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Vengalil S, Mahale R, Chakradhar N, Alluri S, Sagar Navanith PR, Ganaraja VH, Haripriya KR, Vikram HV, Asranna A, Mailankody P, Seshagiri DV, Cheerla HM, Maturu VN, Vaddepally CR, Kenchaiah R, Srijithesh PR, Chaudhuri JR, Netravathi M, Alladi S. The Spectrum of Neuro-COVID: A Study of a Comprehensively Investigated Large Cohort from India. Ann Indian Acad Neurol 2022; 25:194-202. [PMID: 35693675 PMCID: PMC9175391 DOI: 10.4103/aian.aian_310_21] [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: 04/09/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Though reports of neurological manifestations of COVID-19 have emerged from various parts of the world, the cohorts reported are from the West and mostly derived from electronic databases. Much remains unknown regarding neuro-COVID in developing countries. India is the second-worst affected country, and this study reports the neurological manifestations of COVID-19 in a comprehensively evaluated cohort. Objective: The aim of this study was to describe the range of neurological manifestations of COVID-19 in India with an emphasis on the risk factors, laboratory and imaging findings and short-term outcome. Methods: Retrospective review of hospital records of all confirmed COVID-19 patients with neurological manifestations, receiving inpatient care in two neurology referral hospitals were done. All demographic, clinical details, investigations, and treatment were analysed. Results: A total of 120 confirmed COVID-19 cases presenting with neurological symptoms were included. The mean age of illness and duration of illness was 48.03 ± 17.3 years and 10.9 ± 17.3 days respectively. New onset of neurological symptoms occurred in 100 cases while 20 patients had worsening of pre-existing neurological illness. Stroke was the commonest neurological disorder (43%), followed by encephalopathy (23%) and Guillain-Barre syndrome (10%). Other unusual neurological manifestations included new-onset headache (7%), seizures including denovo status epilepticus (5%) and meningo-encephalitis (5%). Nearly half of the patients had preceding COVID-19 symptoms. Poor outcome at discharge was seen in 40% and mortality occurred in 15%. Conclusion: Stroke and encephalopathy constitute the most common neurological manifestations. The absence of preceding COVID-19 symptoms in nearly half the cases is striking. Poor outcome was seen in nearly 50% despite early recognition and management.
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Affiliation(s)
- Seena Vengalil
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Rohan Mahale
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - N Chakradhar
- Department of Neurology, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - Swathi Alluri
- Department of Neurology, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - P R Sagar Navanith
- Department of Pulmonary Medicine, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - V H Ganaraja
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - K R Haripriya
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Holla Venkappayya Vikram
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Ajay Asranna
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pooja Mailankody
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Doniparthi V Seshagiri
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - H Manoj Cheerla
- Department of Pulmonary Medicine, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - V N Maturu
- Department of Pulmonary Medicine, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - C R Vaddepally
- Department of Pulmonary Medicine, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - Raghavendra Kenchaiah
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - P R Srijithesh
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Jaydip Ray Chaudhuri
- Department of Neurology, Yashoda Super Speciality Hospitals, Somajiguda, Hyderabad, Telangana, India
| | - M Netravathi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Aggarwal A, Adukia S, Bhatt M. Video Anthology of Movement Disorders Due to Infections in South Asia. Mov Disord Clin Pract 2021; 8:843-858. [PMID: 34405094 DOI: 10.1002/mdc3.13275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/23/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
South Asia, encompassing many populous countries including India, Pakistan, and Bangladesh, is home to a wide variety of infectious diseases several of which are disproportionately prevalent, endemic or distinctive to the region. These result in considerable morbidity and mortality, which can be greatly reduced through public-health measures, timely diagnosis and treatment. Some of these infectious diseases have neurological manifestations including movement disorders either due to the pathogen being neuroinvasive or via an immune-mediated response. For diseases such as Japanese encephalitis, movement disorders are the primary manifestation while for others, they can be a presenting feature. Thus, recognizing these movement disorders is often crucial to the diagnosis of the particular infection, and/or to exclude infection as a cause and arrive at the correct alternate diagnosis. Once diagnosed, the infection-related movement disorders are treated by targeting the infectious agent, or symptomatically. In this article, we describe and illustrate a variety of movement disorders that are seen in patients infected by viruses, bacteria and parasites in South Asia. This would be of value to neurologists practicing in the region and, with the increasing ease in movement of people and pathogens, those practicing elsewhere.
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Affiliation(s)
- Annu Aggarwal
- Movement Disorder Clinic, Department of Neurosciences Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai India
| | - Sachin Adukia
- Movement Disorder Clinic, Department of Neurosciences Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai India
| | - Mohit Bhatt
- Movement Disorder Clinic, Department of Neurosciences Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai India
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Rutovic S, Volevach E, Maršálková H, Fumagalli AI, Corea F. What the Aftermath of the Global Pandemic Will Mean for Neurologists. Neurol Int 2021; 13:297-303. [PMID: 34287348 PMCID: PMC8293413 DOI: 10.3390/neurolint13030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Stela Rutovic
- Department of Neurology, University Hospital Dubrava, Avenija Gojka Suska 6, 10000 Zagreb, Croatia
- Correspondence:
| | - Ekaterina Volevach
- International Clinical Research Center, St. Anne’s University Hospital, 60200 Brno, Czech Republic; (E.V.); (H.M.)
| | - Hana Maršálková
- International Clinical Research Center, St. Anne’s University Hospital, 60200 Brno, Czech Republic; (E.V.); (H.M.)
| | | | - Francesco Corea
- Stroke and Neurology Unit, San Giovanni Battista Hospital, 06034 Foligno, Italy;
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