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Lee SH, Bonifacio F, Prudente AS, Choi YI, Roh J, Adjafre BL, Park CK, Jung SJ, Cunha TM, Berta T. STING recognition of viral dsDNA by nociceptors mediates pain in mice. Brain Behav Immun 2024; 121:29-42. [PMID: 39025416 DOI: 10.1016/j.bbi.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/05/2024] [Accepted: 07/15/2024] [Indexed: 07/20/2024] Open
Abstract
Pain is often one of the initial indicators of a viral infection, yet our understanding of how viruses induce pain is limited. Immune cells typically recognize viral nucleic acids, which activate viral receptors and signaling, leading to immunity. Interestingly, these viral receptors and signals are also present in nociceptors and are associated with pain. Here, we investigate the response of nociceptors to nucleic acids during viral infections, specifically focusing on the role of the viral signal, Stimulator of Interferon Genes (STING). Our research shows that cytosolic double-stranded DNA (dsDNA) from viruses, like herpes simplex virus 1 (HSV-1), triggers pain responses through STING expression in nociceptors. In addition, STING agonists alone can elicit pain responses. Notably, these responses involve the direct activation of STING in nociceptors through TRPV1. We also provided a proof-of-concept showing that STING and TRPV1 significantly contribute to the mechanical hypersensitivity induced by HSV-1 infection. These findings suggest that STING could be a potential therapeutic target for relieving pain during viral infections.
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Affiliation(s)
- Sang Hoon Lee
- Pain Research Center, Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, OH, United States
| | - Fabio Bonifacio
- Center for Research in Inflammatory Diseases, Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Arthur Silveira Prudente
- Pain Research Center, Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, OH, United States
| | - Y I Choi
- Department of Physiology, Medical School, Hanyang University, Seoul, South Korea
| | - Jueun Roh
- Pain Research Center, Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, OH, United States; Gachon Pain Center and Department of Physiology, College of Medicine, Gachon University, Incheon, South Korea
| | - Beatriz Lima Adjafre
- Pain Research Center, Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, OH, United States; Center for Research in Inflammatory Diseases, Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Chul-Kyu Park
- Gachon Pain Center and Department of Physiology, College of Medicine, Gachon University, Incheon, South Korea
| | - Sung Jun Jung
- Department of Physiology, Medical School, Hanyang University, Seoul, South Korea
| | - Thiago M Cunha
- Center for Research in Inflammatory Diseases, Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - Temugin Berta
- Pain Research Center, Department of Anesthesiology, University of Cincinnati Medical Center, Cincinnati, OH, United States.
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Oliveira KB, de Souza FMA, de Sá LBM, Pacheco ALD, Prado MR, de Sousa Rodrigues CF, Bassi ÊJ, Santana-Melo I, Silva-Júnior A, Sabino-Silva R, Shetty AK, de Castro OW. Potential Mechanisms Underlying COVID-19-Mediated Central and Peripheral Demyelination: Roles of the RAAS and ADAM-17. Mol Neurobiol 2024:10.1007/s12035-024-04329-8. [PMID: 38965171 DOI: 10.1007/s12035-024-04329-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
Demyelination is among the most conspicuous neurological sequelae of SARS-CoV-2 infection (COVID-19) in both the central (CNS) and peripheral (PNS) nervous systems. Several hypotheses have been proposed to explain the mechanisms underlying demyelination in COVID-19. However, none have considered the SARS-CoV-2's effects on the renin-angiotensin-aldosterone system (RAAS). Therefore, our objective in this review is to evaluate how RAAS imbalance, caused by direct and indirect effects of SARS-CoV-2 infection, could contribute to myelin loss in the PNS and CNS. In the PNS, we propose that demyelination transpires from two significant changes induced by SARS-CoV-2 infection, which include upregulation of ADAM-17 and induction of lymphopenia. Whereas, in the CNS, demyelination could result from RAAS imbalance triggering two alterations: (1) a decrease in angiotensin type II receptor (AT2R) activity, responsible for restraining defense cells' action on myelin; (2) upregulation of ADAM-17 activity, leading to impaired maturation of oligodendrocytes and myelin formation. Thus, we hypothesize that increased ADAM-17 activity and decreased AT2R activity play roles in SARS-CoV-2 infection-mediated demyelination in the CNS.
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Affiliation(s)
- Kellysson Bruno Oliveira
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Fernanda Maria Araujo de Souza
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Letícia Barros Maurício de Sá
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Amanda Larissa Dias Pacheco
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Mariana Reis Prado
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Célio Fernando de Sousa Rodrigues
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Ênio José Bassi
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Igor Santana-Melo
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Abelardo Silva-Júnior
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil
| | - Robinson Sabino-Silva
- Department of Physiology, Institute of Biomedical Sciences, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil
| | - Ashok K Shetty
- Institute for Regenerative Medicine, Department of Cell Biology and Genetics, Texas A&M University School of Medicine, College Station, TX, USA.
- Institute for Regenerative Medicine, Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, 77843, USA.
| | - Olagide Wagner de Castro
- Institute of Biological Sciences and Health, Federal University of Alagoas (UFAL), Av. Lourival de Melo Mota, Km 14, Campus A. C. Simões, Cidade Universitária, Maceió, AL, CEP, 57072-970, Brazil.
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Rau A, Gonzalez-Escamilla G, Schroeter N, Othmann A, Dressing A, Weiller C, Urbach H, Reisert M, Groppa S, Hosp JA. Inflammation-Triggered Enlargement of Choroid Plexus in Subacute COVID-19 Patients with Neurological Symptoms. Ann Neurol 2024. [PMID: 38934493 DOI: 10.1002/ana.27016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To investigate whether choroid plexus volumes in subacute coronavirus disease 2019 (COVID-19) patients with neurological symptoms could indicate inflammatory activation or barrier dysfunction and assess their association with clinical data. METHODS Choroid plexus volumes were measured in 28 subacute COVID-19 patients via cerebral magnetic resonance imaging (MRI), compared with those in infection-triggered non-COVID-19 encephalopathy patients (n = 25), asymptomatic individuals after COVID-19 (n = 21), and healthy controls (n = 21). Associations with inflammatory serum markers (peak counts of leukocytes, C-reactive protein [CRP], interleukin 6), an MRI-based marker of barrier dysfunction (CSF volume fraction [V-CSF]), and clinical parameters like olfactory performance and cognitive scores (Montreal Cognitive Assessment) were investigated. RESULTS COVID-19 patients showed significantly larger choroid plexus volumes than control groups (p < 0.001, η2 = 0.172). These volumes correlated significantly with peak leukocyte levels (p = 0.001, Pearson's r = 0.621) and V-CSF (p = 0.009, Spearman's rho = 0.534), but neither with CRP nor interleukin 6. No significant correlations were found with clinical parameters. INTERPRETATION In patients with subacute COVID-19, choroid plexus volume is a marker of central nervous system inflammation and barrier dysfunction in the presence of neurologic symptoms. The absence of plexus enlargement in infection-triggered non-COVID-19 encephalopathy suggests a specific severe acute respiratory syndrome coronavirus 2 effect. This study also documents an increase in choroid plexus volume for the first time as a parainfectious event. ANN NEUROL 2024.
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Affiliation(s)
- Alexander Rau
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriel Gonzalez-Escamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nils Schroeter
- Department of Neurology and Clinical Neuroscience, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ahmed Othmann
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andrea Dressing
- Department of Neurology and Clinical Neuroscience, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Cornelius Weiller
- Department of Neurology and Clinical Neuroscience, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marco Reisert
- Department of Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Stereotactic and Functional Neurosurgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sergiu Groppa
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jonas A Hosp
- Department of Neurology and Clinical Neuroscience, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Kozłowski P, Leszczyńska A, Ciepiela O. Long COVID Definition, Symptoms, Risk Factors, Epidemiology and Autoimmunity: A Narrative Review. AMERICAN JOURNAL OF MEDICINE OPEN 2024; 11:100068. [PMID: 39034937 PMCID: PMC11256271 DOI: 10.1016/j.ajmo.2024.100068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 07/23/2024]
Abstract
The virus called SARS-CoV-2 emerged in 2019 and quickly spread worldwide, causing COVID-19. It has greatly impacted on everyday life, healthcare systems, and the global economy. In order to save as many lives as possible, precautions such as social distancing, quarantine, and testing policies were implemented, and effective vaccines were developed. A growing amount of data collected worldwide allowed the characterization of this new disease, which turned out to be more complex than other common respiratory tract infections. An increasing number of convalescents presented with a variety of nonspecific symptoms emerging after the acute infection. This possible new global health problem was identified and labelled as long COVID. Since then, a great effort has been made by clinicians and the scientific community to understand the underlying mechanisms and to develop preventive measures and effective treatment. The role of autoimmunity induced by SARS-CoV-2 infection in the development of long COVID is discussed in this review. We aim to deliver a description of several conditions with an autoimmune background observed in COVID-19 convalescents, including Guillain-Barré syndrome, antiphospholipid syndrome and related thrombosis, and Kawasaki disease highlighting a relationship between SARS-CoV-2 infection and the development of autoimmunity. However, further studies are required to determine its true clinical significance.
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Affiliation(s)
- Paweł Kozłowski
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Leszczyńska
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
| | - Olga Ciepiela
- Central Laboratory, University Clinical Centre of the Medical University of Warsaw, Warsaw, Poland
- Department of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
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5
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Liu T, Wu H, Sun L, Wei J. Role of Inflammation in the Development of COVID-19 to Parkinson's Disease. J Inflamm Res 2024; 17:3259-3282. [PMID: 38800597 PMCID: PMC11127656 DOI: 10.2147/jir.s460161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) can lead to neurological symptoms such as headaches, confusion, seizures, hearing loss, and loss of smell. The link between COVID-19 and Parkinson's disease (PD) is being investigated, but more research is needed for a definitive connection. Methods Datasets GSE22491 and GSE164805 were selected to screen differentially expressed gene (DEG), and immune infiltration and gene set enrichment analysis (GSEA) of the DEG were performed. WGCNA analyzed the DEG and selected the intersection genes. Potential biological functions and signaling pathways were determined, and diagnostic genes were further screened using gene expression and receiver operating characteristic (ROC) curves. Screening and molecular docking of ibuprofen as a therapeutic target. The effectiveness of ibuprofen was verified by constructing a PD model in vitro, and constructing "COVID19-PD" signaling pathway, and exploring the role of angiotensin-converting enzyme 2 (ACE2) in PD. Results A total of 13 DEG were screened from the GSE36980 and GSE5281 datasets. Kyoto encyclopedia of genes and genomes (KEGG) analysis showed that the DEG were mainly associated with the hypoxia-inducible factor (HIF-1), epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor resistance, etc. After analysis, it is found that ibuprofen alleviates PD symptoms by inhibiting the expression of nuclear factor kappa-B (NF-κB), interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α). Based on signal pathway construction, the importance of ACE2 in COVID-19-induced PD has been identified. ACE2 is found to have widespread distribution in the brain. In the 1-methyl-4-phenyl-1,2,3,6-te-trahydropyridine (MPTP)-induced ACE2-null PD mice model, more severe motor and non-motor symptoms, increased NF-κB p65 and α-synuclein (α-syn) expression with significant aggregation, decreased tyrosine hydroxylase (TH), severe neuronal loss, and neurodegenerative disorders. Conclusion Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the risk of PD through an inflammatory environment and downregulation of ACE2, providing evidence for the molecular mechanism and targeted therapy associated with COVID-19 and PD.
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Affiliation(s)
- Tingting Liu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Institute of Neurourology and Urodynamics, Huaihe Hospital of Henan University, Kaifeng, 475004, People’s Republic of China
| | - Haojie Wu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Institute of Neurourology and Urodynamics, Huaihe Hospital of Henan University, Kaifeng, 475004, People’s Republic of China
| | - Lin Sun
- College of Chemistry and Molecular Sciences, Henan University, Kaifeng, 475004, People’s Republic of China
| | - Jianshe Wei
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Institute of Neurourology and Urodynamics, Huaihe Hospital of Henan University, Kaifeng, 475004, People’s Republic of China
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Huang Y, Chen T, Chen X, Wan L, Hou X, Zhuang J, Jiang J, Li Y, Qiu J, Yu K, Zhuang J. Corneal Stroma Analysis and Related Ocular Manifestations in Recovered COVID-19 Patients. Invest Ophthalmol Vis Sci 2024; 65:14. [PMID: 38713483 PMCID: PMC11086707 DOI: 10.1167/iovs.65.5.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/12/2024] [Indexed: 05/08/2024] Open
Abstract
Purpose The purpose of this study was to assess the impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) on corneal stroma characteristics, ocular manifestations, and post-recovery refractive surgery outcomes after varying recovery durations. Methods Fresh corneal lenticules from patients with post-coronavirus disease 2019 (COVID-19; recovered within 135 days) and healthy controls (HCs) after small incision lenticule extraction (SMILE) surgery were obtained for experimental validation of SARS-CoV-2 susceptibility, morphological changes, and immune response of the corneal stroma. Corneal optical density (CD) was measured using the Pentacam HR. Corneal epithelium thickness (ET) and endothelium parameters were evaluated by wide-field optical coherence tomography (OCT) and non-contact specular microscopy (SP-1P), respectively. All the patients were assessed after SMILE surgery until 3 month of follow-up. Results The cornea was susceptible to SARS-CoV-2 with the presence of SARS-CoV-2 receptors (CD147 and ACE2) and spike protein remnants (4 out of 58) in post-recovery corneal lenticules. Moreover, SARS-CoV-2 infection triggered immune responses in the corneal stroma, with elevated IL-6 levels observed between 45 and 75 days post-recovery, which were then lower at around day 105. Concurrently, corneal mid-stromal nerve length and branching were initially higher in the 60D to 75D group and returned to control levels by day 135. A similar trend was observed in CD within zones 0 to 2 and 2 to 6 and in the hexagonal cells (HEX) ratio in endothelial cells, whereas ET remained consistent. Notably, these changes did not affect the efficacy, safety, or predictability of post-recovery SMILE surgery. Conclusions SARS-CoV-2 induces temporal alterations in corneal stromal morphology and function post-recovery. These findings provided a theoretical basis for corneal health and refractive surgery management in the post-COVID-19 milieu.
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Affiliation(s)
- Yuke Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Taiwei Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Xi Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Linxi Wan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Xiangtao Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Jiejie Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Jingyi Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Yan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Jin Qiu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Jing Zhuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Tianhe District, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
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Chavhan R, Wanjari A, Kumar S, Acharya S, Rathod N, Reddy H, Gemnani R. A Comprehensive Review on Navigating the Neurological Landscape of COVID-19: Insights Into Etiopathogenesis and Clinical Management. Cureus 2024; 16:e60079. [PMID: 38860093 PMCID: PMC11163389 DOI: 10.7759/cureus.60079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 05/10/2024] [Indexed: 06/12/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a global health crisis with significant neurological implications. While initially characterized by respiratory symptoms, COVID-19 has been increasingly recognized for its diverse neurological manifestations, including encephalopathy, stroke, peripheral neuropathies, and neuropsychiatric disorders. Understanding the neurological landscape of COVID-19 is essential for elucidating its pathophysiology, optimizing clinical management, and improving patient outcomes. This comprehensive review provides insights into the etiopathogenesis, clinical manifestations, diagnostic approaches, management strategies, and prognostic implications of neurological involvement in COVID-19. Mechanistic insights highlight the multifactorial nature of neurological complications involving direct viral invasion, immune-mediated mechanisms, and thrombotic events. Diagnostic challenges underscore the importance of a multidisciplinary approach to patient care, while management strategies emphasize early recognition and appropriate intervention. Long-term neurological sequelae and prognostic factors are also examined, emphasizing the need for comprehensive follow-up and rehabilitation services. Finally, recommendations for future research prioritize efforts to elucidate underlying mechanisms, identify biomarkers, and evaluate rehabilitative interventions. By addressing these challenges, we can better understand and mitigate the neurological consequences of the ongoing COVID-19 pandemic.
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Affiliation(s)
- Roma Chavhan
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Anil Wanjari
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Nishant Rathod
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Harshitha Reddy
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
| | - Rinkle Gemnani
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institiute of Higher Education and Research, Wardha, IND
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8
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Duan X, Huang Z, Zhang S, Zhu G, Wang R, Wang Z. SARS-CoV-2 Infection Impairs Oculomotor Functions: A Longitudinal Eye-tracking Study. J Eye Mov Res 2024; 17:10.16910/jemr.17.1.2. [PMID: 38694262 PMCID: PMC11060831 DOI: 10.16910/jemr.17.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024] Open
Abstract
Although Severe Acute Respiratory Syndrome Coronavirus 2 infection (SARS-CoV-2) is primarily recognized as a respiratory disease, mounting evidence suggests that it may lead to neurological and cognitive impairments. The current study used three eye-tracking tasks (free-viewing, fixation, and smooth pursuit) to assess the oculomotor functions of mild infected cases over six months with symptomatic SARS-CoV-2 infected volunteers. Fifty symptomatic SARS-CoV-2 infected, and 24 self-reported healthy controls completed the eye-tracking tasks in an initial assessment. Then, 45, and 40 symptomatic SARS-CoV-2 infected completed the tasks at 2- and 6-months post-infection, respectively. In the initial assessment, symptomatic SARS-CoV-2 infected exhibited impairments in diverse eye movement metrics. Over the six months following infection, the infected reported overall improvement in health condition, except for self-perceived mental health. The eye movement patterns in the free-viewing task shifted toward a more focal processing mode and there was no significant improvement in fixation stability among the infected. A linear discriminant analysis shows that eye movement metrics could differentiate the infected from healthy controls with an accuracy of approximately 62%, even 6 months post-infection. These findings suggest that symptomatic SARSCoV- 2 infection may result in persistent impairments in oculomotor functions, and the employment of eye-tracking technology can offer valuable insights into both the immediate and long-term effects of SARS-CoV-2 infections. Future studies should employ a more balanced research design and leverage advanced machine-learning methods to comprehensively investigate the impact of SARSCoV- 2 infection on oculomotor functions.
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Affiliation(s)
| | | | | | | | - Rong Wang
- Zhejiang Sci-Tech University, Hangzhou, China
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Passos V, Henkel LM, Wang J, Zapatero-Belinchón FJ, Möller R, Sun G, Waltl I, Schneider T, Wachs A, Ritter B, Kropp KA, Zhu S, Deleidi M, Kalinke U, Schulz TF, Höglinger G, Gerold G, Wegner F, Viejo-Borbolla A. Innate immune response to SARS-CoV-2 infection contributes to neuronal damage in human iPSC-derived peripheral neurons. J Med Virol 2024; 96:e29455. [PMID: 38323709 DOI: 10.1002/jmv.29455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
Severe acute respiratory coronavirus 2 (SARS-CoV-2) causes neurological disease in the peripheral and central nervous system (PNS and CNS, respectively) of some patients. It is not clear whether SARS-CoV-2 infection or the subsequent immune response are the key factors that cause neurological disease. Here, we addressed this question by infecting human induced pluripotent stem cell-derived CNS and PNS neurons with SARS-CoV-2. SARS-CoV-2 infected a low number of CNS neurons and did not elicit a robust innate immune response. On the contrary, SARS-CoV-2 infected a higher number of PNS neurons. This resulted in expression of interferon (IFN) λ1, several IFN-stimulated genes and proinflammatory cytokines. The PNS neurons also displayed alterations characteristic of neuronal damage, as increased levels of sterile alpha and Toll/interleukin receptor motif-containing protein 1, amyloid precursor protein and α-synuclein, and lower levels of cytoskeletal proteins. Interestingly, blockade of the Janus kinase and signal transducer and activator of transcription pathway by Ruxolitinib did not increase SARS-CoV-2 infection, but reduced neuronal damage, suggesting that an exacerbated neuronal innate immune response contributes to pathogenesis in the PNS. Our results provide a basis to study coronavirus disease 2019 (COVID-19) related neuronal pathology and to test future preventive or therapeutic strategies.
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Affiliation(s)
- Vania Passos
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Lisa M Henkel
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Jiayi Wang
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Francisco J Zapatero-Belinchón
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- Cluster of Excellence-Resolving Infection Susceptibility (RESIST), Hannover Medical School, Hannover, Germany
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
| | - Rebecca Möller
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Guorong Sun
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Inken Waltl
- Institute for Experimental Infection Research, TWINCORE, Centre for Experimental and Clinical Infection Research, A Joint Venture between the Helmholtz Centre for Infection Research and the Hannover Medical School, Hannover, Germany
| | - Talia Schneider
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Amelie Wachs
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Birgit Ritter
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Kai A Kropp
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Shuyong Zhu
- Hannover Medical School, Institute of Virology, Hannover, Germany
| | - Michela Deleidi
- Center of Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Ulrich Kalinke
- Cluster of Excellence-Resolving Infection Susceptibility (RESIST), Hannover Medical School, Hannover, Germany
- Institute for Experimental Infection Research, TWINCORE, Centre for Experimental and Clinical Infection Research, A Joint Venture between the Helmholtz Centre for Infection Research and the Hannover Medical School, Hannover, Germany
| | - Thomas F Schulz
- Hannover Medical School, Institute of Virology, Hannover, Germany
- Cluster of Excellence-Resolving Infection Susceptibility (RESIST), Hannover Medical School, Hannover, Germany
| | - Günter Höglinger
- Department of Neurology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence-Resolving Infection Susceptibility (RESIST), Hannover Medical School, Hannover, Germany
| | - Gisa Gerold
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
- Cluster of Excellence-Resolving Infection Susceptibility (RESIST), Hannover Medical School, Hannover, Germany
- Department of Clinical Microbiology, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Abel Viejo-Borbolla
- Hannover Medical School, Institute of Virology, Hannover, Germany
- Cluster of Excellence-Resolving Infection Susceptibility (RESIST), Hannover Medical School, Hannover, Germany
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10
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Minzenmay L, Antoniadis G, Paľa A, Bäzner UM, Knoll A, Petkov M, Wirtz CR, Pedro MT. The impact of SARS-Covid-19 pandemic on peripheral nerve surgery - A single centre report. Clin Neurol Neurosurg 2024; 237:108124. [PMID: 38266330 DOI: 10.1016/j.clineuro.2024.108124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE SARS-Cov-19 pandemic totally changed daily routine work in German hospitals. As hospital capacity was reduced, many surgeries were postponed or even cancelled. On March 25th 2020 the German Society of Neurosurgery (DGNC) published a statement in which urgent non-elective surgeries were defined for each neurosurgical domain, whereas elective interventions were deferred. The present work examines the impact of these Covid strategies focusing on patients with peripheral lesions who were conducted to our department during this period of time. METHODS All patients who underwent any peripheral nerve surgery at our department from January 2018 until December 2022, were included. The complete range of surgeries including peripheral nerve lesions was examined encompassing compression syndromes, traumatic lesions of brachial plexus, traumatic lesions and tumors of single peripheral nerves. The numbers of surgical procedures were compared before, during and after pandemic. Pearson correlation coefficient was analysed. RESULTS From 2018 to 2022 the total number of surgical procedures involving peripheral nerves included 2422 procedures. Compression syndromes made up the largest proportion (1433 operations, 59%), followed by peripheral nerve lesions (445 operations, 18%), peripheral nerve tumors (344 operations, 14%) and lesions of the brachial plexus (142 operations, 6%). The average was 40,5 interventions per month, the range was 7-63. Two declines in the number of peripheral nerve surgeries were noted during this period. The first was in April and May 2020 with an average drop of 65% and 41% respectively. In these months the average number of operations was 37. The second decrease was from October 2021 until January 2022, where number of surgeries was reduced by 16%, 36%, 83% and 18% with an average number of 50 operations. Both declines showed a significant and strong correlation with the lower number of compression syndrome treatments (r = 0.952, p < 0.001 and r = 0.968, p < 0.001), while no drop and no significant correlation was found in the treatment of traumatic peripheral nerve injuries (p = 0.769, r = 0.095 and p = 0.243, r = 0.366) and traumatic brachial plexus injuries (p = 0.787, r = 0.088 and p = 0.780, r = 0.09). A weak significant correlation was seen in the treatment numbers of peripheral nerve tumors (p = 0.017, r = 0.672 and p = 0.015, r = 0.67). CONCLUSION Covid-19 pandemic lead to a significant decrease in the number of nerve decompressions, since, according to the German Society of Neurosurgery, those were considered as elective surgeries.
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Affiliation(s)
- Lena Minzenmay
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany.
| | - Gregor Antoniadis
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany
| | - Andrej Paľa
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany
| | - Ute Marlies Bäzner
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany
| | - Andreas Knoll
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany
| | - Martin Petkov
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany
| | | | - Maria Teresa Pedro
- University of Ulm, Department of Neurosurgery, Lindenallee 2, 89312 Günzburg, Germany
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11
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Błażejewski G, Witkoś J, Hartman-Petrycka M. Changes in sensitivity and hedonic rating to transcutaneous electrical nerve stimulation following COVID-19. Sci Rep 2024; 14:1233. [PMID: 38216666 PMCID: PMC10786926 DOI: 10.1038/s41598-024-51596-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
COVID-19 affects not only the respiratory system but also other biological systems such as the nervous system. Usually, these changes are reported based on the patient's subjective description. The aim of our study, therefore, was to objectively determine the effect that the SARS-CoV-2 virus and COVID-19 disease has on sensory threshold and the hedonic and subjective perception of an electrical stimulus. The sensory threshold was tested on the inner forearm by applying non-invasive transcutaneous electrical nerve stimulation (TENS) with 100 Hz and 100 µs parameters and a biphasic current waveform. The study involved 211 participants, aged 22-79 years, with a mean age of 56.9 ± 12.1 years. There were 131 subjects in the COVID group, while the NON-COVID group, the control group, was matched to the COVID group in terms of gender, age, body mass index and presence of chronic diseases. The research was carried out in 2022. Sensory sensitivity was highest in the group that had suffered with COVID-19. The median sensory sensitivity was 11 mA in the COVID group and 14 mA (p < 0.001) in the NON-COVID group, however, the current sensitivity threshold decreased over time (R = 0.52, p < 0.001). Post COVID-19, the electrical stimulus was more often perceived as unpleasant: COVID versus NON-COVID (23% vs. 3%, p < 0.001) and as a different sensation to tingling (27% vs. 2%, p < 0.001). Post-COVID-19 patients have a lower sensory threshold, the electrical stimulus is more often described as unpleasant and in subjective feelings it is more often described as pinching. The differences between COVID and NON-COVID decrease with time since the onset of COVID symptoms.
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Affiliation(s)
- Grzegorz Błażejewski
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland.
| | - Joanna Witkoś
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Magdalena Hartman-Petrycka
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
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12
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Larrow DR, Hartnick C. Bilateral Vocal Cord Paralysis Requiring Long-term Tracheostomy After SARS-CoV-2 Infection. Pediatrics 2024; 153:e2023061897. [PMID: 38111347 DOI: 10.1542/peds.2023-061897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 12/20/2023] Open
Abstract
Bilateral vocal cord paralysis can cause obstruction of glottic airflow, resulting in respiratory distress and the need for a surgical airway. We report a case of acute onset bilateral vocal cord paralysis in a healthy adolescent patient 9 days after a mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This 15-year-old patient presented with dyspnea, tachypnea, and stridor. A fiberoptic laryngoscopy revealed bilateral vocal fold paralysis with limited vocal cord abduction causing respiratory distress. A detailed set of diagnostic test results, including blood work, imaging, and a lumbar puncture, were all negative other than her new onset diagnosis of SARS-CoV-2 infection. The patient underwent tracheostomy placement with the subsequent resolution of her symptoms. Her vocal cord function remains impaired, and the patient continues to be tracheostomy-dependent 13 months after the initial presentation. SARS-CoV-2 infection has multiple well-established neurologic complications in children. The current case suggests that vocal cord paralysis may be an additional neuropathic sequela of the virus. Vocal cord pathology should be an important consideration when constructing a differential for children presenting with voice, swallowing, or breathing complaints after SARS-CoV-2 infection.
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13
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Toruńska E, Owczarek-Konopka M, Konopka M, Gielecki JS, Klepacki Ł. Brachial plexopathy as a result of anatomical prone position in COVID-19 patients-Systematic review. Clin Anat 2024; 37:92-101. [PMID: 37646090 DOI: 10.1002/ca.24112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/08/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
In patients with COVID-19 different methods improving therapy have been used, including one of the anatomical position-prone position, to support ventilation. The aim of this review was to summarize the cases of brachial plexopathy as a consequence of the prone position in COVID-19 patients, and thus bring closer the issue of the brachial plexus in the face of clinical aspects of its function, palsy, and consequences. The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed, inclusion criteria were created according to Patients, Interventions, Comparisons, Outcomes (PICO). PubMed and Scopus were searched until April 1, 2023 by entering the key term with Boolean terms. The risk of bias was assessed using JBI's critical appraisal tools. Fifteen papers with 30 patients were included in the review. This study showed that brachial plexopathy after the prone position occurs more often among males, who are at least 50 years old with comorbidities like hypertension, overweight, and diabetes mellitus. The most common symptoms were weakness, pain, and motion deficits. Duration of the prone position session and the number of episodes were different as well as the modification of positioning. Brachial plexopathy is a significant problem during prone position, especially when hospitalization is prolonged, patients are males, have comorbidities, and changes in body weight. Attention should be drawn to understand the anatomy of the brachial plexus, correct positioning, avoiding factors worsening the prognosis, and proper nutrition of the patients.
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Affiliation(s)
- Ewa Toruńska
- Department of Anatomy, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | | | - Mikołaj Konopka
- Department of Anatomy, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | | | - Łukasz Klepacki
- Department of Anatomy, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
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14
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Sideratou CM, Papaneophytou C. Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems. Infect Dis Rep 2023; 15:806-830. [PMID: 38131885 PMCID: PMC10742861 DOI: 10.3390/idr15060072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as 'long- COVID-19' (or simply 'long- COVID'), emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as 'post-acute sequelae of SARS-CoV-2 infection' (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review summarizes the primary effects of long COVID on the respiratory, cardiovascular, and nervous systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID's pathogenesis.
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Affiliation(s)
| | - Christos Papaneophytou
- Department of Life Sciences, School of Life and Health Sciences, University of Nicosia, 2417 Nicosia, Cyprus;
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15
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Wang Q, Gu H, Tao Y, Zhao Y, Meng Z. Number of initial symptoms of SARS-CoV-2 infection is associated with the risk of otological symptoms: a retrospective study. BMC Infect Dis 2023; 23:862. [PMID: 38062350 PMCID: PMC10704705 DOI: 10.1186/s12879-023-08866-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The characteristics of otological symptoms in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are lacking. Almost no research has been conducted to explore the emergence of otological symptoms after coronavirus disease 2019 infection. The aims of this study were to investigate the prevalence and specific clinical characteristics of and risk factors for otological symptoms among patients with SARS-CoV-2 infection. METHODS We included two groups to investigate the prevalence and clinical characteristics of otological symptoms among patients with SARS-CoV-2 infection. The first sample (S1) was drawn retrospectively from four communities via questionnaires, and the second sample (S2) from an outpatient clinic. RESULTS A total of 189 participants were included in S1 (124 women [65.6%]; mean [standard deviation (SD)] age, 33.66 [13.56] years), and 47 in S2 (25 women [53.2%]; mean [SD] age, 45.28 [14.64] years). The most prevalent otological symptoms in S1 were dizziness (15.9%), tinnitus (7.9%), aural fullness (6.9%), otalgia (5.3%), hearing loss (1.6%), and otopyorrhoea (1.1%). Moreover, for each additional typical symptom of SARS-CoV-2 infection, the risk (odds ratio) of otological symptoms increased by 1.33 (95% confidence interval: 1.10-1.61, p = 0.003). The prevalence of aural fullness was higher in the unvaccinated group than that in the group receiving two or three vaccinations (p = 0.018). CONCLUSIONS Various otological symptoms may occur in patients with SARS-CoV-2 infection. The number of typical symptoms of SARS-CoV-2 infection is positively associated with the probability of otological symptoms. However, vaccination may reduce the probability of certain otological symptoms.
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Affiliation(s)
- Qiang Wang
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hailing Gu
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Tao
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Zhao
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China.
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China.
| | - Zhaoli Meng
- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China.
- Department of Audiology and Speech Language Pathology, West China Hospital, Sichuan University, Chengdu, China.
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16
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Gao H, Wang S, Duan H, Wang Y, Zhu H. Biological analysis of the potential pathogenic mechanisms of Infectious COVID-19 and Guillain-Barré syndrome. Front Immunol 2023; 14:1290578. [PMID: 38115996 PMCID: PMC10728822 DOI: 10.3389/fimmu.2023.1290578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/23/2023] [Indexed: 12/21/2023] Open
Abstract
Background Guillain-Barré syndrome (GBS) is a medical condition characterized by the immune system of the body attacking the peripheral nerves, including those in the spinal nerve roots, peripheral nerves, and cranial nerves. It can cause limb weakness, abnormal sensations, and facial nerve paralysis. Some studies have reported clinical cases associated with the severe coronavirus disease 2019 (COVID-19) and GBS, but how COVID-19 affects GBS is unclear. Methods We utilized bioinformatics techniques to explore the potential genetic connection between COVID-19 and GBS. Differential expression of genes (DEGs) related to COVID-19 and GBS was collected from the Gene Expression Omnibus (GEO) database. By taking the intersection, we obtained shared DEGs for COVID-19 and GBS. Subsequently, we utilized bioinformatics analysis tools to analyze common DEGs, conducting functional enrichment analysis and constructing Protein-protein interaction networks (PPI), Transcription factors (TF) -gene networks, and TF-miRNA networks. Finally, we validated our findings by constructing the Receiver Operating Characteristic (ROC) curves. Results This study utilizes bioinformatics tools for the first time to investigate the close genetic relationship between COVID-19 and GBS. CAMP, LTF, DEFA1B, SAMD9, GBP1, DDX60, DEFA4, and OAS3 are identified as the most significant interacting genes between COVID-19 and GBS. In addition, the signaling pathway of NOD-like receptors is believed to be essential in the link between COVID-19 and GBS.
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Affiliation(s)
| | | | | | | | - Hui Zhu
- Department of Neurology, The First Teaching Hospital of Jilin University, Changchun, Jilin, China
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17
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Cappelletti G, Colombrita C, Limanaqi F, Invernizzi S, Garziano M, Vanetti C, Moscheni C, Santangelo S, Zecchini S, Trabattoni D, Silani V, Clerici M, Ratti A, Biasin M. Human motor neurons derived from induced pluripotent stem cells are susceptible to SARS-CoV-2 infection. Front Cell Neurosci 2023; 17:1285836. [PMID: 38116398 PMCID: PMC10728732 DOI: 10.3389/fncel.2023.1285836] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction COVID-19 typically causes Q7 respiratory disorders, but a high proportion of patients also reports neurological and neuromuscular symptoms during and after SARSCoV-2 infection. Despite a number of studies documenting SARS-CoV-2 infection of various neuronal cell populations, the impact of SARS-CoV-2 exposure on motor neuronal cells specifically has not been investigated so far. Methods Thus, by using human iPSC-derived motor neurons (iPSC-MNs) we assessed: (i) the expression of SARS-CoV-2 main receptors; (ii) iPSC-MN infectability by SARS-CoV-2; and (iii) the effect of SARS-CoV-2 exposure on iPSC-MN transcriptome. Results Gene expression profiling and immunofluorescence (IF) analysis of the main host cell receptors recognized by SARS-CoV-2 revealed that all of them are expressed in iPSC-MNs, with CD147 and NRP1 being the most represented ones. By analyzing SARS-CoV-2 N1 and N2 gene expression over time, we observed that human iPSC-MNs were productively infected by SARS-CoV-2 in the absence of cytopathic effect. Supernatants collected from SARS-CoV-2-infected iPSC-MNs were able to re-infect VeroE6 cells. Image analyses of SARS-CoV-2 nucleocapsid proteins by IF confirmed iPSC-MN infectability. Furthermore, SARS-CoV-2 infection in iPSCMNs significantly altered the expression of genes (IL-6, ANG, S1PR1, BCL2, BAX, Casp8, HLA-A, ERAP1, CD147, MX1) associated with cell survival and metabolism, as well as antiviral and inflammatory response. Discussion These results suggest for the very first time that SARS-CoV-2 can productively infect human iPSC-derived MNs probably by binding CD147 and NRP1 receptors. Such information will be important to unveil the biological bases of neuromuscular disorders characterizing SARS-CoV-2 infection and the so called long-COVID symptoms.
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Affiliation(s)
- Gioia Cappelletti
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Claudia Colombrita
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Fiona Limanaqi
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Laboratory of Immunology, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Sabrina Invernizzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Micaela Garziano
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
- Laboratory of Immunology, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudia Vanetti
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Claudia Moscheni
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Serena Santangelo
- Department of Medical Biotechnology and Translational Medicine, Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Silvia Zecchini
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Daria Trabattoni
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, University of Milan, Milan, Italy
| | - Mario Clerici
- Laboratory of Immunology, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Don C. Gnocchi Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Foundation, Milan, Italy
| | - Antonia Ratti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - Mara Biasin
- Laboratory of Immune-Biology, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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18
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Arora H, Bode A, Avula S, Naik R, Palleti S, Chandramohan D. Unilateral foot drop due to prone positioning in COVID-19: A case report. Clin Case Rep 2023; 11:e8287. [PMID: 38084357 PMCID: PMC10710528 DOI: 10.1002/ccr3.8287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/27/2023] [Accepted: 11/18/2023] [Indexed: 08/13/2024] Open
Abstract
KEY CLINICAL MESSAGE Understanding the complications arising from prone positioning following mechanical ventilation during management of acute respiratory distress from COVID-19. ABSTRACT Acute respiratory distress syndrome (ARDS) resulting from coronavirus disease 2019 (COVID-19) has been one of the well-known complications of the disease since it was first reported in 2020. Mechanical ventilation for severe ARDS has been widely utilized for the management of such patients. Prone positioning (PP) is associated with improved oxygenation and overall outcomes in both intubated and non-intubated patients. However, there are several complications associated with this procedure, including compressive neuropathies. In this article, we report a case of unilateral foot drop following mechanical ventilation and PP during the management of ARDS from COVID-19.
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Affiliation(s)
| | - Anna Bode
- Burrell College of Osteopathic MedicineLas CrucesNew MexicoUSA
| | - Sreekant Avula
- University of Minnesota, Twin CitiesMinneapolisMinnesotaUSA
| | - Roopa Naik
- Geisinger Wyoming Valley Medical CenterWilkes‐BarrePennsylvaniaUSA
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Al-Mazidi SH, ALRouq F, Alsabty AS, Alhajlah A, AlYahya A, Alsabih A, Al-Taweraqi R, Alahmari AS, Al-Dakhil L, Habib S. Relationship Between Clinical Outcomes and Nerve Conduction Studies Before and After Viral Infections in Healthy Individuals: Case Series. Cureus 2023; 15:e48980. [PMID: 38111436 PMCID: PMC10726065 DOI: 10.7759/cureus.48980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The neurological effect of viral respiratory infections has been acknowledged in many studies. However, patients who recovered from this infection show neurological manifestations and are not being routinely transferred for electrodiagnostic evaluation. AIM This study aimed to examine the neurological effect of viral respiratory infections on the nerve function using electrophysiology in patients fully recovered from viral respiratory infections. METHODS To limit bias in the results, the authors decided to choose patients who recovered from one virus in all participants (coronavirus). Medical records were screened for patients who performed nerve conduction studies (NCSs) before the coronavirus pandemic. Thirty patients met our inclusion criteria, and only 10 showed up to perform NCS. Data of the NCS was compared before and after the coronavirus infection for motor and sensory NCS parameters. RESULTS An increase in both the median and ulnar sensory nerve latencies and a decrease in the sensory nerve amplitude was observed. Also, there was a decrease in the motor conduction velocity (MCV) of the ulnar nerves and motor amplitude in the median nerve. In the lower limbs, there was a decrease in the sural nerve latency, increased MCV in the tibial nerves, and decreased MCV in the peroneal nerves. The proximal amplitudes of the tibial and peroneal nerves were increased, but the distal amplitude was increased only in the peroneal nerves and decreased in the tibial nerves. CONCLUSION There is a significant impact of viral infections on the peripheral nerves. Large-scale prospective studies are required to investigate the pathogenesis of the neuropathy and myopathy after viral infections.
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Affiliation(s)
| | - Fawzia ALRouq
- Physiology, King Saud University, College of Medicine, Riyadh, SAU
| | - Areej S Alsabty
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Abdullah Alhajlah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Asma AlYahya
- Physiology, King Saud University, College of Medicine, Riyadh, SAU
| | - Ahmed Alsabih
- Physiology, King Saud University, College of Medicine, Riyadh, SAU
| | | | | | - Lina Al-Dakhil
- Research, King Saud Medical City, Research Center, Riyadh, SAU
| | - Syed Habib
- Physiology, King Saud University, Riyadh, SAU
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20
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Díaz-Cano Carmona I, López Lozano AM, Pérez Rastrollo FJ, Moreno Moreno AM, Barrera Chacón JM. [Functional evaluation in patient with critical SARS-CoV-2 disease: Cohort study in a third level hospital rehabilitation unit]. Rehabilitacion (Madr) 2023; 57:100779. [PMID: 36738656 PMCID: PMC9790869 DOI: 10.1016/j.rh.2022.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION SARS-COV-2 pneumonia is a highly contagious respiratory disease that causes respiratory, physical and psychological dysfunctions. We present the results of patient assessment when they were discharged from the ICU. MATERIAL AND METHOD Cohort study of patients affected by SARS-COV-2 pneumonia admitted to the intensive care unit from 01/10/2020 to 31/07/2021. We collect sociodemographic data, personal history, ICU and hospital stay, Barthel, FAC and mMRC (pre-admission/initial assessment/discharge), development of osteomuscular and/or neurological pathology and need for rehabilitation treatment. RESULTS A total of 341 patients were evaluated, of which 224 met criteria. The average age was 63 years (68.75% men). Mean ICU/hospital stay were 27/44 days. They were assessed by physiatry, after that, we provide a guide developed by physiatry, solving doubts about the disease and setting exercises of intensity and progressive difficulty, to be carried out during the admission and at home. Neurological pathology was present at 42.86% patients, of whom a 83.33% were peripheral nervous system disease. The total of the sample needed respiratory physiotherapy and a 72.32% motor physiotherapy. CONCLUSIONS In our study, a high number of patients have needed rehabilitation treatment in order to get functional recovery, highlighting the development of post-COVID neurological pathology. SARS-COV-2 generates other complications, not only respiratory, subsidiary to be assessed and treated by rehabilitation services for a comprehensive recovery that minimizes sequelae.
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Affiliation(s)
- I Díaz-Cano Carmona
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - A M López Lozano
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F J Pérez Rastrollo
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A M Moreno Moreno
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J M Barrera Chacón
- UGC Medicina Física y Rehabilitación Hospital Universitario Virgen del Rocío, Sevilla, España
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21
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Abrams RMC, Zhou L, Shin SC. Persistent post-COVID-19 neuromuscular symptoms. Muscle Nerve 2023; 68:350-355. [PMID: 37466117 DOI: 10.1002/mus.27940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023]
Abstract
Neuromuscular symptoms may develop or persist after resolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Besides residual sensorimotor symptoms associated with acute neuromuscular complications of coronavirus disease-2019 (COVID-19), such as Guillain-Barré syndrome, critical illness neuromyopathy, and rhabdomyolysis, patients may report persistent autonomic symptoms, sensory symptoms, and muscle symptoms in the absence of these acute complications, including palpitations, orthostatic dizziness and intolerance, paresthesia, myalgia, and fatigue. These symptoms may be associated with long COVID, also known as post-COVID-19 conditions or postacute sequelae of SARS-CoV-2 infection, which may significantly impact quality of life. Managing these symptoms represents a challenge for health-care providers. Recent advances have identified small-fiber neuropathy as a potential etiology that may underlie autonomic dysfunction and paresthesia in some long COVID patients. The pathogenic mechanisms underlying myalgia and fatigue remain elusive and need to be investigated. Herein we review the current state of knowledge regarding the evaluation and management of patients with persistent post-COVID-19 neuromuscular symptoms.
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Affiliation(s)
- Rory M C Abrams
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lan Zhou
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Susan C Shin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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22
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Heidari ME, Nazemi P, Feizabad E, Beiranvand F, Afzali M. Cranial nerve involvement among COVID-19 survivors. Front Neurol 2023; 14:1182543. [PMID: 37602247 PMCID: PMC10436332 DOI: 10.3389/fneur.2023.1182543] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction COVID-19 was first reported in November 2019 in China and rapidly spread across the globe. COVID-19 causes neurologic symptoms and complications, which may persist even after recovery in patients. The objective of this research was to determine the involvement of cranial nerves in COVID-19 survivors. Method This was a retrospective study. The study was conducted between March and July of 2022. The analysis included 98 patients with a certain positive polymerase chain reaction. SPSS software version 19 was utilized for data analysis. Results The average age of the participants was 40.47 years (8.81). The olfactory nerve was found to be the most frequently involved cranial nerve (36.7%). Over 20% of participants had a taste disorder. The findings from the regression analysis indicated that lung involvement and age have a direct and significant relationship with cranial nerve involvement and can serve as its predictors (p = 0.001). Conclusion It seems that cranial nerve involvement was sustained in COVID-19 patients who survived. In addition, elderly patients and patients with severe illnesses were more likely to show cranial symptoms. It is necessary to monitor COVID-19 survivors for neurological symptoms.
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Affiliation(s)
| | - Pershang Nazemi
- Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Feizabad
- Community Medicine Specialist, Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Beiranvand
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Afzali
- Department of Neurology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
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23
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Ameer MZ, Haiy AU, Bajwa MH, Abeer H, Mustafa B, Ameer F, Amjad Z, Rehman AU. Association of Parsonage-Turner syndrome with COVID-19 infection and vaccination: a systematic review. J Int Med Res 2023; 51:3000605231187939. [PMID: 37523491 PMCID: PMC10392513 DOI: 10.1177/03000605231187939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVES The exact etiology of Parsonage-Turner syndrome is unknown, but it is known to be preceded by infection, vaccination, or surgical intervention. In this review, we describe associations of Parsonage-Turner syndrome with COVID-19 infection and vaccination. METHODS A systematic literature search was conducted using PubMed/MEDLINE, ScienceDirect, and Google Scholar. Microsoft Excel was used for data extraction and statistical analysis. The quality of case reports and case series was assessed using the Joanna Briggs Institute Critical Appraisal Tool. RESULTS We selected 44 case reports and 10 case series, including 68 patients (32 post-vaccination and 36 with post-COVID-19 infection Parsonage-Turner syndrome). Middle-aged males were predominantly affected in both groups. The most frequently administered vaccine was Comirnaty (Pfizer) (53%). The mean latency was 11.7 days in the post-vaccination group and 20.3 days in the post-infection group. The most affected nerves in both groups were the axillary, suprascapular, and musculocutaneous nerves; and 78.1% and 38.9% of patients showed partial amelioration of their symptoms in the post-vaccination and post-infection groups, respectively. CONCLUSION Post-vaccination Parsonage-Turner syndrome presents earlier than post-infection disease. Pain and sensorimotor deficits of the upper limb are common in both situations. Complete or partial recovery occurs in most cases.
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Affiliation(s)
| | - Ata Ul Haiy
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | - Huzaifa Abeer
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Biah Mustafa
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Fatima Ameer
- Department of Medicine, Mayo Hospital, King Edward Medical University, Lahore, Pakistan
| | - Zunaira Amjad
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Aqeeb Ur Rehman
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
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24
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Zhu D, Zhao R, Yuan H, Xie Y, Jiang Y, Xu K, Zhang T, Chen X, Suo C. Host Genetic Factors, Comorbidities and the Risk of Severe COVID-19. J Epidemiol Glob Health 2023; 13:279-291. [PMID: 37160831 PMCID: PMC10169198 DOI: 10.1007/s44197-023-00106-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/17/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was varied in disease symptoms. We aim to explore the effect of host genetic factors and comorbidities on severe COVID-19 risk. METHODS A total of 20,320 COVID-19 patients in the UK Biobank cohort were included. Genome-wide association analysis (GWAS) was used to identify host genetic factors in the progression of COVID-19 and a polygenic risk score (PRS) consisted of 86 SNPs was constructed to summarize genetic susceptibility. Colocalization analysis and Logistic regression model were used to assess the association of host genetic factors and comorbidities with COVID-19 severity. All cases were randomly split into training and validation set (1:1). Four algorithms were used to develop predictive models and predict COVID-19 severity. Demographic characteristics, comorbidities and PRS were included in the model to predict the risk of severe COVID-19. The area under the receiver operating characteristic curve (AUROC) was applied to assess the models' performance. RESULTS We detected an association with rs73064425 at locus 3p21.31 reached the genome-wide level in GWAS (odds ratio: 1.55, 95% confidence interval: 1.36-1.78). Colocalization analysis found that two genes (SLC6A20 and LZTFL1) may affect the progression of COVID-19. In the predictive model, logistic regression models were selected due to simplicity and high performance. Predictive model consisting of demographic characteristics, comorbidities and genetic factors could precisely predict the patient's progression (AUROC = 82.1%, 95% CI 80.6-83.7%). Nearly 20% of severe COVID-19 events could be attributed to genetic risk. CONCLUSION In this study, we identified two 3p21.31 genes as genetic susceptibility loci in patients with severe COVID-19. The predictive model includes demographic characteristics, comorbidities and genetic factors is useful to identify individuals who are predisposed to develop subsequent critical conditions among COVID-19 patients.
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Affiliation(s)
- Dongliang Zhu
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Renjia Zhao
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
| | - Huangbo Yuan
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yijing Xie
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
| | - Kelin Xu
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China
| | - Chen Suo
- Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China.
- Fudan University Taizhou Institute of Health Sciences, Yaocheng Road 799, Taizhou, Jiangsu, China.
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25
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Spiteri R, Barakat S, Vukicevic M. COVID-19 and sudden-onset ocular neurogenic palsy in prior healthy patients: a systematic review. Strabismus 2023; 31:145-151. [PMID: 37448224 DOI: 10.1080/09273972.2023.2232419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
BACKGROUND The aim of this systematic review is to identify cases of neurogenic ocular palsy in the presence of COVID-19 and to document patient characteristics, type of palsy and possible aetiologies. METHODS A systematic search of PubMed, Medline and CINAHL databases was conducted on the 6th of January 2023 to identify cases of neurogenic ocular palsy in patients with current or previous COVID-19 infection. Data were pooled to summarise the neurogenic palsy, patient clinical characteristics and proposed palsy mechanisms. RESULTS The combined database search yielded 1197 articles. Of these, 23 publications consisting of 25 patients met the inclusion criteria. Most patients were male (68%) and ranged in age from 2 to 71 years (median=32.7, SD=21.4). Seven patients (28%) were children aged 2 to 10 years old. Abducens palsies were most common (68%) and the most common ocular presentation was diplopia (76%) with an average time of onset 15 days from testing positive to COVID-19 or having symptoms of the virus. Proposed mechanism of development of a neurogenic palsy secondary to COVID-19 infection was classified into one of three categories: vascular/thrombotic, a viral neuro-invasive or inflammatory virus-mediated immune response. DISCUSSION This study suggests that COVID-19 infection may be linked to oculomotor, trochlear and abducens nerve palsies and the underlying mechanisms may vary but are difficult to definitively establish. Further studies investigating the onset of neurogenic palsy secondary to COVID-19 infection is required.
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Affiliation(s)
- Ryan Spiteri
- Discipline of Orthoptics, School of Allied Health Human Services and Sport, La Trobe University, Melbourne
| | - Sousann Barakat
- Discipline of Orthoptics, School of Allied Health Human Services and Sport, La Trobe University, Melbourne
| | - Meri Vukicevic
- Discipline of Orthoptics, School of Allied Health Human Services and Sport, La Trobe University, Melbourne
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26
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Florek S, Piegza M, Dębski P, Gorczyca P, Pudlo R. How COVID-19 pandemic period influences on the selected mental health parameters of Polish respondents? Front Psychol 2023; 14:1126471. [PMID: 37303919 PMCID: PMC10248506 DOI: 10.3389/fpsyg.2023.1126471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/29/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction There are many different articles about COVID-19 pandemic period and its influence on people and their behavior. Nevertheless, there is little research on the slightly later period of the pandemic, that is, the time when specific adaptation mechanisms in society should start to take place. Methods Our research was conducted by means of an online survey. Four hundred and eighty five adults participated, including 349 (71.96%) women and 136 (28.04%) men. The Buss-Perry aggression scale, Alcohol Use Disorders Identification Test and Generalized Anxiety Disorder 7 scale were used. The results were statistically processed using Statistica 13.3 software. Results Within the study population, positive correlations were noted between anxiety and generalized aggression, anger, hostility, physical and psychological aggression. In the female group, anxiety correlates positively with generalized aggression, anger, hostility, verbal and physical aggression. Among male subjects, anxiety correlates positively with aggression, anger, and hostility. Alcohol consumption has a significant association with verbal aggression. Statistically, more women experience anxiety, more men have inflated scores on the AUDIT scale and on verbal and physical aggression. Younger people are more likely than older people to experience anxiety and have inflated scores on hostility. Those with secondary education scored significantly higher on the GAD-7 scale and the aggression scale (and all subscales except anger) compared to respondents with higher education. Discussion As a result of adaptation to the COVID-19 pandemic, anxiety is no longer a factor in increased evels of alcohol consumption. The pandemic has not affected differences in alcohol consumption between men and women. The presence of a positive correlation between anxiety and aggression and the sociodemographic structure of those characterized by increased aggression are also unchanged. Anxiety directly influences aggressive behavior in a relatively strong way. Appropriate health-promoting measures should be implemented to protect the public from the negative effects of the COVID-19 pandemic.
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27
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Iacono S, Schirò G, Davì C, Mastrilli S, Abbott M, Guajana F, Arnao V, Aridon P, Ragonese P, Gagliardo C, Colomba C, Scichilone N, D’Amelio M. COVID-19 and neurological disorders: what might connect Parkinson's disease to SARS-CoV-2 infection. Front Neurol 2023; 14:1172416. [PMID: 37273689 PMCID: PMC10232873 DOI: 10.3389/fneur.2023.1172416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 06/06/2023] Open
Abstract
SARS-CoV-2 infection leading to Coronavirus disease 19 (COVID-19) rapidly became a worldwide health emergency due to its elevated infecting capacity, morbidity, and mortality. Parkinson’s disease (PD) is the second most common neurodegenerative disorder and, nowadays the relationship between SARS-CoV-2 outbreak and PD reached a great interest. Apparently independent one from the other, both diseases share some pathogenetic and clinical features. The relationship between SARS-CoV-2 infection and PD is complex and it depends on the direction of the association that is which of the two diseases comes first. Some evidence suggests that SARS-CoV-2 infection might be a possible risk factor for PD wherein the exposure to SARS-CoV-2 increase the risk for PD. This perspective comes out from the increasing cases of parkinsonism following COVID-19 and also from the anatomical structures affected in both COVID-19 and early PD such as olfactory bulb and gastrointestinal tract resulting in the same symptoms such as hyposmia and constipation. Furthermore, there are many reported cases of patients who developed hypokinetic extrapyramidal syndrome following SARS-CoV-2 infection although these would resemble a post-encephalitic conditions and there are to date relevant data to support the hypothesis that SARS-CoV-2 infection is a risk factor for the development of PD. Future large, longitudinal and population-based studies are needed to better assess whether the risk of developing PD after COVID-19 exists given the short time span from the starting of pandemic. Indeed, this brief time-window does not allow the precise estimation of the incidence and prevalence of PD after pandemic when compared with pre-pandemic era. If the association between SARS-CoV-2 infection and PD pathogenesis is actually putative, on the other hand, vulnerable PD patients may have a greater risk to develop COVID-19 being also more prone to develop a more aggressive disease course. Furthermore, PD patients with PD showed a worsening of motor and non-motor symptoms during COVID-19 outbreak due to both infection and social restriction. As well, the worries related to the risk of being infected should not be neglected. Here we summarize the current knowledge emerging about the epidemiological, pathogenetic and clinical relationship between SARS-CoV-2 infection and PD.
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Affiliation(s)
- Salvatore Iacono
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Chiara Davì
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Sergio Mastrilli
- Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone di Palermo, Palermo, Italy
| | - Michelle Abbott
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Fabrizio Guajana
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Valentina Arnao
- UO Neurologia e Stroke Unit, Azienda di Rilievo Nazionale ad Alta Specializzazione, Ospedali Civico Di Cristina Benfratelli, Palermo, Italy
| | - Paolo Aridon
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Cesare Gagliardo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Claudia Colomba
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Nicola Scichilone
- Division of Respiratory Diseases, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Marco D’Amelio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
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Serafini RA, Frere JJ, Zimering J, Giosan IM, Pryce KD, Golynker I, Panis M, Ruiz A, tenOever BR, Zachariou V. SARS-CoV-2 airway infection results in the development of somatosensory abnormalities in a hamster model. Sci Signal 2023; 16:eade4984. [PMID: 37159520 PMCID: PMC10422867 DOI: 10.1126/scisignal.ade4984] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
Although largely confined to the airways, SARS-CoV-2 infection has been associated with sensory abnormalities that manifest in both acute and chronic phenotypes. To gain insight on the molecular basis of these sensory abnormalities, we used the golden hamster model to characterize and compare the effects of infection with SARS-CoV-2 and influenza A virus (IAV) on the sensory nervous system. We detected SARS-CoV-2 transcripts but no infectious material in the cervical and thoracic spinal cord and dorsal root ganglia (DRGs) within the first 24 hours of intranasal virus infection. SARS-CoV-2-infected hamsters exhibited mechanical hypersensitivity that was milder but prolonged compared with that observed in IAV-infected hamsters. RNA sequencing analysis of thoracic DRGs 1 to 4 days after infection suggested perturbations in predominantly neuronal signaling in SARS-CoV-2-infected animals as opposed to type I interferon signaling in IAV-infected animals. Later, 31 days after infection, a neuropathic transcriptome emerged in thoracic DRGs from SARS-CoV-2-infected animals, which coincided with SARS-CoV-2-specific mechanical hypersensitivity. These data revealed potential targets for pain management, including the RNA binding protein ILF3, which was validated in murine pain models. This work elucidates transcriptomic signatures in the DRGs triggered by SARS-CoV-2 that may underlie both short- and long-term sensory abnormalities.
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Affiliation(s)
- Randal A. Serafini
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Justin J. Frere
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Jeffrey Zimering
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ilinca M. Giosan
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Kerri D. Pryce
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ilona Golynker
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Maryline Panis
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Anne Ruiz
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Benjamin R. tenOever
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Venetia Zachariou
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pharmacology, Physiology and Biophysics, Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA
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Vaz N, Franquet E, Heidari P, Chow DZ, Jacene HA, Ng TSC. COVID-19: Findings in nuclear medicine from head to toe. Clin Imaging 2023; 99:10-18. [PMID: 37043868 PMCID: PMC10081937 DOI: 10.1016/j.clinimag.2023.04.003] [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: 10/02/2022] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
COVID-19 is a multisystemic disease, and hence its potential manifestations on nuclear medicine imaging can extend beyond the lung. Therefore, it is important for the nuclear medicine physician to recognize these manifestations in the clinic. While FDG-PET/CT is not indicated routinely in COVID-19 evaluation, its unique capability to provide a functional and anatomical assessment of the entire body means that it can be a powerful tool to monitor acute, subacute, and long-term effects of COVID-19. Single-photon scintigraphy is routinely used to assess conditions such as pulmonary embolism, cardiac ischemia, and thyroiditis, and COVID-19 may present in these studies. The most common nuclear imaging finding of COVID-19 vaccination to date is hypermetabolic axillary lymphadenopathy. This may pose important diagnostic and management dilemmas in oncologic patients, particularly those with malignancies where the axilla constitutes a lymphatic drainage area. This article aims to summarize the relevant literature published since the beginning of the pandemic on the intersection between COVID-19 and nuclear medicine.
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Affiliation(s)
- Nuno Vaz
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States.
| | - Elisa Franquet
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Pedram Heidari
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - David Z Chow
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
| | - Heather A Jacene
- Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, United States
| | - Thomas S C Ng
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States
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Zhang Q, Jiu Y. The regulation of host cytoskeleton during SARS-CoV-2 infection in the nervous system. BRAIN SCIENCE ADVANCES 2023. [DOI: 10.26599/bsa.2023.9050004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
The global economy and public health are currently under enormous pressure since the outbreak of COVID-19. Apart from respiratory discomfort, a subpopulation of COVID-19 patients exhibits neurological symptoms such as headache, myalgia, and loss of smell. Some have even shown encephalitis and necrotizing hemorrhagic encephalopathy. The cytoskeleton of nerve cells changes drastically in these pathologies, indicating that the cytoskeleton and its related proteins are closely related to the pathogenesis of nervous system diseases. In this review, we present the up-to-date association between host cytoskeleton and coronavirus infection in the context of the nervous system. We systematically summarize cytoskeleton-related pathogen-host interactions in both the peripheral and central nervous systems, hoping to contribute to the development of clinical treatment in COVID-19 patients.
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Affiliation(s)
- Qian Zhang
- Unit of Cell Biology and Imaging Study of Pathogen Host Interaction, The Center for Microbes, Development and Health, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yaming Jiu
- Unit of Cell Biology and Imaging Study of Pathogen Host Interaction, The Center for Microbes, Development and Health, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
- University of Chinese Academy of Sciences, Beijing 100049, China
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Askari H, Rabiei F, Lohrasbi F, Ghadir S, Ghasemi-Kasman M. The Latest Cellular and Molecular Mechanisms of COVID-19 on Non-Lung Organs. Brain Sci 2023; 13:brainsci13030415. [PMID: 36979225 PMCID: PMC10046222 DOI: 10.3390/brainsci13030415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
Understanding the transmission pathways of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will aid in developing effective therapies directed at the virus’s life cycle or its side effects. While severe respiratory distress is the most common symptom of a coronavirus 2019 (COVID-19) infection, the virus is also known to cause damage to almost every major organ and system in the body. However, it is not obvious whether pathological changes in extra-respiratory organs are caused by direct infection, indirect, or combination of these effects. In this narrative review, we first elaborate on the characteristics of SARS-CoV-2, followed by the mechanisms of this virus on various organs such as brain, eye, and olfactory nerve and different systems such as the endocrine and gastrointestinal systems.
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Affiliation(s)
- Hamid Askari
- Student Research Committee, Babol University of Medical Sciences, Babol 47176-47745, Iran
| | - Fatemeh Rabiei
- Student Research Committee, Babol University of Medical Sciences, Babol 47176-47745, Iran
| | - Fatemeh Lohrasbi
- Student Research Committee, Babol University of Medical Sciences, Babol 47176-47745, Iran
| | - Sara Ghadir
- Student Research Committee, Babol University of Medical Sciences, Babol 47176-47745, Iran
| | - Maryam Ghasemi-Kasman
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-47745, Iran
- Department of Physiology, School of Medicine, Babol University of Medical Sciences, Babol 47176-47745, Iran
- Correspondence: ; Tel./Fax: +98-11-32190557
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Zavaroni S, Tristano I, Casamenti V, Colonna V, Cereti M, Mamone M, Prencipe U, Sanzone F, Murgia M, Masala S, Beccacece A, Vetrano M, Vulpiani MC, Bemporad J. Ultrasound-based neuropathy diagnosis in COVID-19 patients in post-intensive care rehabilitation settings. A retrospective observational study. Arch Phys Med Rehabil 2023:S0003-9993(23)00101-6. [PMID: 36854349 PMCID: PMC9968491 DOI: 10.1016/j.apmr.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES using ultrasound scanning to examine the correlation between increase of Common Fibular Nerve's (CFN) Cross Sectional Area (CSA) and functional impairment of foot dorsiflexor muscles as an early sign of peripheral neuropathy. DESIGN retrospective observational study. SETTING in-patient rehabilitation unit between November 2020 and July 2021. PARTICIPANTS 26 inpatients who underwent prolonged hospitilization in ICU'S and were diagnosed with CRYMINE after SARS-COV-2 infection. Physical examination and ultrasound scanning of the CFN and EMG/ENG were carried out on each patient. INTERVENTIONS not applicable MAIN OUTCOME MEASURE(S): CFN's CSA at the peroneal head. RESULTS we verified a significant increase in the CSA of the CFN measured at the peroneal head in more than 90% of the nerves tested. A cut off value of CFN's CSA of 0,20 cm was used to identify pathological nerves. No correlations with other variables (BMI, ICU days) were found. CONCLUSION US scanning of the CFN appears to be an early and specific test in the evaluation of CPN's abnormalities in post COVID-19 patients. US scanning is a reproducible, cost effective, safe and easily administered bedside tool to diagnose a loss of motor function when abnormalities in peripheral nerves are present.
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Affiliation(s)
- Susanna Zavaroni
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Isabella Tristano
- University of Rome "La Sapienza", Policlinico Umberto I, viale Regina Elena 328, Roma, Italy
| | - Vittoria Casamenti
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Vincenzo Colonna
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Margherita Cereti
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Maria Mamone
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Umberto Prencipe
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Fernando Sanzone
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy
| | - Massimiliano Murgia
- University of Rome "La Sapienza", Policlinico Umberto I, viale Regina Elena 328, Roma, Italy
| | | | - Alessia Beccacece
- National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Via Portuense 292, 00149 Roma, Italy
| | - Mario Vetrano
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Maria Chiara Vulpiani
- University of Rome "La Sapienza", S. Andrea Hospital, via di Grottarossa 1035/1039, Roma, Italy
| | - Jonathan Bemporad
- Ospedale Privato Accreditato "Sol Et Salus" Spa Rimini, Viale San Salvador 204, Torre Pedrera 47922 RN, Italy.
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Zheng X, Fang Y, Song Y, Liu S, Liu K, Zhu J, Wu X. Is there a causal nexus between COVID-19 infection, COVID-19 vaccination, and Guillain-Barré syndrome? Eur J Med Res 2023; 28:98. [PMID: 36841799 PMCID: PMC9958317 DOI: 10.1186/s40001-023-01055-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/08/2023] [Indexed: 02/27/2023] Open
Abstract
Guillain-Barré syndrome (GBS) is an immune-mediated inflammatory polyradiculoneuropathy, which commonly leads to a very high level of neurological disability. Especially, after the global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the causation between GBS and SARS-CoV-2 infection and the coronavirus disease 2019 (COVID-19) vaccination have aroused widespread concern. In the review, we analyzed the impacts of SARS-CoV-2 infection and COVID-19 vaccination on GBS globally, aiming to further understand the characteristics of GBS associated with COVID-19. Based on the electrophysiological data, patients suffering from GBS related to COVID-19 manifested as an acute inflammatory demyelinating polyneuropathy (AIDP). Moreover, we summarized the current findings, which may evidence GBS linking to SARS-CoV-2 infection and COVID-19 vaccination, and discussed the underlying mechanisms whether and how the SARS-CoV-2 virus and COVID-19 vaccination can induce GBS and its variants.
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Affiliation(s)
- Xiaoxiao Zheng
- grid.64924.3d0000 0004 1760 5735Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Jilin University, Xinmin Street 1#, Changchun, 130021 China
| | - Yong Fang
- grid.64924.3d0000 0004 1760 5735Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Jilin University, Xinmin Street 1#, Changchun, 130021 China
| | - Yanna Song
- grid.412558.f0000 0004 1762 1794Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shan Liu
- grid.64924.3d0000 0004 1760 5735The Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Kangding Liu
- grid.64924.3d0000 0004 1760 5735Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Jilin University, Xinmin Street 1#, Changchun, 130021 China
| | - Jie Zhu
- Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Jilin University, Xinmin Street 1#, Changchun, 130021, China. .,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Karolinska University Hospital, Solna, Stockholm, Sweden.
| | - Xiujuan Wu
- Department of Neurology, Neuroscience Center, The First Hospital of Jilin University, Jilin University, Xinmin Street 1#, Changchun, 130021, China.
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Rabaan AA, Smajlović S, Tombuloglu H, Ćordić S, Hajdarević A, Kudić N, Mutai AA, Turkistani SA, Al-Ahmed SH, Al-Zaki NA, Al Marshood MJ, Alfaraj AH, Alhumaid S, Al-Suhaimi E. SARS-CoV-2 infection and multi-organ system damage: A review. BIOMOLECULES AND BIOMEDICINE 2023; 23:37-52. [PMID: 36124445 PMCID: PMC9901898 DOI: 10.17305/bjbms.2022.7762] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/23/2022] [Indexed: 02/03/2023]
Abstract
The SARS-CoV-2 infection causes COVID-19, which has affected approximately six hundred million people globally as of August 2022. Organs and cells harboring angiotensin-converting enzyme 2 (ACE2) surface receptors are the primary targets of the virus. However, once it enters the body through the respiratory system, the virus can spread hematogenously to infect other body organs. Therefore, COVID-19 affects many organs, causing severe and long-term complications, even after the disease has ended, thus worsening the quality of life. Although it is known that the respiratory system is most affected by the SARS-CoV-2 infection, many organs/systems are affected in the short and long term. Since the COVID-19 disease simultaneously affects many organs, redesigning diagnostic and therapy policies to fit the damaged organs is strongly recommended. Even though the pathophysiology of many problems the infection causes is unknown, the frequency of COVID-19 cases rises with age and the existence of preexisting symptoms. This study aims to update our knowledge of SARS-CoV-2 infection and multi-organ dysfunction interaction based on clinical and theoretical evidence. For this purpose, the study comprehensively elucidates the most recent studies on the effects of SARS-CoV-2 infection on multiple organs and systems, including respiratory, cardiovascular, gastrointestinal, renal, nervous, endocrine, reproductive, immune, and parts of the integumentary system. Understanding the range of atypical COVID-19 symptoms could improve disease surveillance, limit transmission, and avoid additional multi-organ-system problems.
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Affiliation(s)
- Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia,Department of Public Health and Nutrition, The University of Haripur, Haripur, Pakistan,Correspondence to Ali A. Rabaan: ; Huseyin Tombuloglu:
| | - Samira Smajlović
- Laboratory Diagnostics Institute Dr. Dedić, Bihać, Bosnia and Herzegovina
| | - Huseyin Tombuloglu
- Department of Genetics Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Correspondence to Ali A. Rabaan: ; Huseyin Tombuloglu:
| | - Sabahudin Ćordić
- Cantonal Hospital “Dr. Irfan Ljubijankić”, Microbiological Laboratory, Bihać, Bosnia and Herzegovina
| | - Azra Hajdarević
- International Burch University, Faculty of Engineering and Natural Sciences, Department of Genetics and Bioengineering, Ilidža, Bosnia and Herzegovina
| | - Nudžejma Kudić
- University of Sarajevo, Faculty of Agriculture and Food Science, Sarajevo, Bosnia and Herzegovina
| | - Abbas Al Mutai
- Research Center, Almoosa Specialist Hospital, Al Mubarraz, Saudi Arabia,College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh, Saudi Arabia,School of Nursing, Wollongong University, Wollongong, NSW, Australia,Nursing Department, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | - Shamsah H Al-Ahmed
- Specialty Pediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Nisreen A Al-Zaki
- Specialty Pediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Mona J Al Marshood
- Specialty Pediatric Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Amal H Alfaraj
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq, Saudi Arabia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa, Saudi Arabia
| | - Ebtesam Al-Suhaimi
- Biology Department, College of Science and Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Xing Y, Zhang Q, Jiu Y. Coronavirus and the Cytoskeleton of Virus-Infected Cells. Subcell Biochem 2023; 106:333-364. [PMID: 38159233 DOI: 10.1007/978-3-031-40086-5_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The cytoskeleton, which includes actin filaments, microtubules, and intermediate filaments, is one of the most important networks in the cell and undertakes many fundamental life activities. Among them, actin filaments are mainly responsible for maintaining cell shape and mediating cell movement, microtubules are in charge of coordinating all cargo transport within the cell, and intermediate filaments are mainly thought to guard against external mechanical pressure. In addition to this, cytoskeleton networks are also found to play an essential role in multiple viral infections. Due to the COVID-19 epidemic, including SARS-CoV-2, SARS-CoV and MERS-CoV, so many variants have caused wide public concern, that any virus infection can potentially bring great harm to human beings and society. Therefore, it is of great importance to study coronavirus infection and develop antiviral drugs and vaccines. In this chapter, we summarize in detail how the cytoskeleton responds and participates in coronavirus infection by analyzing the possibility of the cytoskeleton and its related proteins as antiviral targets, thereby providing ideas for finding more effective treatments.
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Affiliation(s)
- Yifan Xing
- Shanghai Institute of Immunity and Infection (Formerly Institut Pasteur of Shanghai), Chinese Academy of Sciences, Shanghai, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Qian Zhang
- Unit of Cell Biology and Imaging Study of Pathogen Host Interaction, The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Yaming Jiu
- Shanghai Institute of Immunity and Infection (Formerly Institut Pasteur of Shanghai), Chinese Academy of Sciences, Shanghai, China.
- University of Chinese Academy of Sciences, Beijing, China.
- Unit of Cell Biology and Imaging Study of Pathogen Host Interaction, The Center for Microbes, Development and Health, Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China.
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Shaddad AM, Hussein AARM, Tohamy AMA, Khalil WGE. Short-term evaluation of motor and sensory nerve conduction parameters in COVID-19-associated peripheral neuropathy patients. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2023; 17:15. [PMCID: PMC10000350 DOI: 10.1186/s43168-023-00189-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) is mostly associated with upper and lower respiratory tract manifestations. However, coronavirus disease 19 (COVID-19) can result in a wide range of other systemic symptomatology, including neuropsychiatric, psychological, and psychosocial impairments. Literature regarding neurological compromise, including neuropathy and sensory and motor affection associated with COVID-19, is still limited. This study aims to evaluate the sensory, motor neuropathy, and secondary neurological impairment among patients with mild to moderate coronavirus disease associated with peripheral neuropathy within 1 month. Methods Forty participants, including 20 mild to moderate COVID-19 patients with peripheral neuropathy and 20 age and gender-matched healthy volunteers, were recruited in this case/control study. Laboratory evaluation focused on C-reactive protein (CRP) and D-dimer levels. Oxygen saturation for all participants was recorded. The neurophysiological study included motor nerve study, sensory nerve study, and F wave study for upper and lower limbs were done. Results The two groups were similar regarding baseline data. Neurological symptoms’ onset in the COVID-19 group ranged from 4 to 24 days. Levels of CRP and D-dimer levels were significantly higher in patients versus the control group. Motor nerve conduction (MNC) amplitude and latency for the median nerve were significantly compromised among the COVID-19 group. The MNC latency and F wave latency for the posterior tibial nerve were significantly higher in the COVID-19 group. The CRP and D-dimer levels were associated with a significant positive correlation with a latency of median nerve MNC, sensory nerve conduction (SNC), and f-wave; latency of MNC and F wave of the posterior tibial nerve; and SNC latency for sural nerve. Conclusion neurological involvement can occur in mild to moderate cases of SARS-COV-2 infection and add to the burden of the disease. Neurological symptoms in the course of COVID-19 disease should be interpreted cautiously, and appropriate diagnosis, including nerve conduction studies and management, should be considered. Trial registration ClinicalTrials.gov. NCT05721040.
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Affiliation(s)
- Ahmad M. Shaddad
- grid.252487.e0000 0000 8632 679XChest Department, Faculty of Medicine, Assiut University, Assiut, 71515 Egypt
| | | | - Amal Mohamed Aly Tohamy
- grid.252487.e0000 0000 8632 679XNeuropsychiatry Department, Faculty of Medicine, Assiut University, Assiut, 71515 Egypt
| | - Waleed Gamal Elddine Khalil
- grid.252487.e0000 0000 8632 679XChest Department, Faculty of Medicine, Assiut University, Assiut, 71515 Egypt
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Al-Mazidi S, Al-Dakhil L. Electrophysiological assessment in patients with COVID-19-related peripheral neuropathies and myopathies: a systematic review. J Neurophysiol 2023; 129:191-198. [PMID: 36475865 PMCID: PMC9844972 DOI: 10.1152/jn.00386.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Neurological manifestations associated with Coronavirus Disease-2019 (COVID-19) are commonly reported, but patients were not referred to perform the electrophysiological assessment. We aimed to review the existing literature on clinical studies on COVID-19 peripheral neuropathy to correlate patients' symptoms and characteristics with nerve conduction studies/electromyography (NCS/EMG) outcomes. This protocol is registered in the Open Science Framework (https://www.doi.org/10.17605/OSF.IO/ZF4PK). The systematic search included PubMed, ScienceDirect, and Google Scholar, for articles published from December 2019 to March 2022. A total of 727 articles were collected, and according to our inclusion and exclusion criteria, only 6 articles were included. Of 195 participants, only 175 underwent NCS/EMG assessment. Of these, 44 participants (25.1%) had abnormal EMG, 54 participants (30.8%) had abnormal motor NCS, and only 7 participants (4%) had abnormal sensory NCS. All cases presented with myopathy, while a limited number of cases presented with polyneuropathy. According to motor NCS and EMG, the most affected nerves were the tibial and peroneal in the lower extremities and the ulnar nerve in the upper extremities. Interestingly, the median nerve was reported to be associated with the severity and the rate of motor recovery of patients with COVID-19. COVID-19 generates a demyelinating motor neuropathy and myopathy. Clinicians are encouraged to refer patients with COVID-19 presenting with neurological symptoms to be assessed by electrophysiological methods to objectively determine the nature of their symptoms, follow their prognosis, and plan their rehabilitation.
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Affiliation(s)
- Sarah Al-Mazidi
- 1Physiology Department, College of Medicine, Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Lina Al-Dakhil
- 2King Saud Medical City, Research Center, Riyadh, Saudi Arabia
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Vakili K, Fathi M, Yaghoobpoor S, Sayehmiri F, Nazerian Y, Nazerian A, Mohamadkhani A, Khodabakhsh P, Réus GZ, Hajibeygi R, Rezaei-Tavirani M. The contribution of gut-brain axis to development of neurological symptoms in COVID-19 recovered patients: A hypothesis and review of literature. Front Cell Infect Microbiol 2022; 12:983089. [PMID: 36619768 PMCID: PMC9815719 DOI: 10.3389/fcimb.2022.983089] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022] Open
Abstract
The gut microbiota undergoes significant alterations in response to viral infections, particularly the novel SARS-CoV-2. As impaired gut microbiota can trigger numerous neurological disorders, we suggest that the long-term neurological symptoms of COVID-19 may be related to intestinal microbiota disorders in these patients. Thus, we have gathered available information on how the virus can affect the microbiota of gastrointestinal systems, both in the acute and the recovery phase of the disease, and described several mechanisms through which this gut dysbiosis can lead to long-term neurological disorders, such as Guillain-Barre syndrome, chronic fatigue, psychiatric disorders such as depression and anxiety, and even neurodegenerative diseases such as Alzheimer's and Parkinson's disease. These mechanisms may be mediated by inflammatory cytokines, as well as certain chemicals such as gastrointestinal hormones (e.g., CCK), neurotransmitters (e.g., 5-HT), etc. (e.g., short-chain fatty acids), and the autonomic nervous system. In addition to the direct influences of the virus, repurposed medications used for COVID-19 patients can also play a role in gut dysbiosis. In conclusion, although there are many dark spots in our current knowledge of the mechanism of COVID-19-related gut-brain axis disturbance, based on available evidence, we can hypothesize that these two phenomena are more than just a coincidence and highly recommend large-scale epidemiologic studies in the future.
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Affiliation(s)
- Kimia Vakili
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mobina Fathi
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Yaghoobpoor
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sayehmiri
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasaman Nazerian
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ashraf Mohamadkhani
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pariya Khodabakhsh
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gislaine Z. Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Ramtin Hajibeygi
- Department of Cardiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mostafa Rezaei-Tavirani
- Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Mostafa Rezaei-Tavirani,
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Lai YH, Chen HY, Chiu HH, Kang YN, Wong SB. Peripheral Nervous System Adverse Events after the Administration of mRNA Vaccines: A Systematic Review and Meta-Analysis of Large-Scale Studies. Vaccines (Basel) 2022; 10:vaccines10122174. [PMID: 36560584 PMCID: PMC9781046 DOI: 10.3390/vaccines10122174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Although neurological complications after the administration of vaccines against coronavirus disease 2019 (COVID-19) are rare, they might result in long-term morbidity. This study was designed to determine the risk of peripheral nervous system (PNS) adverse events after the administration of mRNA vaccines against COVID-19. Large-scale randomized controlled trials (RCTs) and cohort studies were systematically searched in databases, and 15 cohort studies were included in the synthesis. Among all PNS adverse events, only Bell's palsy and Guillain-Barré syndrome (GBS) had sufficient data and were included for further analysis. Individuals who received mRNA vaccines had a higher risk of Bell's palsy than the unvaccinated group, and the risk of Bell's palsy after BNT162b2 was significantly higher than after mRNA-1273. Regarding GBS, no significant difference in the risk was observed between BNT162b2 and the unvaccinated group, but BNT126b2 introduced a higher risk of post-vaccinated GBS than mRNA-1273. In conclusion, PNS adverse events, especially Bell's palsy, should be carefully observed after mRNA vaccination against COVID-19. With the opportunity of vaccination campaigns on such a large scale, further investigation and surveillance of post-vaccination neurological adverse events should also be established.
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Affiliation(s)
- Yu-Hsin Lai
- Department of Pediatrics, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei 231405, Taiwan
| | - Hong-Yu Chen
- Department of General Medicine, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei 231405, Taiwan
| | - Hsin-Hui Chiu
- Department of Pediatrics, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei 231405, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yi-No Kang
- Department of Pediatrics, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei 231405, Taiwan
- Cochrane Taiwan, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: (Y.-N.K.); (S.-B.W.)
| | - Shi-Bing Wong
- Department of Pediatrics, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei 231405, Taiwan
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Correspondence: (Y.-N.K.); (S.-B.W.)
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Marcolino MS, Anschau F, Kopittke L, Pires MC, Barbosa IG, Pereira DN, Ramos LEF, Assunção LFI, Costa ASDM, Nogueira MCA, Duani H, Martins KPMP, Moreira LB, Silva CTCAD, Oliveira NRD, Ziegelmann PK, Guimarães-Júnior MH, Lima MOSDS, Aguiar RLO, Menezes LSM, Oliveira TF, Souza MD, Farace BL, Cimini CCR, Maurílio ADO, Guimarães SMM, Araújo SF, Nascimento GF, Silveira DV, Ruschel KB, Oliveira TCD, Schwarzbold AV, Nasi LA, Floriani MA, Santos VBD, Ramos CM, Alvarenga JCD, Scotton ALBA, Manenti ERF, Crestani GP, Batista JDL, Ponce D, Machado-Rugolo J, Bezerra AFB, Martelli PJDL, Vianna HR, Castro LCD, Medeiros CRG, Vietta GG, Pereira EC, Chatkin JM, Godoy MFD, Delfino-Pereira P, Teixeira AL. Frequency and burden of neurological manifestations upon hospital presentation in COVID-19 patients: Findings from a large Brazilian cohort. J Neurol Sci 2022; 443:120485. [PMID: 36375382 PMCID: PMC9645948 DOI: 10.1016/j.jns.2022.120485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Scientific data regarding the prevalence of COVID-19 neurological manifestations and prognosis in Latin America countries is still lacking. Therefore, the study aims to understand neurological manifestations of SARS-CoV 2 infection and outcomes in the Brazilian population. METHODS This study is part of the Brazilian COVID-19 Registry, a multicentric cohort, including data from 37 hospitals. For the present analysis, patients were grouped according to the presence of reported symptoms (i.e., headache; anosmia and ageusia; syncope and dizziness) vs. clinically-diagnosed neurological manifestations (clinically-defined neurological syndrome: neurological signs or diagnoses captured by clinical evaluation) and matched with patients without neurological manifestations by age, sex, number of comorbidities, hospital of admission, and whether or not patients had underlying neurological disease. RESULTS From 6,635 hospitalized patients with COVID-19, 30.8% presented reported neurological manifestations, 10.3% were diagnosed with a neurological syndrome and 60.1% did not show any neurological manifestations. In patients with reported symptoms, the most common ones were headache (20.7%), ageusia (11.1%) and anosmia (8.0%). In patients with neurological syndromes, acute encephalopathy was the most common diagnosis (9.7%). In the matched analysis, patients with neurological syndromes presented more cases of septic shock (17.0 vs. 13.0%, p = 0.045), intensive care unit admission (45.3 vs. 38.9%, p = 0.023), and mortality (38.7 vs. 32.6%, p = 0.026; and 39.2 vs. 30.3%, p < 0.001) when compared to controls. CONCLUSION COVID-19 in-hospital patients with clinically defined neurological syndromes presented a higher incidence of septic shock, ICU admission and death when compared to controls.
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Affiliation(s)
- Milena Soriano Marcolino
- Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 110, Belo Horizonte, Brazil; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 190, sala 246, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS/ CNPq). R. Ramiro Barcelos, 2359, Prédio 21, Sala 507, Porto Alegre, Brazil.
| | - Fernando Anschau
- Grupo Hospitalar Conceição. Brazilian National Health System, Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor. Av. Francisco Trein, 326, Porto Alegre, Brazil.
| | - Luciane Kopittke
- Grupo Hospitalar Conceição. Brazilian National Health System, Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor. Av. Francisco Trein, 326, Porto Alegre, Brazil.
| | - Magda Carvalho Pires
- Department of Statistics, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos, 6627, ICEx, sala 4071, Belo Horizonte, Brazil.
| | - Izabela Guimarães Barbosa
- Mental Health Department, Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 190, sala 246, Belo Horizonte, Brazil.
| | - Daniella Nunes Pereira
- Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena, 190, Belo Horizonte, Brazil.
| | - Lucas Emanuel Ferreira Ramos
- Department of Statistics, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos, 6627, ICEx, sala 4071, Belo Horizonte, Brazil.
| | - Luís Fernando Israel Assunção
- Department of Statistics, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos, 6627, ICEx, sala 4071, Belo Horizonte, Brazil.
| | | | | | - Helena Duani
- Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 110, Belo Horizonte, Brazil.
| | - Karina Paula Medeiros Prado Martins
- Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 110, Belo Horizonte, Brazil.
| | | | | | | | | | | | | | | | - Luanna Silva Monteiro Menezes
- Instituto Mário Penna, Hospital Luxemburgo. R. Joaquim Cândido Filho, 91, Belo Horizonte, Brazil; Hospital Metropolitano Odilon Behrens. R. Formiga, 50, Belo Horizonte, Brazil.
| | | | - Maíra Dias Souza
- Hospital Metropolitano Odilon Behrens. R. Formiga, 50, Belo Horizonte, Brazil.
| | - Bárbara Lopes Farace
- Hospital Risoleta Tolentino Neves. R. das Gabirobas, 01, Belo Horizonte, Brazil.
| | | | | | | | | | | | | | - Karen Brasil Ruschel
- Institute for Health Technology Assessment (IATS/ CNPq). R. Ramiro Barcelos, 2359, Prédio 21, Sala 507, Porto Alegre, Brazil; Hospital Universitário Canoas. Av. Farroupilha, 8001, Canoas, Rio Grande do Sul, Brazil.
| | | | | | - Luiz Antônio Nasi
- Hospital Moinhos de Vento. R. Ramiro Barcelos, 910, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Maiara Anschau Floriani
- Hospital Moinhos de Vento. R. Ramiro Barcelos, 910, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Veridiana Baldon Dos Santos
- Grupo Hospitalar Conceição. Brazilian National Health System, Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor. Av. Francisco Trein, 326, Porto Alegre, Brazil.
| | | | | | | | | | | | | | - Daniela Ponce
- Hospital das Clínicas da Faculdade de Medicina de Botucatu. Av. Professor Mário Rubens Guimarães Montenegro, Botucatu, São Paulo, Brazil.
| | - Juliana Machado-Rugolo
- Hospital das Clínicas da Faculdade de Medicina de Botucatu. Av. Professor Mário Rubens Guimarães Montenegro, Botucatu, São Paulo, Brazil.
| | | | | | | | | | | | | | | | | | | | - Polianna Delfino-Pereira
- Department of Internal Medicine, Medical School, Universidade Federal de Minas Gerais. Av. Professor Alfredo Balena 110, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS/ CNPq). R. Ramiro Barcelos, 2359, Prédio 21, Sala 507, Porto Alegre, Brazil.
| | - Antonio Lucio Teixeira
- Faculdade Santa Casa BH. Av. dos Andradas, 2688, Belo Horizonte, Brazil; Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, UT Health Houston. 7000 Fannin St, Houston, EUA, USA.
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Castaneda DM, Chambers MM, Johnsen PH, Fedorka CJ. Parsonage-Turner Syndrome following COVID-19 infection: A Report of Three Cases. JSES REVIEWS, REPORTS, AND TECHNIQUES 2022; 3:247-251. [PMID: 36506342 PMCID: PMC9721159 DOI: 10.1016/j.xrrt.2022.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
Introduction Parsonage-Turner Syndrome (PTS), previously referred to as neuralgic amyotrophy or idiopathic brachial plexopathy, is a rare neurological syndrome characterized by an abrupt onset of shoulder pain followed by neurological deficits of motor weakness, numbness, and muscular atrophy. Although the pathophysiology and specific cause of PTS remain unclear, it has been reported following trauma, vaccination, surgical procedures and viral infection. Our practice has seen an increase in the incidence of PTS with the COVID-19 pandemic. We aim to describe three cases of patients found to have PTS shortly after proven infection with COVID-19 during the Omicron surge. Case Description Three patients developed symptoms of PTS within a few weeks of having COVID-19. All three cases had normal imaging and an EMG that diagnosed PTS. The first is a 23-year-old male who developed weakness and shoulder pain two weeks after his COVID-19 diagnosis. The second was a 58-year-old male who was intubated with COVID-19 pneumonia and woke up with extreme weakness and pain in his left arm. The final case was a 76-year-old male with a remote history of a left total shoulder arthroplasty who also developed acute pain and weakness soon after testing positive for COVID-19. All three patient's symptoms and clinical exam have been improving. Discussion In this report, we presented three patients who developed PTS soon after being diagnosed with COVID-19 during the omnicron surge. As we learn more about the COVID-19 virus and its effects on the musculoskeletal system, efficient diagnosis and multidisciplinary treatment of Parsonage-Turner Syndrome will become increasingly valuable to physicians and patients.
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Affiliation(s)
| | | | - Parker H. Johnsen
- Cooper Bone and Joint Institute, Cooper University Healthcare, Camden, NJ, USA
| | - Catherine J. Fedorka
- Cooper Medical School of Rowan University, Camden, NJ, USA,Cooper Bone and Joint Institute, Cooper University Healthcare, Camden, NJ, USA,Corresponding Author: Catherine J. Fedorka, MD, 3 Cooper Plaza Ste 408, Camden, NJ 08103, USA
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Maranduca MA, Vamesu CG, Tanase DM, Clim A, Drochioi IC, Pinzariu AC, Filip N, Dima N, Tudorancea I, Serban DN, Serban IL. The RAAS Axis and SARS-CoV-2: From Oral to Systemic Manifestations. Medicina (B Aires) 2022; 58:medicina58121717. [PMID: 36556919 PMCID: PMC9784172 DOI: 10.3390/medicina58121717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
One of the essential regulators of arterial blood pressure, the renin-angiotensin-aldosterone system (RAAS) seems to be one of the most complex mechanisms in the human body. Since the discovery of its key components and their actions, new substances and functions are still being unraveled. The main pathway begins with the secretion of renin in the kidney and culminates with the synthesis of angiotensin II (Ang II)-a strong vasoconstrictor-thanks to the angiotensin-converting enzyme (ACE). Research conducted in 2000 identified another enzyme, named ACE2, that converts Ang II into Ang-(1-7), a heptapeptide with opposing effects to those of Ang II: vasodilation and anti-inflammatory properties. This particular enzyme became of paramount importance during the last two decades, as a result of the confrontation of the human race with life-threatening epidemics. Multiple studies have been performed in order to uncover the link between ACE2 and human coronaviruses, the results of which we systemized in order to create an overview of the pathogenic mechanism. Human coronaviruses, such as SARS-CoV and SARS-CoV-2, attach to ACE2 via their spike proteins (S), causing the destruction of the enzyme. Because ACE2 limits the production of Ang II (by converting it into Ang-(1-7)), its destruction leads to a dysregulated inflammatory response. The purpose of this review is to decipher the complex pathophysiological mechanisms underlying the multiorgan complications (oral, cardiac, pulmonary, systemic) that appear as a result of the interaction of the SARS CoV-2 virus with the angiotensin-converting enzyme type 2.
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Affiliation(s)
- Minela Aida Maranduca
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700115 Iasi, Romania
| | - Calin George Vamesu
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Daniela Maria Tanase
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700115 Iasi, Romania
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Clim
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ilie Cristian Drochioi
- Department of Oral and Maxillofacial Surgery and Reconstructive, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700020 Iasi, Romania
- Correspondence: (I.C.D.); (A.C.P.)
| | - Alin Constantin Pinzariu
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (I.C.D.); (A.C.P.)
| | - Nina Filip
- Department of Morpho-Functional Sciences II, Discipline of Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Nicoleta Dima
- Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700115 Iasi, Romania
- Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ionut Tudorancea
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Cardiology Clinic, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Dragomir Nicolae Serban
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ionela Lacramioara Serban
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Xi X, Han L. Exploring the relationship between novel Coronavirus pneumonia and Parkinson's disease. Medicine (Baltimore) 2022; 101:e31813. [PMID: 36401405 PMCID: PMC9678520 DOI: 10.1097/md.0000000000031813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The hypothesis is that there is 0a relationship between Parkinson's disease and coronavirus disease 2019 (COVID-19). By summarizing the pathogenesis of Parkinson's disease and COVID-19 and the impact of COVID-19 on the central nervous system, the relationship between Parkinson's disease and COVID-19 was analyzed, including whether Parkinson's disease is a predisposition factor for COVID-19 and whether COVID-19 causes the occurrence of Parkinson's disease. Discuss the impact of COVID-19 on patients with Parkinson's disease, including symptoms and life impact. To summarize the principles, goals and methods of home rehabilitation for Parkinson's disease patients during COVID-19. Through the analysis of this paper, it is believed that COVID-19 may cause Parkinson's disease. Parkinson's disease has the condition of susceptibility to COVID-19, but this conclusion is still controversial.
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Affiliation(s)
- Xiaoming Xi
- Rehabilitation Center,Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing
- * Correspondence: Xiaoming Xi, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, No.15, Badachu Xixizhuang, Shijingshan District, Beijing (e-mail: )
| | - Liang Han
- Shandong University of Traditional Chinese Medicine
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Haykal MA, Menkes DL. The Clinical Neurophysiology of COVID-19- Direct Infection, Long-Term Sequelae and Para-Immunization responses: A literature review. Clin Neurophysiol Pract 2022; 8:3-11. [PMID: 36275861 PMCID: PMC9574576 DOI: 10.1016/j.cnp.2022.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic resulting from the SARS-CoV-2 virus is in its third year. There is continuously evolving information regarding its pathophysiology and its effects on the nervous system. Clinical neurophysiology techniques are commonly employed to assess for neuroanatomical localization and/or defining the spectrum of neurological illness. There is an evolving body of literature delineating the effects of the SARS-CoV-2 virus on the nervous system as well as para-immunization responses to vaccination against this virus. This review focuses on the use of neurophysiological diagnostic modalities in the evaluation of potential acute and long-term neurological complications in patients that experience direct infection with SARS-CoV-2 and analyzes those reports of para-immunization responses to vaccination against the SARS-CoV-2 virus. The neurophysiological modalities to be discussed include electroencephalography (EEG), evoked potentials (EPs), nerve conduction studies and electromyography (EMG/NCV), autonomic function tests, transcranial magnetic stimulation (TMS) and Transcranial Doppler ultrasound (TCD).
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Marcic M, Marcic L, Lovric Kojundzic S, Marinovic Guic M, Marcic B, Caljkusic K. Chronic Endothelial Dysfunction after COVID-19 Infection Shown by Transcranial Color-Coded Doppler: A Cross-Sectional Study. Biomedicines 2022; 10:biomedicines10102550. [PMID: 36289812 PMCID: PMC9599030 DOI: 10.3390/biomedicines10102550] [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: 09/02/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
In addition to respiratory symptoms, COVID-19 often causes damage to many other organs, especially in severe forms of the disease. Long-term consequences after COVID-19 are common and often have neurological symptoms. Cerebral vasoreactivity may be impaired after acute COVID-19 and in our study, we wanted to show how constant and reversible are the changes in brain vasoreactivity after infection. This cross-sectional observational study included 49 patients diagnosed with COVID-19 and mild neurological symptoms 300 days after the onset of the disease. We used a transcranial color-coded Doppler (TCCD) and a breath-holding test (BHT) to examine cerebral vasoreactivity and brain endothelial function. We analyzed the parameters of the flow rate through the middle cerebral artery (MCA): peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV), resistance index (RI) and pulsatility index (PI), and we calculated the breath-holding index (BHI). Subjects after COVID-19 infection had lower measured velocity parameters through MCA at rest period and after BHT, lower relative increases of flow velocities after BHT, and lower BHI. We showed that subjects, 300 days after COVID-19, still have impaired cerebral vasoreactivity measured by TCCD and they have chronic endothelial dysfunction.
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Affiliation(s)
- Marino Marcic
- Department of Neurology, University Hospital Center Split, Spinciceva 1, 21000 Split, Croatia
- Correspondence:
| | - Ljiljana Marcic
- Department of Radiology, Polyclinic Medikol, Soltanska 1, 21000 Split, Croatia
- University Department of Health Studies, University of Split, Rudera Boskovica 35, 21000 Split, Croatia
| | - Sanja Lovric Kojundzic
- Department of Radiology, University Hospital Center Split, Spinciceva 1, 21000 Split, Croatia
| | - Maja Marinovic Guic
- University Department of Health Studies, University of Split, Rudera Boskovica 35, 21000 Split, Croatia
- Department of Radiology, University Hospital Center Split, Spinciceva 1, 21000 Split, Croatia
| | - Barbara Marcic
- Department of Medical Genetics, School of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Kresimir Caljkusic
- Department of Neurology, University Hospital Center Split, Spinciceva 1, 21000 Split, Croatia
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Okayasu T, Ohta R, Yamane F, Abe S, Sano C. Hypoglossal Nerve Palsy Following COVID-19 Vaccination in a Young Adult Complicated by Various Medicines. Cureus 2022; 14:e29212. [PMID: 36259036 PMCID: PMC9569189 DOI: 10.7759/cureus.29212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/05/2022] Open
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Wais T, Hasan M, Rai V, Agrawal DK. Gut-brain communication in COVID-19: molecular mechanisms, mediators, biomarkers, and therapeutics. Expert Rev Clin Immunol 2022; 18:947-960. [PMID: 35868344 PMCID: PMC9388545 DOI: 10.1080/1744666x.2022.2105697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/21/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Infection with COVID-19 results in acute respiratory symptoms followed by long COVID multi-organ effects presenting with neurological, cardiovascular, musculoskeletal, and gastrointestinal (GI) manifestations. Temporal relationship between gastrointestinal and neurological symptoms is unclear but warranted for exploring better clinical care for COVID-19 patients. AREAS COVERED We critically reviewed the temporal relationship between gut-brain axis after SARS-CoV-2 infection and the molecular mechanisms involved in neuroinvasion following GI infection. Mediators are identified that could serve as biomarkers and therapeutic targets in SARS-CoV-2. We discussed the potential therapeutic approaches to mitigate the effects of GI infection with SARS-CoV-2. EXPERT OPINION Altered gut microbiota cause increased expression of various mediators, including zonulin causing disruption of tight junction. This stimulates enteric nervous system and signals to CNS precipitating neurological sequalae. Published reports suggest potential role of cytokines, immune cells, B(0)AT1 (SLC6A19), ACE2, TMRSS2, TMPRSS4, IFN-γ, IL-17A, zonulin, and altered gut microbiome in gut-brain axis and associated neurological sequalae. Targeting these mediators and gut microbiome to improve immunity will be of therapeutic significance. In-depth research and well-designed large-scale population-based clinical trials with multidisciplinary and collaborative approaches are warranted. Investigating the temporal relationship between organs involved in long-term sequalae is critical due to evolving variants of SARS-CoV-2.
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Affiliation(s)
- Tameena Wais
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences. Pomona, CA 91766
| | - Mehde Hasan
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences. Pomona, CA 91766
| | - Vikrant Rai
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences. Pomona, CA 91766
| | - Devendra K. Agrawal
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences. Pomona, CA 91766
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Gonzalez A, Abrigo J, Achiardi O, Simon F, Cabello-Verrugio C. Intensive care unit-acquired weakness: From molecular mechanisms to its impact in COVID-2019. Eur J Transl Myol 2022; 32. [PMID: 36036350 PMCID: PMC9580540 DOI: 10.4081/ejtm.2022.10511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/08/2022] [Indexed: 01/08/2023] Open
Abstract
Intensive Care Unit-Acquired Weakness (ICU-AW) is a generalized and symmetric neuromuscular dysfunction associated with critical illness and its treatments. Its incidence is approximately 80% in intensive care unit patients, and it manifests as critical illness polyneuropathy, critical illness myopathy, and muscle atrophy. Intensive care unit patients can lose an elevated percentage of their muscle mass in the first days after admission, producing short- and long-term sequelae that affect patients’ quality of life, physical health, and mental health. In 2019, the world was faced with coronavirus disease 2019 (COVID-19), caused by the acute respiratory syndrome coronavirus 2. COVID-19 produces severe respiratory disorders, such as acute respiratory distress syndrome, which increases the risk of developing ICU-AW. COVID-19 patients treated in intensive care units have shown early diffuse and symmetrical muscle weakness, polyneuropathy, and myalgia, coinciding with the clinical presentation of ICU-AW. Besides, these patients require prolonged intensive care unit stays, invasive mechanical ventilation, and intensive care unit pharmacological therapy, which are risk factors for ICU-AW. Thus, the purposes of this review are to discuss the features of ICU-AW and its effects on skeletal muscle. Further, we will describe the mechanisms involved in the probable development of ICU-AW in severe COVID-19 patients.
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Serafini RA, Frere JJ, Zimering J, Giosan IM, Pryce KD, Golynker I, Panis M, Ruiz A, tenOever B, Zachariou V. SARS-CoV-2 Airway Infection Results in Time-dependent Sensory Abnormalities in a Hamster Model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.08.19.504551. [PMID: 36032984 PMCID: PMC9413707 DOI: 10.1101/2022.08.19.504551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite being largely confined to the airways, SARS-CoV-2 infection has been associated with sensory abnormalities that manifest in both acute and long-lasting phenotypes. To gain insight on the molecular basis of these sensory abnormalities, we used the golden hamster infection model to characterize the effects of SARS-CoV-2 versus Influenza A virus (IAV) infection on the sensory nervous system. Efforts to detect the presence of virus in the cervical/thoracic spinal cord and dorsal root ganglia (DRGs) demonstrated detectable levels of SARS-CoV-2 by quantitative PCR and RNAscope uniquely within the first 24 hours of infection. SARS-CoV-2-infected hamsters demonstrated mechanical hypersensitivity during acute infection; intriguingly, this hypersensitivity was milder, but prolonged when compared to IAV-infected hamsters. RNA sequencing (RNA-seq) of thoracic DRGs from acute infection revealed predominantly neuron-biased signaling perturbations in SARS-CoV-2-infected animals as opposed to type I interferon signaling in tissue derived from IAV-infected animals. RNA-seq of 31dpi thoracic DRGs from SARS-CoV-2-infected animals highlighted a uniquely neuropathic transcriptomic landscape, which was consistent with substantial SARS-CoV-2-specific mechanical hypersensitivity at 28dpi. Ontology analysis of 1, 4, and 30dpi RNA-seq revealed novel targets for pain management, such as ILF3. Meta-analysis of all SARS-CoV-2 RNA-seq timepoints against preclinical pain model datasets highlighted both conserved and unique pro-nociceptive gene expression changes following infection. Overall, this work elucidates novel transcriptomic signatures triggered by SARS-CoV-2 that may underlie both short- and long-term sensory abnormalities while also highlighting several therapeutic targets for alleviation of infection-induced hypersensitivity. One Sentence Summary SARS-CoV-2 infection results in an interferon-associated transcriptional response in sensory tissues underlying time-dependent hypersensitivity.
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Affiliation(s)
- Randal A. Serafini
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1022, New York, NY, 10029
| | - Justin J. Frere
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box #1124, New York, NY, 10029
- Department of Microbiology, New York University Langone, 430-450 E. 29 St., New York, NY 10016
| | - Jeffrey Zimering
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1022, New York, NY, 10029
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box #1136, New York, NY, 10029
| | - Ilinca M. Giosan
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1022, New York, NY, 10029
| | - Kerri D. Pryce
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1022, New York, NY, 10029
| | - Ilona Golynker
- Department of Microbiology, New York University Langone, 430-450 E. 29 St., New York, NY 10016
| | - Maryline Panis
- Department of Microbiology, New York University Langone, 430-450 E. 29 St., New York, NY 10016
| | - Anne Ruiz
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1022, New York, NY, 10029
| | - Benjamin tenOever
- Department of Microbiology, New York University Langone, 430-450 E. 29 St., New York, NY 10016
| | - Venetia Zachariou
- Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1022, New York, NY, 10029
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place Box #1677, New York, New York 10029
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Sodagar A, Javed R, Tahir H, Razak SIA, Shakir M, Naeem M, Yusof AHA, Sagadevan S, Hazafa A, Uddin J, Khan A, Al-Harrasi A. Pathological Features and Neuroinflammatory Mechanisms of SARS-CoV-2 in the Brain and Potential Therapeutic Approaches. Biomolecules 2022; 12:biom12070971. [PMID: 35883527 PMCID: PMC9313047 DOI: 10.3390/biom12070971] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
The number of deaths has been increased due to COVID-19 infections and uncertain neurological complications associated with the central nervous system. Post-infections and neurological manifestations in neuronal tissues caused by COVID-19 are still unknown and there is a need to explore how brainstorming promoted congenital impairment, dementia, and Alzheimer’s disease. SARS-CoV-2 neuro-invasion studies in vivo are still rare, despite the fact that other beta-coronaviruses have shown similar properties. Neural (olfactory or vagal) and hematogenous (crossing the blood–brain barrier) pathways have been hypothesized in light of new evidence showing the existence of SARS-CoV-2 host cell entry receptors into the specific components of human nerve and vascular tissue. Spike proteins are the primary key and structural component of the COVID-19 that promotes the infection into brain cells. Neurological manifestations and serious neurodegeneration occur through the binding of spike proteins to ACE2 receptor. The emerging evidence reported that, due to the high rate in the immediate wake of viral infection, the olfactory bulb, thalamus, and brain stem are intensely infected through a trans-synaptic transfer of the virus. It also instructs the release of chemokines, cytokines, and inflammatory signals immensely to the blood–brain barrier and infects the astrocytes, which causes neuroinflammation and neuron death; and this induction of excessive inflammation and immune response developed in more neurodegeneration complications. The present review revealed the pathophysiological effects, molecular, and cellular mechanisms of possible entry routes into the brain, pathogenicity of autoantibodies and emerging immunotherapies against COVID-19.
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Affiliation(s)
- Aisha Sodagar
- Department of Botany, Faculty of Sciences, University of Agriculture, Faisalabad 38040, Pakistan;
| | - Rasab Javed
- Institute of Microbiology, University of Agriculture, Faisalabad 38040, Pakistan;
| | - Hira Tahir
- Department of Botany, Government College Women University Faisalabad, Faisalabad 38000, Pakistan;
| | - Saiful Izwan Abd Razak
- Bioinspired Device and Tissue Engineering Research Group, School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia;
- Sports Innovation & Technology Centre, Institute of Human Centred Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia
| | - Muhammad Shakir
- School of Life Sciences, Northeast Normal University, Changchun 130024, China;
| | - Muhammad Naeem
- College of Life Science, Hebei Normal University, Shijiazhuang 050024, China;
| | - Abdul Halim Abdul Yusof
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru 81310, Johor, Malaysia;
| | - Suresh Sagadevan
- Nanotechnology & Catalysis Research Centre, University of Malaya, Kuala Lumpur 50603, Kuala Lumpur, Malaysia;
| | - Abu Hazafa
- Department of Biochemistry, Faculty of Sciences, University of Agriculture, Faisalabad 38040, Pakistan
- Correspondence: or (A.H.); (A.K.); (A.A.-H.)
| | - Jalal Uddin
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia;
| | - Ajmal Khan
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat Al Mauz, Nizwa 616, Oman
- Correspondence: or (A.H.); (A.K.); (A.A.-H.)
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat Al Mauz, Nizwa 616, Oman
- Correspondence: or (A.H.); (A.K.); (A.A.-H.)
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