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Neurotoxicology May 2024The global coronavirus 2019 (COVID-19) pandemic began in early 2020, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In mid-2020 the CIAO...
BACKGROUND
The global coronavirus 2019 (COVID-19) pandemic began in early 2020, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In mid-2020 the CIAO (Modelling the Pathogenesis of COVID-19 Using the Adverse Outcome Pathway Framework) project was established, bringing together over 75 interdisciplinary scientists worldwide to collaboratively investigate the underlying biological mechanisms of COVID-19 and consolidate the data using the Adverse Outcome Pathway (AOP) Framework. Neurological symptoms such as anosmia and encephalitis have been frequently reported to be associated with infection with SARS-CoV-2.
OBJECTIVE
Within CIAO, a working group was formed to conduct a systematic scoping review of COVID-19 and its related neurological symptoms to determine which key events and modulating factors are most commonly reported and to identify knowledge gaps.
DESIGN
LitCOVID was used to retrieve 86,075 papers of which 10,244 contained relevant keywords. After title and abstract screening, 2,328 remained and their full texts were reviewed based on predefined inclusion and exclusion criteria. 991 studies fulfilled the inclusion criteria and were retrieved to conduct knowledge synthesis.
RESULTS
The majority of publications reported human observational studies. Early key events were less likely to be reported compared to middle and late key events/adverse outcomes. The majority of modulating factors described related to age or sex. Less recognised COVID-19 associated AO or neurological effects of COVID-19 were also identified including multiple sclerosis/demyelination, neurodegeneration/cognitive effects and peripheral neuronal effects.
CONCLUSION
There were many methodological and reporting issues noted in the reviewed studies. In particular, publication abstracts would benefit from clearer reporting of the methods and endpoints used and the key findings, to ensure relevant papers are included when systematic reviews are conducted. The information extracted from the scoping review may be useful in understanding the mechanisms of neurological effects of COVID-19 and to further develop or support existing AOPs linking COVID-19 and its neurological key events and adverse outcomes. Further evaluation of the less recognised COVID-19 effects is needed.
PubMed: 38763473
DOI: 10.1016/j.neuro.2024.05.003 -
Neurologic Clinics Nov 2020Several different types of exposure have the potential to produce olfactory and gustatory deficits related to neurotoxicity. Although the literature contains relatively...
Several different types of exposure have the potential to produce olfactory and gustatory deficits related to neurotoxicity. Although the literature contains relatively few studies of such chemoreceptive dysfunction in the context of toxic exposure, this review explores the strength of such published associations. Several studies collectively demonstrated moderately strong evidence for an association between manganese dust exposure and olfactory deficits. Evidence of associations between individual chemicals, therapeutics, and composites, such as World Trade Center debris, and olfactory and gustatory deficits remains limited or mixed. Further need for controlled studies for clinical management, exposure limits, and policy development is identified.
Topics: Humans; Neurotoxicity Syndromes; Olfaction Disorders; Smell; Taste
PubMed: 33040872
DOI: 10.1016/j.ncl.2020.08.002 -
Journal of Clinical Nursing Jan 2024Single studies support the presence of several post-COVID-19 symptoms; however, there is no evidence for the synthesis of symptoms. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Single studies support the presence of several post-COVID-19 symptoms; however, there is no evidence for the synthesis of symptoms.
OBJECTIVE
We attempt to provide an overview of the persistent symptoms that post-COVID-19 patients encounter, as well as the duration of these symptoms to help them plan their rehabilitation.
DESIGN
Systematic review and meta-analysis.
PARTICIPANTS
A total of 16 studies involving 8756 patients post-COVID-19 were included.
METHODS
The CINAHL, PubMed, EMBASE, Scopus, and Web of Science databases were searched from 2019 to August 2021. Observational studies that reported data on post-COVID-19 symptoms were included. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal for Observational Studies. We included medium- to high-quality studies. We used a random-effects model for the meta-analytical pooled prevalence of each post-COVID-19 symptom, and I statistics for heterogeneity.
RESULTS
From the 2481 studies identified, 16 met the inclusion criteria. The sample included 7623 hospitalised and 1133 non-hospitalised patients. We found the most prevalent symptoms were fatigue and dyspnea with a pooled prevalence ranging from 42% (27%-58%). Other post-COVID-19 symptoms included sleep disturbance 28% (14%-45%), cough 25% (10%-44%), anosmia/ageusia 24% (7%-47%), fever 21% (4%-47%), myalgia 17% (2%-41%), chest pain 11% (5%-20%), and headache 9% (2%-20%). In addition to physical symptoms, anxiety/depression was also prevalent 27% (8%-53%).
CONCLUSIONS
Fatigue and dyspnea were the most prevalent post-COVID-19 symptoms and experienced up to 12 months.
RELEVANCE TO CLINICAL PRACTICE
Multiple persistent symptoms are still experienced until 12 months of post-Covid 19. This meta-analysis should provide some awareness to nurses to highlights the unmet healthcare needs of post-COVID-19 patients. Long-term monitoring for the evaluation and treatment of symptoms and conditions and rehabilitation programs should be conducted.
Topics: Humans; COVID-19; Chest Pain; Cough; Dyspnea; Fatigue
PubMed: 36426658
DOI: 10.1111/jocn.16471 -
Avicenna Journal of Medicine Oct 2021Pregnancy is an immunocompromised state and, for this reason, a pregnant woman is at a higher risk of getting infected as compared with a healthy individual. There... (Review)
Review
Pregnancy is an immunocompromised state and, for this reason, a pregnant woman is at a higher risk of getting infected as compared with a healthy individual. There is limited data available regarding the impact of COVD-19 on pregnancy; however, the case of miscarriage due to placental infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in second trimester has already been reported. We searched for all published articles in PubMed, Science Direct, Cochrane, Scopus, and Embase. The literature search produced 167 relevant publications; 67 manuscripts were further excluded because they did not satisfy our inclusion criteria. Out of the remaining 100 articles, 78 were excluded after full text screening. Therefore, a total of 22 articles were eligible for review in our study. Overall, these 22 studies included a total of 7,034 participants: 2,689 (38.23%) SARS-CoV-2 positive pregnant women, of which 2,578 (95.87%) were laboratory confirmed and 111 (4.13%) were clinically diagnosed. Among the positive patients, there were 174 (6.47%) cases of abortion, of them 168 (96.55%) were spontaneous abortions and 6 (3.45%) were missed. Most patients either reported mild symptoms of fever, cough, fatigue, and anosmia or they presented asymptomatic. Additional investigation and rigorous research are warranted to confirm placental pathology mechanisms concerning COVID-19 to protect maternal and fetal health.
PubMed: 34881203
DOI: 10.1055/s-0041-1736540 -
European Journal of Neurology Jun 2024The aim was to provide insights to the characteristics of headache in the context of COVID-19 on behalf of the Headache Scientific Panel and the Neuro-COVID-19 Task...
BACKGROUND AND PURPOSE
The aim was to provide insights to the characteristics of headache in the context of COVID-19 on behalf of the Headache Scientific Panel and the Neuro-COVID-19 Task Force of the European Academy of Neurology (EAN) and the European Headache Federation (EHF).
METHODS
Following the Delphi method the Task Force identified six relevant questions and then conducted a systematic literature review to provide evidence-based answers and suggest specific diagnostic criteria.
RESULTS
No data for facial pain were identified in the literature search. (1) Headache incidence during acute COVID-19 varies considerably, with higher prevalence rates in prospective compared to retrospective studies (28.9%-74.6% vs. 6.5%-34.0%). (2) Acute COVID-19 headache is usually bilateral or holocranial and often moderate to severe with throbbing pain quality lasting 2-14 days after first signs of COVID-19; photo-phonophobia, nausea, anosmia and ageusia are common associated features; persistent headache shares similar clinical characteristics. (3) Acute COVID-19 headache is presumably caused by immune-mediated mechanisms that activate the trigeminovascular system. (4) Headache occurs in 13.3%-76.9% following SARS-CoV-2 vaccination and occurs more often amongst women with a pre-existing primary headache; the risk of developing headache is higher with the adenoviral-vector-type vaccines than with other preparations. (5) Headache related to SARS-CoV-2 vaccination is mostly bilateral, and throbbing, pressing, jolting or stabbing. (6) No studies have been conducted investigating the underlying mechanism of headache attributed to SARS-CoV-2 vaccines.
CONCLUSION
The results of this joint EAN/EHF initiative provide a framework for a better understanding of headache in the context of SARS-CoV-2 infection and vaccination.
Topics: Humans; COVID-19; COVID-19 Vaccines; Facial Pain; Headache; SARS-CoV-2; Vaccination
PubMed: 38415282
DOI: 10.1111/ene.16251 -
The Journal of Venomous Animals and... 2022Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a... (Review)
Review
Peripheral facial paralysis (PFP) has been shown to be a neurological manifestation of COVID-19. The current study presents two cases of PFP after COVID-19, along with a rapid review of known cases in the literature. Both case reports were conducted following CARE guidelines. We also performed a systematic review of PFP cases temporally related to COVID-19 using PubMed, Embase, and Cochrane Library databases on August 30, 2021, using a rapid review methodology. The two patients experienced PFP 102 and 110 days after COVID-19 symptom onset. SARS-CoV-2 RNA was detected in nasal samples through reverse-transcription real-time polymerase chain reaction (RT-qPCR) testing. Anosmia was the only other neurological manifestation. PFP was treated with steroids in both cases, with complete subsequent recovery. In the rapid review, we identified 764 articles and included 43 studies. From those, 128 patients with PFP were analyzed, of whom 42.1% (54/128) were male, 39.06% (50/128) female, and in 23 cases the gender was not reported. The age range was 18 to 59 (54.68%). The median time between COVID-19 and PFP was three days (ranging from the first symptom of COVID-19 to 40 days after the acute phase of infection). Late PFP associated with COVID-19 presents mild symptoms and improves with time, with no identified predictors. Late PFP should be added to the spectrum of neurological manifestations associated with the long-term effects of SARS-CoV-2 infection as a post COVID-19 condition.
PubMed: 36305011
DOI: 10.1590/1678-9199-JVATITD-2022-0020 -
Acta Neurochirurgica Jan 2021Olfactory groove meningiomas (OGMs) are commonly treated with open craniotomy. Endonasal approaches have also been described.
Eyebrow supraorbital keyhole craniotomy for olfactory groove meningiomas with endoscope assistance: case series and systematic review of extent of resection, quantification of postoperative frontal lobe injury, anosmia, and recurrence.
BACKGROUND
Olfactory groove meningiomas (OGMs) are commonly treated with open craniotomy. Endonasal approaches have also been described.
OBJECTIVE
To present clinical and radiographic outcomes for the minimally invasive eyebrow incision supraorbital keyhole approach with endoscopic assistance for OGMs.
METHODS
We performed a retrospective single-center cohort study and a systematic literature review.
RESULTS
Fifteen patients were identified, all with Grade I meningiomas. Radiographic gross total resection of enhancing tumor was achieved in all patients. Mean frontal lobe fluid-attenuated inversion recovery volume decreased from 11.1 ± 18.3 cm preoperatively to 9.9 ± 11.4 cm immediately postoperatively, and there was minimal new restricted diffusion (3.2 ± 2.2 cm; max 7.5 cm). Median length of stay was 3 days (range 2-8). Vision was improved in 4 (80%) and stable in 1 (20%) of 5 patients with a preoperative deficit. New postoperative anosmia occurred in 3 (23%) of 13 patients with any preoperative olfaction. All patients were satisfied with their cosmetic result at 3 months. After a median follow-up of 32.2 months, there were 2 (13.3%) asymptomatic radiographic recurrences, 1 treated with radiosurgery and the other with endoscopic endonasal approach (EEA). No patients required further craniotomy. Systematic review revealed the present series to be the largest to date reporting disaggregated outcomes for the eyebrow approach to OGM.
CONCLUSION
The eyebrow incision supraorbital keyhole craniotomy with endoscopic assistance is a safe and effective approach to OGM with tumor control rates similar to more invasive open approaches and better than the endonasal approach. Rates of frontal lobe injury, CSF leak and anosmia are comparatively low.
Topics: Aged; Anosmia; Cohort Studies; Craniotomy; Endoscopes; Eyebrows; Female; Frontal Lobe; Humans; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Recurrence, Local; Neuroendoscopy; Nose; Postoperative Complications; Postoperative Period; Retrospective Studies; Treatment Outcome
PubMed: 32888076
DOI: 10.1007/s00701-020-04552-x -
Journal of Nuclear Medicine : Official... Jul 2022Molecular imaging techniques such as PET and SPECT have been used to shed light on how coronavirus disease 2019 (COVID-19) affects the human brain. We provide a...
Molecular imaging techniques such as PET and SPECT have been used to shed light on how coronavirus disease 2019 (COVID-19) affects the human brain. We provide a systematic review that summarizes the current literature according to 5 predominant topics. First, a few case reports have suggested reversible cortical and subcortical metabolic alterations in rare cases with concomitant para- or postinfectious encephalitis. Second, imaging findings in single patients with the first manifestations of parkinsonism in the context of COVID-19 resemble those in neurodegenerative parkinsonism (loss of nigrostriatal integrity), but scarceness of data and a lack of follow-up preclude further etiologic conclusions (e.g., unmasking/hastening of neurodegeneration vs. infectious or parainfectious parkinsonism). Third, several case reports and a few systematic studies have addressed focal symptoms and lesions, most notably hyposmia. The results have been variable, although some studies found regional hypometabolism of regions related to olfaction (e.g., orbitofrontal and mesiotemporal). Fourth, a case series and systematic studies in inpatients with COVID-19-related encephalopathy (acute to subacute stage) consistently found a frontoparietal-dominant neocortical dysfunction (on imaging and clinically) that proved to be grossly reversible in most cases until 6 mo. Fifth, studies on post-COVID-19 syndrome have provided controversial results. In patients with a high level of self-reported complaints (e.g., fatigue, memory impairment, hyposmia, and dyspnea), some authors found extensive areas of limbic and subcortical hypometabolism, whereas others found no metabolic alterations on PET and only minor cognitive impairments (if any) on neuropsychologic assessment. Furthermore, we provide a critical appraisal of studies with regard to frequent methodologic issues and current pathophysiologic concepts. Finally, we devised possible applications of PET and SPECT in the clinical work-up of diagnostic questions related to COVID-19.
Topics: Anosmia; Brain; COVID-19; Coronavirus Infections; Humans; Molecular Imaging; Pandemics; Parkinsonian Disorders; Pneumonia, Viral; Post-Acute COVID-19 Syndrome
PubMed: 35177424
DOI: 10.2967/jnumed.121.263085 -
Frontiers in Neurology 2022To identify neurological aspects of Coronavirus disease 2019 (COVID-19) and to investigate COVID-19 infected patients with and without olfactory dysfunction in relation...
OBJECTIVES
To identify neurological aspects of Coronavirus disease 2019 (COVID-19) and to investigate COVID-19 infected patients with and without olfactory dysfunction in relation to polymerase chain reaction (PCR) assay results for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the cerebrospinal fluid (CSF).
METHODS
PubMed and EMBASE databases were searched until March 26, 2021, for observational studies with COVID-19 patients that had performed CSF PCR assay due to the neurologic symptom and reported anosmia status.
RESULTS
Initially, 2,387 studies were identified;167 studies performed SARS-CoV-2 CSF PCR assay, of which our review comprised 45 observational studies that conducted CSF PCR assay for SARS-CoV-2 in 101 patients and reported anosmia status in 55 of 101 patients. Central and peripheral neurological manifestations observed in COVID-19 patients were diverse. The most common neurological diagnoses were Guillain-Barré syndrome (GBS) and its variants (24%), followed by encephalopathy (21%). The SARS-CoV-2 PCR assay was positive in only four CSF samples, of which two patients had olfactory dysfunction while the others did not.
CONCLUSIONS
The neurological spectrum of COVID-19 is diverse, and direct neuroinvasion of SARS-CoV-2 is rare. The neuroprotection against SARS-CoV-2 in COVID-19 patients with anosmia is controversial, as an equal number of patients with and without olfactory dysfunction had positive CSF PCR results for SARS-CoV-2 in our study, and further studies are required to provide more insight into this topic.
PubMed: 35911902
DOI: 10.3389/fneur.2022.887164 -
European Archives of... Sep 2020The sudden onset of smell and taste loss has been reported as a symptom related to COVID-19. There is urgent need to provide insight to the pandemic and evaluate anosmia...
PURPOSE
The sudden onset of smell and taste loss has been reported as a symptom related to COVID-19. There is urgent need to provide insight to the pandemic and evaluate anosmia as a potential screening symptom that might contribute to the decision to test suspected cases or guide quarantine instructions.
METHODS
Systematic review of the PubMed/Medline, Cochrane databases and preprints up to May 3, 2020. Combined search terms included: "COVID-19", "SARS-CoV-2", "coronavirus", "nose", "anosmia", "hyposmia", "olfactory loss", "smell loss", "taste loss", and "hypogeusia".
RESULTS
Our search identified 18 reviewed articles and 6 manuscript preprints, including a large epidemiological study, four observational case series, five case-controlled studies, five cross-sectional studies, five case series of anosmic patients and four electronic surveys. Great methodological differences were noted. A significant prevalence of anosmia is reported in COVID-19 patients. Controlled studies indicate that anosmia is more common in COVID-19 patients than in patients suffering from other viral infections or controls. Most of the studies reported either smell loss or smell plus taste loss. Less severe COVID-19 disease is related to a greater prevalence of anosmia. A quick recovery of the smell loss may be expected in most COVID-19 cases.
CONCLUSION
Anosmia is more prevalent in COVID-19 patients than in patients suffering from other respiratory infections or controls.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Cross-Sectional Studies; Female; Humans; Male; Olfaction Disorders; Pandemics; Pneumonia, Viral; SARS-CoV-2; Self Report; Smell; Taste Disorders
PubMed: 32447496
DOI: 10.1007/s00405-020-06069-6