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Journal of Integrative Neuroscience Apr 2022Though primarily a pulmonary disease, Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus can generate devastating disease states that affect multiple... (Review)
Review
BACKGROUND
Though primarily a pulmonary disease, Coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus can generate devastating disease states that affect multiple organ systems including the central nervous system (CNS). The various neurological disorders associated with COVID-19 range in severity from mild symptoms such as headache, or myalgias to more severe symptoms such as stroke, psychosis, and anosmia. While some of the COVID-19 associated neurological complications are mild and reversible, a significant number of patients suffer from stroke. Studies have shown that COVID-19 infection triggers a wave of inflammatory cytokines that induce endothelial cell dysfunction and generate coagulopathy that increases the risk of stroke or thromboses. Inflammation of the endothelium following infection may also destabilize atherosclerotic plaque and induce thrombotic stroke. Although uncommon, there have also been reports of hemorrhagic stroke associated with COVID-19. The proposed mechanisms include a blood pressure increase caused by infection leading to a reduction in angiotensin converting enzyme-2 (ACE-2) levels that results in an imbalance of the renin-angiotensin system ultimately manifesting inflammation and vasoconstriction. Coagulopathy, as demonstrated by elevated prothrombin time (PT), has also been posited as a factor contributing to hemorrhagics stroke in patients with COVID-19. Other neurological conditions associated with COVID-19 include encephalopathy, anosmia, encephalitis, psychosis, brain fog, headache, depression, and anxiety. Though there are several hypotheses reported in the literature, a unifying pathophysiological mechanism of many of these disorders remains unclear. Pulmonary dysfunction leading to poor oxygenation of the brain may explain encephalopathy and other disorders in COVID-19 patients. Alternatively, a direct invasion of the CNS by the virus or breach of the blood-brain barrier by the systemic cytokines released during infection may be responsible for these conditions. Notwithstanding, the relationship between the inflammatory cytokine levels and conditions such as depression and anxiety is contradictory and perhaps the social isolation during the pandemic may in part be a contributing factor to some of the reported CNS disorders.
OBJECTIVE
In this article, we review the current literature pertaining to some of the most significant and common neurological disorders such as ischemic and hemorrhagic stroke, encephalopathy, encephalitis, brain fog, Long COVID, headache, Guillain-Barre syndrome, depression, anxiety, and sleep disorders in the setting of COVID-19. We summarize some of the most relevant literature to provide a better understanding of the mechanistic details regarding these disorders in order to help physicians monitor and treat patients for significant COVID-19 associated neurologic impairments.
METHODS
A literature review was carried out by the authors using PubMed with the search terms "COVID-19" and "Neurology", "Neurological Manifestations", "Neuropsychiatric Manifestations", "Stroke", "Encephalopathy", "Headache", "Guillain-Barre syndrome", "Depression", "Anxiety", "Encephalitis", "Seizure", "Spasm", and "ICUAW". Another search was carried out for "Long-COVID" and "Post-Acute COVID-19" and "Neurological Manifestations" or "Neuropsychiatric Manifestations". Articles such as case reports, case series, and cohort studies were included as references. No language restrictions were enforced. In the case of anxiety and depression, attempts were made to focus mainly on articles describing these conditions in infected patients.
RESULTS
A total of 112 articles were reviewed. The incidence, clinical outcomes, and pathophysiology of selected neurological disorders are discussed below. Given the recent advent of this disease, the incidence of certain neurologic sequelae was not always available. Putative mechanisms for each condition in the setting of COVID-19 are outlined.
Topics: Anosmia; COVID-19; Cytokines; Disease Progression; Encephalitis; Headache; Hemorrhagic Stroke; Humans; Inflammation; Nervous System Diseases; SARS-CoV-2; Stroke; Post-Acute COVID-19 Syndrome
PubMed: 35633158
DOI: 10.31083/j.jin2103077 -
Asian Journal of Surgery Nov 2023
Topics: Humans; Ageusia; Propofol; Anosmia; Anesthesia, General
PubMed: 37734983
DOI: 10.1016/j.asjsur.2023.07.001 -
International Journal of Developmental... Oct 2022Anosmia, the loss of the sense of smell, is usually associated with rhinopathies and has been reported as a common symptom of COVID-19. There is no specific drug to... (Review)
Review
INTRODUCTION
Anosmia, the loss of the sense of smell, is usually associated with rhinopathies and has been reported as a common symptom of COVID-19. There is no specific drug to treat this condition, although some evidence suggests that melatonin could promote the recovery of olfactory sensory neurons.
METHODS
We set out to perform a narrative review to synthesize the current evidence in this area in respect of our hypothesis that melatonin may be linked with anosmia and play a part in oxidative stress and the regulation of inflammation. The main electronic databases (MEDLINE/PubMed, Embase, and Cochrane) were searched.
RESULTS
The search produced 26 articles related to our hypothesis. Some studies examined issues related to melatonin's effects and its use as adjuvant therapy for COVID-19. Despite some studies suggesting that melatonin may have potential in the treatment of COVID-19, to the best of our knowledge, there have been no trials that have used it to treat anosmia associated with the disease. Few articles identified proposed that melatonin might have an effect on olfactory cells.
DISCUSSION
Further experimental and clinical research on the role of circadian melatonin in the olfactory system is warranted. This will provide evidence of the use of melatonin in the management of anosmia. A number of identified studies suggest that the imbalanced release of melatonin by the pineal gland associated with sleep disturbance may play a role in anosmia, although the specific pathway is not yet entirely clear. This may be a base for further research into the potential role of melatonin as adjuvant treatment of anosmia.
Topics: Anosmia; COVID-19; Humans; Melatonin; Oxidative Stress
PubMed: 35766866
DOI: 10.1002/jdn.10208 -
Lung Jun 2021
Topics: Anosmia; COVID-19; Humans; SARS-CoV-2
PubMed: 33893845
DOI: 10.1007/s00408-021-00448-4 -
International Journal of Molecular... Aug 2021The year 2020 became the year of the outbreak of coronavirus, SARS-CoV-2, which escalated into a worldwide pandemic and continued into 2021. One of the unique symptoms... (Review)
Review
The year 2020 became the year of the outbreak of coronavirus, SARS-CoV-2, which escalated into a worldwide pandemic and continued into 2021. One of the unique symptoms of the SARS-CoV-2 disease, COVID-19, is the loss of chemical senses, i.e., smell and taste. Smell training is one of the methods used in facilitating recovery of the olfactory sense, and it uses essential oils of lemon, rose, clove, and eucalyptus. These essential oils were not selected based on their chemical constituents. Although scientific studies have shown that they improve recovery, there may be better combinations for facilitating recovery. Many phytochemicals have bioactive properties with anti-inflammatory and anti-viral effects. In this review, we describe the chemical compounds with anti- inflammatory and anti-viral effects, and we list the plants that contain these chemical compounds. We expand the review from terpenes to the less volatile flavonoids in order to propose a combination of essential oils and diets that can be used to develop a new taste training method, as there has been no taste training so far. Finally, we discuss the possible use of these in clinical settings.
Topics: Ageusia; Anosmia; COVID-19; Humans; Phytochemicals; SARS-CoV-2; COVID-19 Drug Treatment
PubMed: 34445619
DOI: 10.3390/ijms22168912 -
International Journal of Infectious... Jun 2021The cutaneous manifestations of coronavirus disease 2019 (COVID-19) have been covered insufficiently in the literature. (Review)
Review
BACKGROUND
The cutaneous manifestations of coronavirus disease 2019 (COVID-19) have been covered insufficiently in the literature.
METHODS
Thirty-nine patients admitted to the study hospital with confirmed COVID-19 who experienced various skin manifestations during hospitalization or in the convalescence period, were analysed retrospectively.
RESULTS
Thirty-nine patients with COVID-19, admitted to the study hospital between 23 March and 12 September 2020, had intra-infectious rash or lesions of cutaneous vasculitis during convalescence. The most common cutaneous manifestations of COVID-19 were erythematous and erythematous papular rash. Twenty-seven of the 39 patients had anosmia (69.2%), 26 patients had ageusia (66.7%), 34 patients had pneumonia (87.2%) and 24 patients had intra-infectious enterocolitis (61.5%). Skin biopsies were rarely performed in these patients. This article reports the results of biopsies performed in two patients, showing histopathological and immunohistochemical changes in erythematous rash and erythema multiforme-like lesions. Both skin biopsies revealed early fibrous remodelling of the dermis, suggesting similarity with changes that occur in the lungs and other tissues in patients with COVID-19.
CONCLUSIONS
Correlations between skin lesions and anosmia, ageusia and enteritis in patients with COVID-19 do not seem to be accidental, but are associated with a similar response to ACE2 receptor expression in these tissues.
Topics: Ageusia; Anosmia; COVID-19; Enteritis; Female; Humans; Male; Retrospective Studies; SARS-CoV-2; Skin Diseases
PubMed: 33887455
DOI: 10.1016/j.ijid.2021.04.058 -
Brazilian Journal of Otorhinolaryngology 2021
Topics: Anosmia; COVID-19; Humans; Olfaction Disorders; Pandemics; SARS-CoV-2
PubMed: 33593712
DOI: 10.1016/j.bjorl.2021.02.001 -
CJEM Jul 2021
Topics: Anosmia; COVID-19; Humans; Olfaction Disorders; Pandemics; SARS-CoV-2
PubMed: 33881763
DOI: 10.1007/s43678-021-00135-6 -
The Pediatric Infectious Disease Journal Jun 2022COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric...
INTRODUCTION
COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric cases with COVID-19 from Turkey and make an objective assessment with a smell awareness questionnaire.
MATERIAL AND METHODS
This multicenter prospective cohort study was conducted with pediatric infection clinics in 37 centers in 19 different cities of Turkey between October 2020 and March 2021. The symptoms of 10.157 COVID-19 cases 10-18 years old were examined. Age, gender, other accompanying symptoms, and clinical severity of the disease of cases with anosmia and ageusia included in the study were recorded. The cases were interviewed for the smell awareness questionnaire at admission and one month after the illness.
RESULTS
Anosmia was present in 12.5% (1.266/10.157) of COVID-19 cases 10-18 years of age. The complete records of 1053 patients followed during the study period were analyzed. The most common symptoms accompanying symptoms with anosmia were ageusia in 885 (84%) cases, fatigue in 534 cases (50.7%), and cough in 466 cases (44.3%). Anosmia was recorded as the only symptom in 84 (8%) of the cases. One month later, it was determined that anosmia persisted in 88 (8.4%) cases. In the smell awareness questionnaire, the score at admission was higher than the score one month later (P < 0.001).
DISCUSSION
With this study, we have provided the examination of a large case series across Turkey. Anosmia and ageusia are specific symptoms seen in cases of COVID-19. With the detection of these symptoms, it should be aimed to isolate COVID-19 cases in the early period and reduce the spread of the infection. Such studies are important because the course of COVID-19 in children differs from adults and there is limited data on the prevalence of anosmia.
Topics: Adolescent; Adult; Ageusia; Anosmia; COVID-19; Child; Cohort Studies; Humans; Prevalence; Prospective Studies; SARS-CoV-2; Turkey
PubMed: 35349499
DOI: 10.1097/INF.0000000000003526 -
Journal of Biomolecular Structure &... Apr 2023The COVID-19 pandemic is a very contagious respiratory illness with has affected millions of individuals worldwide. In addition to the well-known symptoms of any...
The COVID-19 pandemic is a very contagious respiratory illness with has affected millions of individuals worldwide. In addition to the well-known symptoms of any respiratory virus, COVID-19 can present with anosmia (failure to smell) and dysgeusia (distortion of the sense of taste). It appears to be a genetic link to the biological mechanisms underlying COVID-19-related anosmia and dysgeusia. Significant locus in the vicinity of the UGT2A1 and UGT2A2 genes are currently considered as the main culprit of the symptoms. However, more studies are needed to delineate a clear pathophysiology.Communicated by Ramaswamy H. Sarma.
Topics: Humans; COVID-19; Dysgeusia; Smell; Taste; Anosmia; Pandemics; SARS-CoV-2; Olfaction Disorders; Glucuronosyltransferase
PubMed: 35147485
DOI: 10.1080/07391102.2022.2039773