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Vellieux G, Sonneville R, Vledouts S, Jaquet P, Rouvel-Tallec A, d’Ortho MP. COVID-19-Associated Neurological Manifestations: An Emerging Electroencephalographic Literature. Front Physiol 2021; 11:622466. [PMID: 33679425 PMCID: PMC7933549 DOI: 10.3389/fphys.2020.622466] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/29/2020] [Indexed: 02/02/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide since the end of year 2019 and is currently responsive for coronavirus infectious disease 2019 (COVID-19). The first reports considered COVID-19 as a respiratory tract disease responsible for pneumonia, but numerous studies rapidly emerged to warn the medical community of COVID-19-associated neurological manifestations, including encephalopathy at the acute phase and other postinfectious manifestations. Using standard visual analysis or spectral analysis, recent studies reported electroencephalographic (EEG) findings of COVID-19 patients with various neurological symptoms. Most EEG recordings were normal or revealed non-specific abnormalities, such as focal or generalized slowing, interictal epileptic figures, seizures, or status epilepticus. Interestingly, novel EEG abnormalities over frontal areas were also described at the acute phase. Underlying mechanisms leading to brain injury in COVID-19 are still unknown and matters of debate. These frontal EEG abnormalities could emphasize the hypothesis whereby SARS-CoV-2 enters the central nervous system (CNS) through olfactory structures and then spreads in CNS via frontal lobes. This hypothesis is reinforced by the presence of anosmia in a significant proportion of COVID-19 patients and by neuroimaging studies confirming orbitofrontal abnormalities. COVID-19 represents a new viral disease characterized by not only respiratory symptoms but also a systemic invasion associated with extra-respiratory signs. Neurological symptoms must be the focus of our attention, and functional brain evaluation with EEG is crucial, in combination with anatomical and functional brain imaging, to better understand its pathophysiology. Evolution of symptoms together with EEG patterns at the distance of the acute episode should also be scrutinized.
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Affiliation(s)
- Geoffroy Vellieux
- Université de Paris, NeuroDiderot, Inserm, Paris, France
- Neurophysiologie clinique, Service de Physiologie – Explorations Fonctionnelles, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Romain Sonneville
- Médecine Intensive-Réanimation, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
- Université de Paris, UMR 1148, LVTS, Paris, France
| | - Sérafima Vledouts
- Université de Paris, NeuroDiderot, Inserm, Paris, France
- Neurophysiologie clinique, Service de Physiologie – Explorations Fonctionnelles, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Pierre Jaquet
- Médecine Intensive-Réanimation, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
- Université de Paris, UMR 1148, LVTS, Paris, France
| | - Anny Rouvel-Tallec
- Université de Paris, NeuroDiderot, Inserm, Paris, France
- Neurophysiologie clinique, Service de Physiologie – Explorations Fonctionnelles, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Marie-Pia d’Ortho
- Université de Paris, NeuroDiderot, Inserm, Paris, France
- Neurophysiologie clinique, Service de Physiologie – Explorations Fonctionnelles, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
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Katal S, Gholamrezanezhad A. Neuroimaging findings in COVID-19: A narrative review. Neurosci Lett 2021; 742:135529. [PMID: 33248161 PMCID: PMC7686796 DOI: 10.1016/j.neulet.2020.135529] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 01/24/2023]
Abstract
In this mini-review, we aim to summarize some of the most common neuroimaging findings seen in patients with COVID-19.
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Affiliation(s)
- Sanaz Katal
- Nuclear Medicine Department, Tehran University of Medical Sciences, Iran.
| | - Ali Gholamrezanezhad
- Keck School of Medicine, University of Southern California (USC), Los Angles, CA, USA; Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California (USC), 1520 San Pablo Street, Los Angeles, CA, USA.
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53
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Sanei-Taheri M, Mahboubi-Fooladi Z, Soleimani R. Magnetic resonance imaging of sudden-onset anosmia in COVID-19 infection. CURRENT JOURNAL OF NEUROLOGY 2021; 20:49-51. [PMID: 38011436 PMCID: PMC8511604 DOI: 10.18502/cjn.v20i1.6380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/06/2020] [Indexed: 11/24/2022]
Abstract
The article abstract is not available.
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Affiliation(s)
- Morteza Sanei-Taheri
- Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Mahboubi-Fooladi
- Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Soleimani
- Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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54
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Critical neurological features of COVID-19: Role of imaging methods and biosensors for effective diagnosis. SENSORS INTERNATIONAL 2021; 2:100098. [PMID: 34766055 PMCID: PMC8117537 DOI: 10.1016/j.sintl.2021.100098] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 is a respiratory infection that has been declared as a global health crisis by the WHO. It mainly affects the respiratory system. Apart from respiratory system, it also affects other organs as well including the brain. Numerous emerging reports have demonstrated that the COVID-19 has detrimental effects on neurological functions, and can lead to severe impairment of the central nervous system (CNS). The neurological manifestations linked with COVID-19 include headache, anosmia, encephalitis, epileptic seizures, Guillain-Barre syndrome, stroke and intracerebral hemorrhage alongwith multiple others complications. The CNS related complications may be severe and are linked with poor diagnosis which may worsen the condition. Therefore, there is a need to precisely understand the neurological sequelae along with upcoming clinical outcomes. Here, we present a brief review of the neurological complications and symptoms associated with COVID-19 along with brain imaging findings. Further, we have discussed about the emerging biosensing approaches which may aid in rapid, precise and mass diagnosis of COVID-19.
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55
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18FDG-PET/CT Assessment of COVID-19-Induced Bell's Palsy. Acad Radiol 2021; 28:144-145. [PMID: 33189551 PMCID: PMC7834804 DOI: 10.1016/j.acra.2020.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023]
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56
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Neurological manifestations of coronavirus disease 2019: exploring past to understand present. Neurol Sci 2021; 42:773-785. [PMID: 33428055 PMCID: PMC7798003 DOI: 10.1007/s10072-020-04964-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023]
Abstract
SARS-CoV-2 infection, resulting in Coronavirus disease 2019 (COVID-19), has significantly affected the entire world. It was labelled a pandemic by World Health Organization. Although it commonly produces respiratory symptoms, neurological features have been described. Neurological manifestations may vary from non-specific symptoms such as headache, dizziness, myalgia and/or fatigue, olfactory or taste dysfunction to specific syndromes including meningitis, stroke, acute transverse myelitis and Guillain-Barre syndrome. This review describes potential pathogenetic mechanisms and neurological manifestations of COVID-19 along with its management. Considering structural and pathogenetic similarity of SARS-CoV-2 with SARS-CoV and MERS viruses, we compared their neurological manifestations and mentioned few features expected in COVID-19 in future. Interestingly, many COVID-19 cases may present with pure neurological manifestations at onset with non-neurological features manifesting few days later and we propose the term "Neuro-COVID syndrome" for such cases. Awareness of neurological manifestations may facilitate its management and improve outcome in such patients.
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57
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What role does 18F-fluorodeoxyglucose PET-computed tomography have in the current pandemic and beyond? Nucl Med Commun 2020; 42:113-116. [PMID: 33252514 DOI: 10.1097/mnm.0000000000001320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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58
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Vergara J, Lirani-Silva C, Brodsky MB, Miles A, Clavé P, Nascimento W, Mourão LF. Potential Influence of Olfactory, Gustatory, and Pharyngolaryngeal Sensory Dysfunctions on Swallowing Physiology in COVID-19. Otolaryngol Head Neck Surg 2020; 164:1134-1135. [PMID: 33167752 DOI: 10.1177/0194599820972680] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Persistent smell and taste disorders have been reported as some of the most common symptoms after COVID-19 (coronavirus disease 2019). Sensory, olfactory, and gustatory functions perform an important role in the initiation and modulation of oropharyngeal swallow biomechanics and salivation as well as in mealtime enjoyment and appetite. Yet, the details of this interaction remain relatively unknown in patients who are infected with and recovering from COVID-19. In this commentary, we discuss the possible impacts of SARS-CoV-2 on the central and peripheral nervous system and consider the pathophysiology of olfactory, gustatory, and pharyngolaryngeal sensory deficits and its influence on deglutition, describing hypotheses and offering guidance for future research.
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Affiliation(s)
- José Vergara
- Department of Surgery, University of Campinas, Campinas, Brazil
| | - Camila Lirani-Silva
- Gerontology Postgraduate Program, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Martin B Brodsky
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA.,Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,Outcomes After Critical Illness and Surgery Research Group, Johns Hopkins University, Baltimore Maryland, USA
| | - Anna Miles
- Speech Science, University of Auckland, Auckland, New Zealand
| | - Pere Clavé
- Gastrointestinal Physiology Laboratory, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (Ciberehd), Hospital de Mataró, Autonomous University of Barcelona, Barcelona, Spain
| | - Weslania Nascimento
- Gastrointestinal Physiology Laboratory, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (Ciberehd), Hospital de Mataró, Autonomous University of Barcelona, Barcelona, Spain
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59
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Karimi-Galougahi M, Yousefi-Koma A, Khalili N, Bakhshayeshkaram M, Haseli S. Transient 18FDG-avid hilar lymph node on PET/CT imaging in asymptomatic COVID-19. IDCases 2020; 22:e00981. [PMID: 33173754 PMCID: PMC7644432 DOI: 10.1016/j.idcr.2020.e00981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 01/18/2023] Open
Abstract
The most common features of coronavirus disease-2019 (COVID-19) pneumonia on chest computed tomography imaging are ground glass opacity and consolidation. Mediastinal and hilar lymph node enlargement are less frequently observed. Herein, we present an unexpected finding of fluorodeoxyglucose (FDG)-avid hilar lymph node in an asymptomatic patient with COVID-19, and show that this is a transient phenomenon, subsiding on a follow-up FDG-PET/CT within 10 days.
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Affiliation(s)
- Mahboobeh Karimi-Galougahi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Yousefi-Koma
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Bakhshayeshkaram
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Haseli
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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60
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Naeini AS, Karimi-Galougahi M, Raad N, Ghorbani J, Taraghi A, Haseli S, Mehrparvar G, Bakhshayeshkaram M. Paranasal sinuses computed tomography findings in anosmia of COVID-19. Am J Otolaryngol 2020; 41:102636. [PMID: 32652405 PMCID: PMC7831990 DOI: 10.1016/j.amjoto.2020.102636] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 12/28/2022]
Abstract
Objective Olfactory dysfunction in coronavirus disease-2019 (COVID-19) is poorly understood. Thus, mechanistic data are needed to elucidate the pathophysiological drivers of anosmia of COVID-19. Methods We performed the current study in patients who presented with anosmia and COVID-19 as documented by the polymerase chain reaction (PCR) assay between April 1st and May 15st, 2020. We assessed for the conductive causes of anosmia with computed tomography (CT) of paranasal sinuses. Results 49 patients who presented with anosmia and positive PCR assay for COVID-19 were included. The average age was 45 ± 12.2 years. Complete anosmia was present in 85.7% of patients and 91.8% of patients reported sudden onset of olfactory dysfunction. Taste disturbance was common (75.5%). There were no significant pathological changes in the paranasal sinuses on CT scans. Olfactory cleft and ethmoid sinuses appeared normal while in other sinuses, partial opacification was detected only in some cases. Conclusion We did not find significant mucosal changes or olfactory cleft abnormality on CT imaging in patients with anosmia of COVID-19. Conductive causes of anosmia (i.e., mucosal disease) do not seem play a significant role in anosmia of COVID-19.
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61
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Pan S, Chen WC, Baal JD, Sugrue LP. Neuroradiological Features of Mild and Severe SARS-CoV-2 Infection. Acad Radiol 2020; 27:1507-1514. [PMID: 32912668 PMCID: PMC7456302 DOI: 10.1016/j.acra.2020.08.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/24/2022]
Abstract
RATIONALE AND OBJECTIVES An increasing number of neurological complications and corresponding radiological findings have been reported in patients with COVID-19 infection. The purpose of this study is to systematically review the current literature on COVID-19-associated neuroradiological findings and examine the prevalence of different findings in patients with both severe and mild COVID-19 infection. MATERIALS AND METHODS A comprehensive literature search of the PubMed and Embase databases was performed. Any studies reporting CT or MRI neuroimaging findings in patients with confirmed COVID-19 infection were included. Patient demographics, main radiological findings, neurological symptoms, and severity of COVID-19 infection were tabulated and quantified according to infection severity. RESULTS Sixty-one studies published between 2019 and 2020 comprising 711 patients were analyzed according to severity of respiratory symptoms. The main neuroradiological findings for patients with mild classification were cranial nerve abnormalities, ischemic infarction, and white matter abnormalities, while the main findings in patients with severe classification were white matter abnormalities, ischemic infarction, and hemorrhagic events. CONCLUSION Neuroradiological manifestations in COVID-19 infection are highly heterogeneous and differ based on the severity of COVID-19 infection. Cranial nerve abnormalities appear exclusive to mild infection, with a high degree of olfactory tract involvement, while hemorrhagic events are more common in severe infection. Notably, ischemic infarction was equally prevalent in both mild and severe COVID-19 infection. Healthcare providers treating COVID-19 patients should be aware of these potential complications and consider neurological assessment and neuroimaging studies when indicated.
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Affiliation(s)
- Simon Pan
- Department of Radiology and Biomedical Imaging, Neuroradiology Section, University of California, San Francisco, California, USA
| | - Willam C Chen
- Department of Radiation Oncology, University of California, San Francisco, 505 Parnassus Ave, San Francisco, California, 94143, USA
| | - Joe D Baal
- Department of Radiology and Biomedical Imaging, Neuroradiology Section, University of California, San Francisco, California, USA
| | - Leo P Sugrue
- Department of Radiology and Biomedical Imaging, Neuroradiology Section, University of California, San Francisco, California, USA.
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Morbelli S, Ekmekcioglu O, Barthel H, Albert NL, Boellaard R, Cecchin D, Guedj E, Lammertsma AA, Law I, Penuelas I, Semah F, Traub-Weidinger T, van de Giessen E, Varrone A, Garibotto V. COVID-19 and the brain: impact on nuclear medicine in neurology. Eur J Nucl Med Mol Imaging 2020; 47:2487-2492. [PMID: 32700058 PMCID: PMC7375837 DOI: 10.1007/s00259-020-04965-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy. .,Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Department of Health Sciences(DISSAL), University of Genoa, Genoa, Italy.
| | - Ozgul Ekmekcioglu
- Department of Nuclear Medicine, Sisli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University, Leipzig, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, Ludwig Maximilians-University of Munich, Munich, Germany
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Eric Guedj
- APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, Aix Marseille Univ, Marseille, France
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ivan Penuelas
- Department of Nuclear Medicine, Clinica Universidad de Navarra, IdiSNA, University of Navarra, Pamplona, Spain
| | - Franck Semah
- Nuclear Medicine Department, University Hospital, Lille, France
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Elsmarieke van de Giessen
- Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, Meibergdreef 9, Amsterdam, The Netherlands
| | - Andrea Varrone
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Valentina Garibotto
- NIMTLab, Faculty of Medicine, Geneva University, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
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63
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Delorme C, Paccoud O, Kas A, Hesters A, Bombois S, Shambrook P, Boullet A, Doukhi D, Le Guennec L, Godefroy N, Maatoug R, Fossati P, Millet B, Navarro V, Bruneteau G, Demeret S, Pourcher V. COVID-19-related encephalopathy: a case series with brain FDG-positron-emission tomography/computed tomography findings. Eur J Neurol 2020; 27:2651-2657. [PMID: 32881133 PMCID: PMC7461074 DOI: 10.1111/ene.14478] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022]
Abstract
Aim The aim of this paper is to describe the clinical features of COVID‐19‐related encephalopathy and their metabolic correlates using brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) imaging. Background and purpose A variety of neurological manifestations have been reported in association with COVID‐19. COVID‐19‐related encephalopathy has seldom been reported and studied. Methods We report four cases of COVID‐19‐related encephalopathy. The diagnosis was made in patients with confirmed COVID‐19 who presented with new‐onset cognitive disturbances, central focal neurological signs, or seizures. All patients underwent cognitive screening, brain magnetic resonance imaging (MRI), lumbar puncture, and brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) (FDG‐PET/CT). Results The four patients were aged 60 years or older, and presented with various degrees of cognitive impairment, with predominant frontal lobe impairment. Two patients presented with cerebellar syndrome, one patient had myoclonus, one had psychiatric manifestations, and one had status epilepticus. The delay between first COVID‐19 symptoms and onset of neurological symptoms was between 0 and 12 days. None of the patients had MRI features of encephalitis nor significant cerebrospinal fluid (CSF) abnormalities. SARS‐CoV‐2 RT‐PCR in the CSF was negative for all patients. All patients presented with a consistent brain FDG‐PET/CT pattern of abnormalities, namely frontal hypometabolism and cerebellar hypermetabolism. All patients improved after immunotherapy. Conclusions Despite varied clinical presentations, all patients presented with a consistent FDG‐PET pattern, which may reflect an immune mechanism.
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Affiliation(s)
- C Delorme
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - O Paccoud
- Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - A Kas
- Nuclear Medicine and LIB Department, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, INSERM U1146, Paris, France
| | - A Hesters
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - S Bombois
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - P Shambrook
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - A Boullet
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - D Doukhi
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - L Le Guennec
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - N Godefroy
- Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - R Maatoug
- Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - P Fossati
- Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - B Millet
- Department of adult Psychiatry, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - V Navarro
- Department of Neurophysiology, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France
| | - G Bruneteau
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - S Demeret
- Department of Neurology, Sorbonne University, Assistance Publique des Hôpitaux de Paris (AP-HP), University Hospitals - Pitié-Salpêtrière Charles Foix, Paris, France
| | - V Pourcher
- Department of Infectious and Tropical diseases, Sorbonne University, AP-HP, University Hospitals Pitié-Salpêtrière Charles Foix, Paris, France.,Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, INSERM 1136, Paris, France
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Scimeca M, Urbano N, Bonfiglio R, Montanaro M, Bonanno E, Schillaci O, Mauriello A. Imaging Diagnostics and Pathology in SARS-CoV-2-Related Diseases. Int J Mol Sci 2020; 21:E6960. [PMID: 32971906 PMCID: PMC7554796 DOI: 10.3390/ijms21186960] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/09/2020] [Accepted: 09/21/2020] [Indexed: 01/18/2023] Open
Abstract
In December 2019, physicians reported numerous patients showing pneumonia of unknown origin in the Chinese region of Wuhan. Following the spreading of the infection over the world, The World Health Organization (WHO) on 11 March 2020 declared the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak a global pandemic. The scientific community is exerting an extraordinary effort to elucidate all aspects related to SARS-CoV-2, such as the structure, ultrastructure, invasion mechanisms, replication mechanisms, or drugs for treatment, mainly through in vitro studies. Thus, the clinical in vivo data can provide a test bench for new discoveries in the field of SARS-CoV-2, finding new solutions to fight the current pandemic. During this dramatic situation, the normal scientific protocols for the development of new diagnostic procedures or drugs are frequently not completely applied in order to speed up these processes. In this context, interdisciplinarity is fundamental. Specifically, a great contribution can be provided by the association and interpretation of data derived from medical disciplines based on the study of images, such as radiology, nuclear medicine, and pathology. Therefore, here, we highlighted the most recent histopathological and imaging data concerning the SARS-CoV-2 infection in lung and other human organs such as the kidney, heart, and vascular system. In addition, we evaluated the possible matches among data of radiology, nuclear medicine, and pathology departments in order to support the intense scientific work to address the SARS-CoV-2 pandemic. In this regard, the development of artificial intelligence algorithms that are capable of correlating these clinical data with the new scientific discoveries concerning SARS-CoV-2 might be the keystone to get out of the pandemic.
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Affiliation(s)
- Manuel Scimeca
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy;
- San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy
- Saint Camillus International University of Health Sciences, Via di Sant’Alessandro, 8, 00131 Rome, Italy
| | - Nicoletta Urbano
- Nuclear Medicine Unit, Department of Oncohaematology, Policlinico “Tor Vergata”, viale oxford 81, 00133 Rome, Italy;
| | - Rita Bonfiglio
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (R.B.); (M.M.); (E.B.); (A.M.)
- Fondazione Umberto Veronesi (FUV), Piazza Velasca 5, 20122 Milano, Italy
| | - Manuela Montanaro
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (R.B.); (M.M.); (E.B.); (A.M.)
| | - Elena Bonanno
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (R.B.); (M.M.); (E.B.); (A.M.)
- Diagnostica Medica’ & ‘Villa dei Platani’, Neuromed Group, 83100 Avellino, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy;
- IRCCS Neuromed, Via Atinense, 18, 8607 Pozzilli, Italy
| | - Alessandro Mauriello
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (R.B.); (M.M.); (E.B.); (A.M.)
- Tor Vergata Oncoscience Research (TOR), University of Rome “Tor Vergata”, 00133 Rome, Italy
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65
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Eliezer M, Hamel AL, Houdart E, Herman P, Housset J, Jourdaine C, Eloit C, Verillaud B, Hautefort C. Loss of smell in patients with COVID-19. Neurology 2020; 95:e3145-e3152. [DOI: 10.1212/wnl.0000000000010806] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/21/2020] [Indexed: 12/24/2022] Open
Abstract
ObjectiveTo assess the physiopathology of olfactory function loss (OFL) in patients with coronavirus disease 2019 (COVID-19), we evaluated the olfactory clefts (OC) on MRI during the early stage of the disease and 1 month later.MethodsThis was a prospective, monocentric, case-controlled study. Twenty severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)–infected patients with OFL were included and compared to 20 age-matched healthy controls. All infected patients underwent olfactory function assessment and 3T MRI, performed both at the early stage of the disease and at the 1-month follow-up.ResultsAt the early stage, SARS-CoV2–infected patients had a mean olfactory score of 2.8 ± 2.7 (range 0–8), and MRI displayed a complete obstruction of the OC in 19 of 20 patients. Controls had normal olfactory scores and no obstruction of the OC on MRI. At the 1 month follow-up, the olfactory score had improved to 8.3 ± 1.9 (range 4–10) in patients, and only 7 of 20 patients still had an obstruction of the OC. There was a correlation between olfactory score and obstruction of the OC (p = 0.004).ConclusionOFL in SARS-CoV2–infected patients is associated with a reversible obstruction of the OC.
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66
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Understanding the Immunologic Characteristics of Neurologic Manifestations of SARS-CoV-2 and Potential Immunological Mechanisms. Mol Neurobiol 2020; 57:5263-5275. [PMID: 32869183 PMCID: PMC7458880 DOI: 10.1007/s12035-020-02094-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022]
Abstract
Similar to its predecessors, coronavirus disease 2019 (COVID-19) exhibits neurotrophic properties, which lead to progression of neurologic sequelae. Besides direct viral invasion to the central nervous system (CNS), indirect CNS involvement through viral-mediated immune response is plausible. Aberrant immune pathways such as extreme release of cytokines (cytokine storm), autoimmunity mediated by cross-reactivity between CNS components and viral particles, and microglial activation propagate CNS damage in these patients. Here, we review the currently available evidence to discuss the plausible immunologic pathways that may contribute to the development of COVID-19 neurological complications, namely Alzheimer’s disease, Parkinson’s disease, stroke, multiple sclerosis, Guillain-Barre syndrome, seizure, and brainstem involvement.
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67
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Aragão MFVV, Leal MC, Cartaxo Filho OQ, Fonseca TM, Valença MM. Anosmia in COVID-19 Associated with Injury to the Olfactory Bulbs Evident on MRI. AJNR Am J Neuroradiol 2020; 41:1703-1706. [PMID: 32586960 PMCID: PMC7583088 DOI: 10.3174/ajnr.a6675] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/01/2020] [Indexed: 12/21/2022]
Abstract
Patients with coronavirus disease 2019 (COVID-19) may have symptoms of anosmia or partial loss of the sense of smell, often accompanied by changes in taste. We report 5 cases (3 with anosmia) of adult patients with COVID-19 in whom injury to the olfactory bulbs was interpreted as microbleeding or abnormal enhancement on MR imaging. The patients had persistent headache (n = 4) or motor deficits (n = 1). This olfactory bulb injury may be the mechanism by which the Severe Acute Respiratory Syndrome coronavirus 2 causes olfactory dysfunction.
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Affiliation(s)
- M F V V Aragão
- From the Universidade Federal de Pernambuco (M.F.V.V.A., M.C.L., M.M.V.), Recife, Brazil
- Centro Diagnostico Multimagem (M.F.V.V.A.), Recife, Brazil
| | - M C Leal
- From the Universidade Federal de Pernambuco (M.F.V.V.A., M.C.L., M.M.V.), Recife, Brazil
- Real Hospital de Beneficencia Portuguesa (M.C.L., O.Q.C.F., T.M.F.), Recife, Brazil
| | - O Q Cartaxo Filho
- Real Hospital de Beneficencia Portuguesa (M.C.L., O.Q.C.F., T.M.F.), Recife, Brazil
| | - T M Fonseca
- Real Hospital de Beneficencia Portuguesa (M.C.L., O.Q.C.F., T.M.F.), Recife, Brazil
| | - M M Valença
- From the Universidade Federal de Pernambuco (M.F.V.V.A., M.C.L., M.M.V.), Recife, Brazil
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68
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Minamimoto R, Hotta M, Ishikane M, Inagaki T. FDG-PET/CT images of COVID-19: a comprehensive review. Glob Health Med 2020; 2:221-226. [PMID: 33330811 PMCID: PMC7731428 DOI: 10.35772/ghm.2020.01056] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/28/2022]
Abstract
Following a lot of reports of coronavirus disease 2019 (COVID-19) CT images, the feature of FDG-PET/ CT imaging of COVID-19 was reported in several articles. Since FDG accumulates in activated inflammatory cells, FDG-PET/CT has huge potential for diagnosing and monitoring of inflammatory disease. However, FDG-PET/CT cannot be routinely used in an emergency setting and is not generally recommended as a first choice for diagnosis of infectious diseases. In this review, we demonstrate FDG-PET/CT imaging features of COVID-19, including our experience and current knowledge, and discuss the value of FDG-PET/CT in terms of estimating the pathologic mechanism.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Inagaki
- Department of General Internal Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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69
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Vavougios GD. SARS-CoV-2 dysregulation of PTBP1 and YWHAE/Z gene expression: A primer of neurodegeneration. Med Hypotheses 2020; 144:110212. [PMID: 33254518 PMCID: PMC7448818 DOI: 10.1016/j.mehy.2020.110212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/20/2020] [Indexed: 12/31/2022]
Abstract
SARS-CoV-2 neurotropism has been increasingly recognized by its imaging and syndromic manifestations in the literature. The purpose of this report is to explore the limited yet salient current evidence that SARS-CoV-2′s host genomic targets PTBP1 and the 14-3-3 protein isoform encoding genes YWHAE and YWHAZ may be hold the key to understanding how neurotropism triggers neurodegeneration and how it may contribute to the onset of neurodegenerative disease. Considering that PTBP1 silencing in particular has recently been shown to reverse clinical parkinsonism and induce neurogenesis, as well as the known interactions of PTBP1 and YWHAE/Z with coronaviruses – most notably 14-3-3 and SARS-CoV, recent studies reinvigorate the infectious etiology hypotheses on major neurodegenerative disease such as AD and iPD. Considering that human coronaviruses with definite neurotropism have been shown to achieve long-term latency within the mammalian CNS as a result of specific accommodating mutations, the corroboration of genomic-level evidence with neuroimaging has vast potential implications for neurodegenerative disease.
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Affiliation(s)
- George D Vavougios
- Department of Neurology, Athens Naval Hospital, P.C. 115 21, Athens, Greece; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, P.C. 41500 Larissa, Greece; Department of Computer Science and Telecommunications, University of Thessaly, Papasiopoulou 2 - 4, P.C. 35 131 - Galaneika, Lamia, Greece.
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70
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Haseli S, Karimi-Galougahi M. Reply to "MRI Evaluation of the Olfactory Clefts in Patients with SARS-CoV-2 Infection Revealed an Unexpected Mechanism for Olfactory Function Loss". Acad Radiol 2020; 27:1192. [PMID: 32553280 PMCID: PMC7284249 DOI: 10.1016/j.acra.2020.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 10/25/2022]
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71
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Le Guennec L, Devianne J, Jalin L, Cao A, Galanaud D, Navarro V, Boutolleau D, Rohaut B, Weiss N, Demeret S. Orbitofrontal involvement in a neuroCOVID-19 patient. Epilepsia 2020; 61:e90-e94. [PMID: 32589794 PMCID: PMC7361605 DOI: 10.1111/epi.16612] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/15/2020] [Accepted: 06/23/2020] [Indexed: 01/01/2023]
Abstract
Neurological manifestations of coronavirus disease 19 (COVID‐19) such as encephalitis and seizures have been reported increasingly, but our understanding of COVID‐19‐related brain injury is still limited. Herein we describe prefrontal involvement in a patient with COVID‐19 who presented prior anosmia, raising the question of a potential trans‐olfactory bulb brain invasion.
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Affiliation(s)
- Loïc Le Guennec
- Neurology Department, Neurological Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France.,Sorbonne Université, Paris, France.,Brain Institute Paris, ICM (Inserm, CNRS, Sorbonne Université), Paris, France
| | - Julia Devianne
- Neurology Department, Neurological Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France.,Sorbonne Université, Paris, France
| | - Laurence Jalin
- Sorbonne Université, Paris, France.,Neurosurgical Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France
| | - Albert Cao
- Neurology Department, Neurological Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France.,Sorbonne Université, Paris, France
| | - Damien Galanaud
- Sorbonne Université, Paris, France.,Neuroradiology Department, Hôpital Pitié-Salpêtrière, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France
| | - Vincent Navarro
- Sorbonne Université, Paris, France.,Brain Institute Paris, ICM (Inserm, CNRS, Sorbonne Université), Paris, France.,Neurology and Neurophysiology Department, Hôpital Pitié-Salpêtrière, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France
| | - David Boutolleau
- Sorbonne Université, Paris, France.,Virology Department, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France
| | - Benjamin Rohaut
- Neurology Department, Neurological Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France.,Sorbonne Université, Paris, France.,Brain Institute Paris, ICM (Inserm, CNRS, Sorbonne Université), Paris, France.,Department of Neurology, Columbia University, New York, New York
| | - Nicolas Weiss
- Neurology Department, Neurological Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France.,Sorbonne Université, Paris, France.,Brain Institute Paris, ICM (Inserm, CNRS, Sorbonne Université), Paris, France
| | - Sophie Demeret
- Neurology Department, Neurological Intensive Care Unit, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, Paris, France.,Sorbonne Université, Paris, France.,Brain Institute Paris, ICM (Inserm, CNRS, Sorbonne Université), Paris, France
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