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Aiyegbusi OL. COVID-19 related headaches: epidemiology, pathophysiology, impacts, and management. Curr Opin Neurol 2023; 36:609-614. [PMID: 37865841 DOI: 10.1097/wco.0000000000001219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
PURPOSE OF REVIEW This is an expert overview of the recent literature on the nature, epidemiology, pathophysiology, impact, and management of COVID-19 related headache, in the acute phase of infection and in post-COVID-19 syndrome. RECENT FINDINGS Headache is one of the commonest symptoms of COVID-19 during acute infection and it is often experienced by individuals who go on to develop long COVID. There is a higher prevalence of headache in individuals with long COVID who contracted the Delta variant than in those who were infected with the Wuhan or Alpha variants. Headaches related to COVID-19 infection are commoner and may be more intense in women.There are indications that presence of headache might indicate a more benign COVID-19 infection and a better chance of survival. However, the impact of COVID-19 related headache could be substantial leading to poor quality of life in individuals affected. Headache that changes in its nature in terms of frequency and severity should be investigated to exclude cerebrovascular complications. There are promising new therapies for its treatment, but further research is needed. SUMMARY The findings of this review can promote a better understanding of COVID-19 related headache and guide clinicians in the management of patients.
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Affiliation(s)
- Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston
- National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham
- NIHR Applied Research Collaboration (ARC) West Midlands
- NIHR Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, Birmingham, UK
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2
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Wesselingh R. Prevalence, pathogenesis and spectrum of neurological symptoms in COVID-19 and post-COVID-19 syndrome: a narrative review. Med J Aust 2023; 219:230-236. [PMID: 37660309 DOI: 10.5694/mja2.52063] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 09/05/2023]
Abstract
Neurological symptoms are not uncommon during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reflect a broad spectrum of neurological disorders of which clinicians should be aware. The underlying pathogenesis of neurological disease in coronavirus disease 2019 (COVID-19) may be due to four mechanisms of nervous system dysfunction and injury: i) direct viral neurological invasion; ii) immune dysregulation; iii) endothelial dysfunction and coagulopathy; and iv) severe systemic COVID-19 disease. Neurological manifestations of acute COVID-19 include headache, peripheral neuropathies, seizures, encephalitis, Guillain-Barré syndrome, and cerebrovascular disease. Commonly reported long term neurological sequelae of COVID-19 are cognitive dysfunction and dysautonomia, which despite being associated with severe acute disease are also seen in people with mild disease. Assessment of cognitive dysfunction after COVID-19 is confounded by a high prevalence of comorbid fatigue, anxiety, and mood disorders. However, other markers of neuroaxonal breakdown suggest no significant neuronal injury apart from during severe acute COVID-19. The long term impact of COVID-19 on neurological diseases remains uncertain and requires ongoing vigilance.
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Affiliation(s)
- Robb Wesselingh
- Monash University, Melbourne, VIC
- Alfred Hospital, Melbourne, VIC
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3
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Sarıoğlu E, Sarıaltın SY, Çoban T. Neurological complications and effects of COVID-19: Symptoms and conceivable mechanisms. BRAIN HEMORRHAGES 2023; 4:154-173. [PMID: 36789140 PMCID: PMC9911160 DOI: 10.1016/j.hest.2023.02.001] [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: 01/12/2023] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 in Wuhan, China. The new coronavirus disease (COVID-19) was declared a global pandemic by the World Health Organization (WHO) in March 2020. SARS-CoV-2 can invade the nervous system aside from infecting the respiratory system as its primary target. The most common nervous system symptoms of COVID-19 are stated as headache, myalgia, fatigue, nausea, vomiting, sudden and unexplained anosmia, and ageusia. More severe conditions such as encephalomyelitis, acute myelitis, thromboembolic events, ischemic stroke, intracerebral hemorrhage, Guillain-Barré-syndrome, Bell's palsy, rhabdomyolysis, and even coma have also been reported. Cohort studies revealed that neurological findings are associated with higher morbidity and mortality. The neurological symptoms and manifestations caused by SARS-CoV-2 and COVID-19 are examined and summarized in this article.
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Affiliation(s)
- Elif Sarıoğlu
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
| | - Sezen Yılmaz Sarıaltın
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
| | - Tülay Çoban
- Ankara University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, 06560 Ankara, Turkey
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Ruggeri M, Ricci M, Pagliaro M, Gerace C. Anosmia predicts memory impairment in post-COVID-19 syndrome: results of a neuropsychological cohort study. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01670-2. [PMID: 37644214 DOI: 10.1007/s00406-023-01670-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023]
Abstract
Recovered COVID-19 patients frequently suffer of cognitive disorders. Several etiopathogenetic mechanisms have been considered for the brain complications in COVID-19 but results are uncertain. Amongst them, an olfactory route to SARS-CoV-2 brain infection might explain cognitive and memory disturbances in post-COVID-19 patients, given the cooccurrence of anosmia and possible underlying limbic involvement. The aims of the study are to investigate cognition of patients with post-COVID-19 syndrome, and to find clinical factors predicting cognitive and memory impairments. 18 patients with post-COVID-19 syndrome underwent neuropsychological assessment and evaluation of clinical parameters. Stepwise regression analysis was used between clinical parameters as factors and cognitive global scores as dependent variables. Since only anosmia predicted memory performances, repeated measures ANOVA of memory scores was conducted between anosmic and non-anosmic patients. We found lack of association between clinical parameters and cognitive performances. Only anosmia was a good predictor for memory performances, with anosmic subjects showing a temporo-mesial amnesic profile. Our study shows novel findings of causal association between transient anosmia during COVID-19 and memory disorders with temporo-mesial dysfunction, probably sharing a common pathophysiological mechanism, and suggesting a possible SARS-CoV 2 infection of the limbic brain via the olfactory route. In contrast to previous studies, cognitive dysfunctions were not associated with respiratory distress, comorbidity, and depression.
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Affiliation(s)
- Massimiliano Ruggeri
- Cognitive Disorders and Dementia Unit, San Camillo Forlanini Hospital, C.ne Gianicolense 57, 00152, Rome, Italy.
- Rehabilitation Center C.A.R., Rome, Italy.
| | - Monica Ricci
- Cognitive Disorders and Dementia Unit, San Camillo Forlanini Hospital, C.ne Gianicolense 57, 00152, Rome, Italy
| | | | - Carmela Gerace
- Cognitive Disorders and Dementia Unit, San Camillo Forlanini Hospital, C.ne Gianicolense 57, 00152, Rome, Italy
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Ousseiran ZH, Fares Y, Chamoun WT. Neurological manifestations of COVID-19: a systematic review and detailed comprehension. Int J Neurosci 2023; 133:754-769. [PMID: 34433369 PMCID: PMC8506813 DOI: 10.1080/00207454.2021.1973000] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/25/2021] [Accepted: 08/16/2021] [Indexed: 12/13/2022]
Abstract
The current pandemic caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is accompanied with a rapid increase of reports and papers detailing its neurological effects and symptoms. The virus infection causes respiratory illness named by the world health organization as corona virus 19 (COVID-19).This systematic review aims to study and summarize the different neurological manifestations of this virus. All articles published and indexed via Pubmed, Medline and Google Scholar databases between January 1st 2020 and February 28th 2021 that reported neurological symptoms of SARS-CoV-2 are reviewed following the Preferred Reporting Items for Systemic review and Meta-Analysis (PRISMA) guidelines.We included data from 113 articles: eight prospective studies, 25 retrospective studies and the rest were case reports/series. COVID-19 can present with central nervous system manifestations, such as headache, encephalitis and encephalopathy, peripheral nervous system manifestations, such as anosmia, ageusia and Guillian Barre syndrome, and skeletal muscle manifestations, such as myalgia and myasthenia gravis. Our systematic review showed that COVID-19 can be manifested by a wide spectrum of neurological symptoms reported either in the early stage or within the course of the disease. However, a detailed comprehension of these manifestations is required and more studies are needed in order to improve our scientific knowledge and to develop preventive and therapeutic measures to control this pandemic.
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Affiliation(s)
- Zeina Hassan Ousseiran
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Youssef Fares
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Wafaa Takash Chamoun
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Loss of Sour Taste Is the Striking Feature among Four Basic Taste Qualities in Tunisian COVID-19 Patients. J Clin Med 2023; 12:jcm12020597. [PMID: 36675526 PMCID: PMC9865029 DOI: 10.3390/jcm12020597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Taste disorders (TDs) have been reported to be very common in patients suffering from coronavirus disease 2019 (COVID-19), which is caused by the SARS-CoV-2 virus. In most of the hitherto conducted studies, a gustatory assessment was performed on the basis of surveys or self-reports by patients. The aim of our study was to undertake an objective assessment of four basic taste qualities by conducting tasting sessions that allowed detection thresholds in COVID-19 Tunisian patients and to study their associations with inflammation. METHODS This analytical cross-sectional study was conducted on 89 patients aged between 21 to 70 years who had been diagnosed with COVID-19. We used Burghart taste strips to assess taste perception of the four taste qualities, i.e., sour, bitter, sweet, and salty. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) were measured. RESULTS Taste disorders were reported by 40.4% of the patients, while objective assessments revealed that 63.8% of participants were suffering from hypogeusia and/or ageusia. Sour taste was the most altered (70.8%) gustatory quality. Patients with severe COVID-19 had significantly lower sour and bitter taste scores when compared to patients with minor/moderate forms. There was no significant association between serum inflammatory markers and taste disorders. However, the relationship between bitter and sweet taste qualities and IL-1β levels was significant (p = 0.018 and p = 0.041). CONCLUSIONS Our results demonstrate the interest in the objective assessment of taste dysfunctions in COVID-19 patients.
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2023; 48:bjad043. [PMID: 38100383 PMCID: PMC11320609 DOI: 10.1093/chemse/bjad043] [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] [Indexed: 12/17/2023] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 235 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,015 COVID-19-positive patients, 36.62% reported taste dysfunction (95% confidence interval: 33.02%-40.39%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 15) versus self-report (n = 220) methodologies (Q = 1.73, df = 1, P = 0.1889). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced,
Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research,
National Institutes of Health, Bethesda, MD,
USA
- Division of Intramural Research, National Institute of Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda,
MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St,
Philadelphia PA 19104, USA
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Narayanan SN, Shivappa P, Padiyath S, Bhaskar A, Li YW, Merghani TH. The Prevalence and Pathophysiology of Chemical Sense Disorder Caused by the Novel Coronavirus. Front Public Health 2022; 10:839182. [PMID: 35734755 PMCID: PMC9207763 DOI: 10.3389/fpubh.2022.839182] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/20/2022] [Indexed: 12/27/2022] Open
Abstract
Emerging viral infections are a ceaseless challenge and remain a global public health concern. The world has not yet come back to normal from the devastating effects of the highly contagious and pathogenic novel coronavirus, or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Olfactory and taste dysfunction is common in patients infected by the novel coronavirus. In light of the emergence of different coronavirus variants, it is important to update the prevalence and pathophysiology of these side effects. In this review, articles published on the prevalence of olfactory and taste dysfunction from coronavirus disease (COVID-19) and their possible pathophysiologic mechanisms have been reviewed and reported. The modulatory role of different SARS-CoV-2 variants on the chemical senses is then described. The clinical relevance of chemical sense disorder and its long-term morbidity and management is also discussed.
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Affiliation(s)
- Sareesh Naduvil Narayanan
- Department of Physiology, Ras Al Khaimah College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
- *Correspondence: Sareesh Naduvil Narayanan ; orcid.org/0000-0002-2980-2352
| | - Pooja Shivappa
- Department of Basic Sciences, Ras Al Khaimah College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
| | - Sreeshma Padiyath
- Independent Microbiology Researcher, Ras Al Khaimah, United Arab Emirates
| | - Anand Bhaskar
- Department of Biomedical Sciences, Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - Yan Wa Li
- Department of Biomedical Sciences, Faculty of Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - Tarig Hakim Merghani
- Department of Physiology, Ras Al Khaimah College of Medical Sciences, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates
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9
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: a systematic review and meta-analysis. Chem Senses 2022; 47:bjac001. [PMID: 35171979 PMCID: PMC8849313 DOI: 10.1093/chemse/bjac001] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19 taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Drawing on previous studies and guided by early meta-analyses, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct measures of taste are at least as sensitive as those obtained by self-report and that the preponderance of evidence confirms taste loss is a symptom of COVID-19. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% confidence interval: 35.34%-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, P = 0.45). Generally, males reported lower rates of taste loss than did females, and taste loss was highest among middle-aged adults. Thus, taste loss is likely a bona fide symptom of COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
- Mackenzie E Hannum
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
- Department of Public Health, University of California Merced, Merced, CA 95348, USA
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104, USA
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10
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Lopes PH, Wellacott L, de Almeida L, Villavicencio LMM, Moreira ALDL, Andrade DS, Souza AMDC, de Sousa RKR, Silva PDS, Lima L, Lones M, do Nascimento JD, Vargas PA, Moioli RC, Blanco Figuerola W, Rennó-Costa C. Measuring the impact of nonpharmaceutical interventions on the SARS-CoV-2 pandemic at a city level: An agent-based computational modelling study of the City of Natal. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000540. [PMID: 36962551 PMCID: PMC10021960 DOI: 10.1371/journal.pgph.0000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic hit almost all cities in Brazil in early 2020 and lasted for several months. Despite the effort of local state and municipal governments, an inhomogeneous nationwide response resulted in a death toll amongst the highest recorded globally. To evaluate the impact of the nonpharmaceutical governmental interventions applied by different cities-such as the closure of schools and businesses in general-in the evolution and epidemic spread of SARS-CoV-2, we constructed a full-sized agent-based epidemiological model adjusted to the singularities of particular cities. The model incorporates detailed demographic information, mobility networks segregated by economic segments, and restricting bills enacted during the pandemic period. As a case study, we analyzed the early response of the City of Natal-a midsized state capital-to the pandemic. Although our results indicate that the government response could be improved, the restrictive mobility acts saved many lives. The simulations show that a detailed analysis of alternative scenarios can inform policymakers about the most relevant measures for similar pandemic surges and help develop future response protocols.
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Affiliation(s)
- Paulo Henrique Lopes
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Liam Wellacott
- Robotics Laboratory, Edinburgh Centre for Robotics, Heriot-Watt University, Edinburgh, United Kingdom
| | - Leandro de Almeida
- Physics Department, Federal University of Rio Grande do Norte, Natal, Brazil
- Laboratório Nacional de Astrofísica, Itajubá, MG, Brazil
| | | | - André Luiz de Lucena Moreira
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Dhiego Souto Andrade
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Alyson Matheus de Carvalho Souza
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Luciana Lima
- Demography Graduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Michael Lones
- Robotics Laboratory, Edinburgh Centre for Robotics, Heriot-Watt University, Edinburgh, United Kingdom
| | | | - Patricia A Vargas
- Robotics Laboratory, Edinburgh Centre for Robotics, Heriot-Watt University, Edinburgh, United Kingdom
| | - Renan Cipriano Moioli
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Robotics Laboratory, Edinburgh Centre for Robotics, Heriot-Watt University, Edinburgh, United Kingdom
| | - Wilfredo Blanco Figuerola
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Computer Science Department, State University of Rio Grande do Norte, Natal, Brazil
| | - César Rennó-Costa
- Bioinformatics Multidisciplinary Environment of the Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Digital Metropolis Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Robotics Laboratory, Edinburgh Centre for Robotics, Heriot-Watt University, Edinburgh, United Kingdom
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Abstract
This article reviews the current state of knowledge and promising new directions concerning the psychology of pandemics. Pandemics are disease outbreaks that spread globally. Historically, psychological factors have been neglected by researchers and health authorities despite evidence that pandemics are, to a large extent, psychological phenomena whereby beliefs and behaviors influence the spreading versus containment of infection. Psychological factors are important in determining (a) adherence to pandemic mitigation methods (e.g., adherence to social distancing), (b) pandemic-related social disruption (e.g., panic buying, racism, antilockdown protests), and (c) pandemic-related distress and related problems (e.g., anxiety, depression, posttraumatic stress disorder, prolonged grief disorder). The psychology of pandemics has emerged as an important field of research and practice during the coronavirus 2019 (COVID-19) pandemic. As a scholarly discipline, the psychology of pandemics is fragmented and diverse, encompassing various psychological subspecialties and allied disciplines, but is vital for shaping clinical practice and public health guidelines for COVID-19 and future pandemics. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada;
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12
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Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile. Healthcare (Basel) 2021; 9:healthcare9111501. [PMID: 34828547 PMCID: PMC8620259 DOI: 10.3390/healthcare9111501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
We analyzed the neurological manifestations in Mexican patients hospitalized with pneumonia due to COVID-19 and investigated the association between demographic, clinical, and biochemical variables and outcomes, including death. A retrospective, analytical study was conducted using the electronic records of patients hospitalized between 1 April 2020 and 30 September 2020. Records of 1040 patients were analyzed: 31.25% died and 79.42% had neurological symptoms, including headache (80.62%), anosmia (32.20%), ageusia (31.96%), myopathy (28.08%), disorientation (14.89%), encephalopathy (12.22%), neuropathy (5.4%), stroke (1.3%), seizures (1.3%), cerebral hemorrhage (1.08%), encephalitis (0.84%), central venous thrombosis (0.36%), and subarachnoid hemorrhage (0.24%). Patients also had comorbidities, such as hypertension (42.30%), diabetes mellitus (38.74%), obesity (61.34%), chronic obstructive pulmonary disease (3.17%), and asthma (2.01%). Factors associated with neurological symptoms were dyspnea, chronic obstructive pulmonary disease, advanced respiratory support, prolonged hospitalization, and worsening fibrinogen levels. Factors associated with death were older age, advanced respiratory support, amine management, chronic obstructive pulmonary disease, intensive care unit management, dyspnea, disorientation, encephalopathy, hypertension, neuropathy, diabetes, male sex, three or more neurological symptoms, and obesity grade 3. In this study we designed a profile to help predict patients at higher risk of developing neurological complications and death following COVID-19 infection.
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Ren AL, Digby RJ, Needham EJ. Neurological update: COVID-19. J Neurol 2021; 268:4379-4387. [PMID: 33929617 PMCID: PMC8085652 DOI: 10.1007/s00415-021-10581-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 12/15/2022]
Abstract
Coronavirus Disease 2019 is predominantly a disorder of the respiratory system, but neurological complications have been recognised since early in the pandemic. The major pathophysiological processes leading to neurological damage in COVID-19 are cerebrovascular disease, immunologically mediated neurological disorders and the detrimental effects of critical illness on the nervous system. It is still unclear whether direct invasion of the nervous system by the Severe Acute Respiratory Syndrome Coronavirus 2 occurs; given the vast numbers of people infected at this point, this uncertainty suggests that nervous system infection is unlikely to represent a significant issue if it occurs at all. In this review, we explore what has been learnt about the neurological complications of COVID-19 over the course of the pandemic, and by which mechanisms these complications most commonly occur.
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Affiliation(s)
- A L Ren
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - R J Digby
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - E J Needham
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
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14
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Hannum ME, Koch RJ, Ramirez VA, Marks SS, Toskala AK, Herriman RD, Lin C, Joseph PV, Reed DR. Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.10.09.21264771. [PMID: 34671775 PMCID: PMC8528083 DOI: 10.1101/2021.10.09.21264771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chemosensory scientists have been skeptical that reports of COVID-19 taste loss are genuine, in part because before COVID-19, taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID-19 patients, we conducted a systematic review and meta-analysis of 376 papers published in 2020-2021, with 241 meeting all inclusion criteria. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta-analysis showed that, among 138,897 COVID-19-positive patients, 39.2% reported taste dysfunction (95% CI: 35.34-43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, p = 0.45). Generally, males reported lower rates of taste loss than did females and taste loss was highest in middle-aged groups. Thus, taste loss is a bona fide symptom COVID-19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.
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Affiliation(s)
| | - Riley J Koch
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Vicente A Ramirez
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
- Department of Public Health, University of California Merced, Merced, CA 95348
| | - Sarah S Marks
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Aurora K Toskala
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Riley D Herriman
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Cailu Lin
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
| | - Paule V Joseph
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- Division of Intramural Research, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Danielle R Reed
- Monell Chemical Senses Center, 3500 Market St, Philadelphia PA 19104
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Peterson CJ, Sarangi A, Bangash F. Neurological sequelae of COVID-19: a review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021; 57:122. [PMID: 34511868 PMCID: PMC8424148 DOI: 10.1186/s41983-021-00379-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/26/2021] [Indexed: 01/28/2023] Open
Abstract
Background The COVID-19 pandemic has produced a myriad of challenges, including identifying and treating neurological sequelae. Main body COVID-19 can cause olfactory and respiratory dysfunction with average recovery within 1 month and a minority of patients experiencing symptoms at 8-month follow-up. Headaches are also very common (up to 93%) amongst patients with persistent COVID-19 symptoms. COVID-19 illness may also affect cognition, although results are mixed. Conclusion While many studies have focused on acute COVID-19 symptoms, more longitudinal studies will need to assess the neurological sequelae of the disease. Furthermore, care must be taken when attributing sequelae to COVID-19 illness and not an unrelated cause. Finally, there is concern that COVID-19 may be associated with secondary illnesses, such as Guillain–Barre, and may even contribute to the development of diseases, such as Alzheimer’s.
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Affiliation(s)
- Christopher J Peterson
- Menninger Department of Psychiatry, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 USA
| | - Ashish Sarangi
- Department of Psychiatry, Texas Tech University Health Sciences Center, 3601 4th St., Lubbock, TX 79430 USA
| | - Fariha Bangash
- SUNY Upstate Medical University, 750E Adams St, Syracuse, NY 13210 USA
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16
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He Y, Bai X, Zhu T, Huang J, Zhang H. What can the neurological manifestations of COVID-19 tell us: a meta-analysis. J Transl Med 2021; 19:363. [PMID: 34425827 PMCID: PMC8381866 DOI: 10.1186/s12967-021-03039-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/17/2021] [Indexed: 02/08/2023] Open
Abstract
Background Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae. Methods We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model. Results A total of 168 articles (n = 292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30–0.37; I2 = 99.17%), smell impairment(33%; 95%CI 0.28–0.38; I2 = 99.40%), taste dysfunction(33%; 95%CI 0.27–0.39; I2 = 99.09%), altered mental status(32%; 95%CI 0.22–0.43; I2 = 99.06%), headache(29%; 95%CI 0.25–0.33; I2 = 99.42%), encephalopathy(26%; 95%CI 0.16–0.38; I2 = 99.31%), alteration of consciousness(13%; 95%CI 0.08–0.19; I2 = 98.10%), stroke(12%; 95%CI 0.08–0.16; I2 = 98.95%), dizziness(10%; 95%CI 0.08–0.13; I2 = 96.45%), vision impairment(6%; 95%CI 0.03–0.09; I2 = 86.82%), intracerebral haemorrhage(5%; 95%CI 0.03–0.09; I2 = 95.60%), seizure(4%; 95%CI 0.02 -0.05; I2 = 98.15%), encephalitis(2%; 95%CI 0.01–0.03; I2 = 90.36%), Guillan-Barré Syndrome (GBS) (1%; 95%CI 0.00–0.03; I2 = 89.48%). Conclusions Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.
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Affiliation(s)
- Yuanyuan He
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Xiaojie Bai
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Tiantian Zhu
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Jialin Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China
| | - Hong Zhang
- Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, 218 jixi road, shushan district, Hefei, Anhui, China.
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Goshtasbi K, Pang J, Lehrich BM, Vasudev M, Birkenbeuel JL, Abiri A, Kuan EC. Association Between Olfactory Dysfunction and Critical Illness and Mortality in COVID-19: A Meta-analysis. Otolaryngol Head Neck Surg 2021; 166:388-392. [PMID: 34030510 DOI: 10.1177/01945998211017442] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Khodayar Goshtasbi
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Orange, California, USA
| | - Jonathan Pang
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Orange, California, USA
| | - Brandon M Lehrich
- Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Milind Vasudev
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Orange, California, USA
| | - Jack L Birkenbeuel
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Orange, California, USA
| | - Arash Abiri
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Orange, California, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Orange, California, USA
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18
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Fogang YF, Noubom M, Bassong PY, Mbonda PC, Mfopou IN, Gams DM, Kuate CT, Kamtchum-Tatuene J. Neurological manifestations in patients with symptomatic COVID-19 admitted to the Bafoussam Regional Hospital, Cameroon. Pan Afr Med J 2021; 38:326. [PMID: 34285749 PMCID: PMC8265250 DOI: 10.11604/pamj.2021.38.326.28973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 03/29/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION although the main manifestations of COVID-19 are respiratory, several neurological symptoms and complications have also been reported. The pandemic seems to have some epidemiological specificities in sub-Saharan Africa, and this may be reflected in the type and frequency of neurological symptoms. This study aimed to report neurological manifestations associated with symptomatic COVID-19 in a sub-Saharan African setting. METHODS we conducted a retrospective review of symptomatic PCR-confirmed COVID-19 cases admitted to the Bafoussam Regional Hospital between March and September 2020. Patients' files were reviewed at discharge by a consultant neurologist. Socio-demographic characteristics, co-morbidities, symptoms on admission, neurological symptoms during hospitalization, management, and in-hospital outcome were recorded. Comparisons between patients with and without neurological symptoms were performed using Fisher's exact and Mann-Whitney U test. RESULTS we enrolled 177 symptomatic patients (68% men). Mean age was 54.6 ± 17.8 years (range 2-99 years). Co-morbidities were present in 57.6% of patients, including hypertension (27.1%) and diabetes mellitus (25.4%). Neurological symptoms were found in 113 (63.8%) patients. The most frequent were headache (39.0%), myalgia (35.6%), anosmia (11.9%), impaired consciousness (10.7%) and delirium (5.6%). Regarding the presenting symptoms, fever was more frequent in patients with neurological symptoms than in those without (81.4% versus 50.0%, p< 0.001), while digestive symptoms were less frequent in patients with neurological symptoms (0.9% versus 9.4%, p= 0.004). CONCLUSION neurological manifestations are frequent and heterogeneous in patients with symptomatic COVID-19. Further studies are needed to clarify the pathophysiology of neurological symptoms in COVID-19 and their impact on patients' long-term outcome.
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Affiliation(s)
- Yannick Fogoum Fogang
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Bafoussam Regional Hospital, Bafoussam, Cameroon
| | - Michel Noubom
- Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Pierre-Yves Bassong
- Faculty of Medicine and Pharmaceutical Sciences, University of Bamenda, Bamenda, Cameroon
| | - Paul Chimi Mbonda
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | | | - Callixte Tegueu Kuate
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Joseph Kamtchum-Tatuene
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada
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19
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Bodnar B, Patel K, Ho W, Luo JJ, Hu W. Cellular mechanisms underlying neurological/neuropsychiatric manifestations of COVID-19. J Med Virol 2021; 93:1983-1998. [PMID: 33300152 PMCID: PMC7897247 DOI: 10.1002/jmv.26720] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022]
Abstract
Patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection manifest mainly respiratory symptoms. However, clinical observations frequently identified neurological symptoms and neuropsychiatric disorders related to COVID-19 (Neuro-SARS2). Accumulated robust evidence indicates that Neuro-SARS2 may play an important role in aggravating the disease severity and mortality. Understanding the neuropathogenesis and cellular mechanisms underlying Neuro-SARS2 is crucial for both basic research and clinical practice to establish effective strategies for early detection/diagnosis, prevention, and treatment. In this review, we comprehensively examine current evidence of SARS-CoV-2 infection in various neural cells including neurons, microglia/macrophages, astrocytes, pericytes/endothelial cells, ependymocytes/choroid epithelial cells, and neural stem/progenitor cells. Although significant progress has been made in studying Neuro-SARS2, much remains to be learned about the neuroinvasive routes (transneuronal and hematogenous) of the virus and the cellular/molecular mechanisms underlying the development/progression of this disease. Future and ongoing studies require the establishment of more clinically relevant and suitable neural cell models using human induced pluripotent stem cells, brain organoids, and postmortem specimens.
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Affiliation(s)
- Brittany Bodnar
- Department of Pathology and Laboratory Medicine, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
- Center for Metabolic Disease Research, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
- Biomedical Sciences Graduate Program, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA 19140
| | - Kena Patel
- Department of Pathology and Laboratory Medicine, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
- Center for Metabolic Disease Research, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
- Undergraduate Research Program, Temple University College of Science and Technology, 1803 North Broad Street, Philadelphia, PA, USA
| | - Wenzhe Ho
- Department of Pathology and Laboratory Medicine, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
| | - Jin Jun Luo
- Department of Neurology and Pharmacology, Temple University Lewis Katz School of Medicine, 3401 N Broad Street, Philadelphia, PA, USA
| | - Wenhui Hu
- Department of Pathology and Laboratory Medicine, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
- Center for Metabolic Disease Research, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA, USA
- Biomedical Sciences Graduate Program, Temple University Lewis Katz School of Medicine, 3500 N Broad Street, Philadelphia, PA 19140
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20
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de Sire A, Andrenelli E, Negrini F, Patrini M, Lazzarini SG, Ceravolo MG. Rehabilitation and COVID-19: a rapid living systematic review by Cochrane Rehabilitation Field updated as of December 31st, 2020 and synthesis of the scientific literature of 2020. Eur J Phys Rehabil Med 2021; 57:181-188. [PMID: 33599442 DOI: 10.23736/s1973-9087.21.06870-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION COVID-19 infection significantly increased mortality risk and the burden of disability in most survivors, regardless of symptom severity at onset. The rehabilitation needs of people infected are receiving growing attention, as evidenced by the increasing number of publications, including those addressing the chronic consequences of infection. This rapid living systematic review reports the evidence published in November and December 2020 and summarises the entire body of literature on rehabilitation in COVID-19 patients published in 2020. EVIDENCE ACQUISITION This update was performed using the methodology reported by the second edition conducted by Cochrane Rehabilitation REH-COVER Action. We searched PubMed, Embase, CINAHL, Scopus, Web of Science, and Pedro databases. Papers related to COVID-19 and rehabilitation were retrieved and summarised descriptively. EVIDENCE SYNTHESIS The search retrieved 4441 studies. After the removal of duplicates and the screening for title and abstract, we retained 105 studies. Of these, we included 54 in the qualitative synthesis of this update. According to OCEBM 2011 levels of evidence table, most studies (64.8%) fall within the category of level 4 evidence. Up to 40.7% of papers included COVID-19 patients in the postacute phase. In 2020, our rapid living systematic review included 230 studies; most of these (73.9%) were level 4 studies, 25.7% were level 3, and only one study was level 2. The evidence level improved over time. While most studies (44.8%) included patients with acute COVID-19, we observed a gradual increase in the number of reports about chronic symptoms and the long-term consequences of the infection. CONCLUSIONS The update of the rapid living systematic review by Cochrane Rehabilitation Field demonstrates an increase in the level of evidence of studies addressing the rehabilitation needs associated with COVID-19 infection. Although most studies are still case reports/series, there is a trend towards conducting prospective investigations of the early natural history of the disease (first months post onset). High-quality-level studies on the efficacy of rehabilitation, and long-term monitoring of the disease and its sequelae are yet to emerge.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
| | | | | | | | - Maria G Ceravolo
- Department of Experimental and Clinical Medicine, "Politecnica delle Marche" University, Ancona, Italy
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21
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Manzo C, Serra-Mestres J, Isetta M, Castagna A. Could COVID-19 anosmia and olfactory dysfunction trigger an increased risk of future dementia in patients with ApoE4? Med Hypotheses 2021; 147:110479. [PMID: 33422806 PMCID: PMC7785277 DOI: 10.1016/j.mehy.2020.110479] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/24/2020] [Indexed: 12/21/2022]
Abstract
The association of the coronavirus disease 2019 (COVID-19) with significant neurological and neuropsychiatric complications has been increasingly reported, both during the acute illness and in its aftermath. However, due to the short duration of patient follow up until now, it is not clear whether this infection will be associated with longer-term neurological and/or neuropsychiatric sequelae. In particular, the question of whether COVID-19 will be associated with an increased risk and rate of future dementia remains open and subject to speculation. During the course of the COVID-19 pandemic, an increasing number of patients have reported sudden anosmia or other olfactory dysfunction as concurrent symptoms. The possibility that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may reach the brain via the olfactory nerve or an upper nasal trancribrial route is an interesting working hypothesis. Among the identified genetic risk factors for Late-onset Alzheimer’s disease (LOAD), Apo E4 is one of the strongest and most frequent. People carrying one or two copies of the e4 allele of Apo E4 have significant odor recognition deficits in comparison to those not carrying this haplotype. The hypothesis invoked in this paper is that anosmia/olfactory dysfunctions induced by SARS-CoV-2 may cause an increased a risk of future neurodegenerative dementia in ApoE4 carriers, and that this risk would be higher than in Apo E4 carriers affected by anosmia not induced by SARS-CoV-2. This would be associated with virus-induced chronic modifications in the central nervous system. It is proposed that COVID-19 patients with anosmia and no other serious symptoms should be followed up as part of specifically designed and approved studies in order to identify the early stages of dementia (especially LOAD and Dementia with Lewy Bodies), thereby improving our knowledge of the mechanisms involved in pre-cognitive stages of neurodegenerative dementia and making best use of any available therapies. This latter opportunity is unique and should not be lost.
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Affiliation(s)
- Ciro Manzo
- Azienda Sanitaria Locale Napoli 3 sud, Internal and Geriatric Medicine Department, Center for Cognitive Disorders and Dementia, Health district no.51 - Pomigliano d'Arco Naples, Italy.
| | - Jordi Serra-Mestres
- Department of Old Age Psychiatry, Central and North West London NHS Foundation Trust, London, UK.
| | - Marco Isetta
- Library and Knowldege Services, Central and North West London NHS Foundation Trust, London, UK.
| | - Alberto Castagna
- Geriatric Medicine Department, Azienda Sanitaria Provinciale Catanzaro, Fragility Outpatient Clinic, Casa della Salute di Chiaravalle Centrale, Chiaravalle Catanzaro, Italy.
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22
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Kim HK, Cho YJ, Lee SY. Neurological Manifestations in Patients with COVID-19: Experiences from the Central Infectious Diseases Hospital in South Korea. J Clin Neurol 2021; 17:435-442. [PMID: 34184452 PMCID: PMC8242315 DOI: 10.3988/jcn.2021.17.3.435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background and Purpose To investigate the incidence and characteristics of neurological manifestations associated with coronavirus disease 2019 (COVID-19). Methods We reviewed the medical records of the consecutive patients with COVID-19 who were admitted to the central infectious diseases hospital designated for the treatment of COVID-19 in South Korea between March 2020 and September 2020. Newly developed neurological manifestations associated with COVID-19 were investigated. The frequency and clinical features of the neurological manifestations were analyzed according to disease severity, which was classified according to World Health Organization interim guidance. Results Of the 306 symptomatic patients, 186 (60.8%) developed at least one neurological manifestation during hospitalization. The most common neurological symptom was headache (n=102, 33.3%), followed by myalgia (n=96, 31.4%) and anosmia/ageusia (n=54, 17.6%). Acute stroke (all ischemic stroke) occurred in three (1.0%) patients, and new-onset seizures occurred in two (0.7%). Neurological manifestation was a presenting symptom of COVID-19 in 72 (23.5%) patients, and was the only symptom of COVID-19 in 12 (3.9%). Stroke, seizure, and impaired consciousness were significantly associated with severe to critical COVID-19, whereas headache and anosmia/ageusia were frequently found in patients with mild to moderate disease. Conclusions Neurological manifestations were commonly observed in patients with COVID-19. During the current pandemic, when patients present with new-onset neurological symptoms, COVID-19 may be considered as part of the differential diagnosis. Attention to severe neurological complications is needed, especially in patients with severe or critical COVID-19.
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Affiliation(s)
- Hyun Kyung Kim
- Department of Neurology, National Medical Center, Seoul, Korea
| | - Yeo Jeong Cho
- Department of Neurology, National Medical Center, Seoul, Korea
| | - Seo Young Lee
- Department of Neurology, School of Medicine, Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Chuncheon, Korea.
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