vaccination: OR 17.3 [95% CI: confidence interval 5.3-68], p < 0.001). e-diary information was available for 136 of the 550 patients, 38.2% (52/136) for COVID-19 and 39.7% (54/136) for vaccination. We observed no significant difference in headache frequency 1 month before and after infection or vaccination, even when comparing patients with and without self-reported migraine worsening. CONCLUSIONS Our preliminary data point to a negligible role of the infection and vaccination on migraine worsening and to the possible presence of a nocebo effect in these settings, as a remarkable proportion of patients had a clear perception of migraine worsening.
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Affiliation(s)
- Laura Melgarejo
- Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Edoardo Caronna
- Headache Clinic, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joana Rosell-Mirmi
- Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Alicia Alpuente
- Headache Clinic, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Torres-Ferrus
- Headache Clinic, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Víctor J Gallardo
- Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Patricia Pozo-Rosich
- Headache Clinic, Neurology Department, Vall d'Hebron Hospital, Barcelona, Spain
- Headache and Neurological Pain Research Group, VHIR, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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Amadoro G, Latina V, Stigliano E, Micera A. COVID-19 and Alzheimer's Disease Share Common Neurological and Ophthalmological Manifestations: A Bidirectional Risk in the Post-Pandemic Future. Cells 2023; 12:2601. [PMID: 37998336 PMCID: PMC10670749 DOI: 10.3390/cells12222601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
A growing body of evidence indicates that a neuropathological cross-talk takes place between the coronavirus disease 2019 (COVID-19) -the pandemic severe pneumonia that has had a tremendous impact on the global economy and health since three years after its outbreak in December 2019- and Alzheimer's Disease (AD), the leading cause of dementia among human beings, reaching 139 million by the year 2050. Even though COVID-19 is a primary respiratory disease, its causative agent, the so-called Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), is also endowed with high neuro-invasive potential (Neurocovid). The neurological complications of COVID-19, resulting from the direct viral entry into the Central Nervous System (CNS) and/or indirect systemic inflammation and dysregulated activation of immune response, encompass memory decline and anosmia which are typically associated with AD symptomatology. In addition, patients diagnosed with AD are more vulnerable to SARS-CoV-2 infection and are inclined to more severe clinical outcomes. In the present review, we better elucidate the intimate connection between COVID-19 and AD by summarizing the involved risk factors/targets and the underlying biological mechanisms shared by these two disorders with a particular focus on the Angiotensin-Converting Enzyme 2 (ACE2) receptor, APOlipoprotein E (APOE), aging, neuroinflammation and cellular pathways associated with the Amyloid Precursor Protein (APP)/Amyloid beta (Aβ) and tau neuropathologies. Finally, the involvement of ophthalmological manifestations, including vitreo-retinal abnormalities and visual deficits, in both COVID-19 and AD are also discussed. Understanding the common physiopathological aspects linking COVID-19 and AD will pave the way to novel management and diagnostic/therapeutic approaches to cope with them in the post-pandemic future.
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Affiliation(s)
- Giuseppina Amadoro
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy;
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Valentina Latina
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy;
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Egidio Stigliano
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;
| | - Alessandra Micera
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184 Rome, Italy
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Pimenta J, Da Silva Oliveira B, Lima ALD, Machado CA, De Souza Barbosa Lacerda L, Rossi L, Queiroz-Junior CM, De Souza-Costa LP, Andrade ACSP, Gonçalves MR, Mota B, Marim FM, Aguiar RS, Guimarães PPG, Teixeira AL, Vieira LB, Guatimosim C, Teixeira MM, De Miranda AS, Costa VV. A suitable model to investigate acute neurological consequences of coronavirus infection. Inflamm Res 2023; 72:2073-2088. [PMID: 37837557 DOI: 10.1007/s00011-023-01798-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 10/16/2023] Open
Abstract
OBJECTIVE AND DESIGN The present study aimed to investigate the neurochemical and behavioral effects of the acute consequences after coronavirus infection through a murine model. MATERIAL Wild-type C57BL/6 mice were infected intranasally (i.n) with the murine coronavirus 3 (MHV-3). METHODS Mice underwent behavioral tests. Euthanasia was performed on the fifth day after infection (5 dpi), and the brain tissue was subjected to plaque assays for viral titration, ELISA, histopathological, immunohistochemical and synaptosome analysis. RESULTS Increased viral titers and mild histological changes, including signs of neuronal degeneration, were observed in the cerebral cortex of infected mice. Importantly, MHV-3 infection induced an increase in cortical levels of glutamate and calcium, which is indicative of excitotoxicity, as well as increased levels of pro-inflammatory cytokines (IL-6, IFN-γ) and reduced levels of neuroprotective mediators (BDNF and CX3CL1) in the mice brain. Finally, behavioral analysis showed impaired motor, anhedonia-like and anxiety-like behaviors in animals infected with MHV-3. CONCLUSIONS In conclusion, the data presented emulate many aspects of the acute neurological outcomes seen in patients with COVID-19. Therefore, this model may provide a preclinical platform to study acute neurological sequelae induced by coronavirus infection and test possible therapies.
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Affiliation(s)
- Jordane Pimenta
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Bruna Da Silva Oliveira
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Anna Luiza Diniz Lima
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Caroline Amaral Machado
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Larisse De Souza Barbosa Lacerda
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Leonardo Rossi
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Celso Martins Queiroz-Junior
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Luiz Pedro De Souza-Costa
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Claudia Santos Pereira Andrade
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Matheus Rodrigues Gonçalves
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bárbara Mota
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Fernanda Martins Marim
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renato Santana Aguiar
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Pedro Pires Goulart Guimarães
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Antônio Lúcio Teixeira
- Department of Psychiatry and Behavioral Sciences, McGovern Medical Houston, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Luciene Bruno Vieira
- Department of Physiology and Biophysics, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cristina Guatimosim
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil
| | - Mauro Martins Teixeira
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Aline Silva De Miranda
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil.
| | - Vivian Vasconcelos Costa
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil.
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Basak I, Harfoot R, Palmer JE, Kumar A, Quiñones-Mateu ME, Schweitzer L, Hughes SM. Neuroproteomic Analysis after SARS-CoV-2 Infection Reveals Overrepresented Neurodegeneration Pathways and Disrupted Metabolic Pathways. Biomolecules 2023; 13:1597. [PMID: 38002279 PMCID: PMC10669333 DOI: 10.3390/biom13111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
Besides respiratory illness, SARS-CoV-2, the causative agent of COVID-19, leads to neurological symptoms. The molecular mechanisms leading to neuropathology after SARS-CoV-2 infection are sparsely explored. SARS-CoV-2 enters human cells via different receptors, including ACE-2, TMPRSS2, and TMEM106B. In this study, we used a human-induced pluripotent stem cell-derived neuronal model, which expresses ACE-2, TMPRSS2, TMEM106B, and other possible SARS-CoV-2 receptors, to evaluate its susceptibility to SARS-CoV-2 infection. The neurons were exposed to SARS-CoV-2, followed by RT-qPCR, immunocytochemistry, and proteomic analyses of the infected neurons. Our findings showed that SARS-CoV-2 infects neurons at a lower rate than other human cells; however, the virus could not replicate or produce infectious virions in this neuronal model. Despite the aborted SARS-CoV-2 replication, the infected neuronal nuclei showed irregular morphology compared to other human cells. Since cytokine storm is a significant effect of SARS-CoV-2 infection in COVID-19 patients, in addition to the direct neuronal infection, the neurons were treated with pre-conditioned media from SARS-CoV-2-infected lung cells, and the neuroproteomic changes were investigated. The limited SARS-CoV-2 infection in the neurons and the neurons treated with the pre-conditioned media showed changes in the neuroproteomic profile, particularly affecting mitochondrial proteins and apoptotic and metabolic pathways, which may lead to the development of neurological complications. The findings from our study uncover a possible mechanism behind SARS-CoV-2-mediated neuropathology that might contribute to the lingering effects of the virus on the human brain.
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Affiliation(s)
- Indranil Basak
- Brain Health Research Centre, Department of Biochemistry, University of Otago, Dunedin 9016, New Zealand
| | - Rhodri Harfoot
- Department of Microbiology and Immunology, University of Otago, Dunedin 9016, New Zealand (M.E.Q.-M.)
| | - Jennifer E. Palmer
- Brain Health Research Centre, Department of Biochemistry, University of Otago, Dunedin 9016, New Zealand
| | - Abhishek Kumar
- Centre for Protein Research, University of Otago, Dunedin 9016, New Zealand
| | - Miguel E. Quiñones-Mateu
- Department of Microbiology and Immunology, University of Otago, Dunedin 9016, New Zealand (M.E.Q.-M.)
| | - Lucia Schweitzer
- Brain Health Research Centre, Department of Biochemistry, University of Otago, Dunedin 9016, New Zealand
| | - Stephanie M. Hughes
- Brain Health Research Centre, Department of Biochemistry, University of Otago, Dunedin 9016, New Zealand
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