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The Journal of Headache and Pain Jan 2022Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms...
BACKGROUND
Neurological symptoms are frequent among patients with COVID-19. Little is known regarding the repercussions of neurological symptoms for patients and how these symptoms are related to one another.
OBJECTIVES
To determine whether there is an association between the neurological symptoms in patients with COVID-19, and to characterize the headache.
METHOD
This was a cross-sectional study. All hospital inpatients and health workers at the Hospital Universitario Oswaldo Cruz with a PCR-confirmed COVID-19 infection between March and June 2020 were considered for the study and were interviewed by telephone at least 2-months after the acute phase of the disease. These patients were identified by the hospital epidemiological surveillance department. A semi-structured questionnaire was used containing sociodemographic and clinical data and the ID-Migraine.
RESULTS
A total of 288 patients was interviewed; 53.1% were male; with a median age of 49.9 (41.5-60.5) years; 91.7% presented some neurological symptom; 22.2% reported some neurological symptom as the symptom that troubled them most during COVID-19. Neurological symptoms were: ageusia (69.8%), headache (69.1%), anosmia (67%), myalgia (44.4%), drowsiness (37.2%), agitation (20.8%); mental confusion (14.9%), syncope (4.9%) and epileptic seizures (2.8%). Females, those who presented with fever, sore throat, anosmia/ageusia and myalgia also presented significantly more with headache (logistic regression). The most frequent headache phenotype was a non-migraine phenotype, was of severe intensity and differed from previous headaches. This persisted for more than 30 days in 18% and for more than 90 days in 10% of patients. Thirteen percent of those with anosmia and 11% with ageusia continued with these complaints after more than 90 days of the acute phase of the disease. Aged over 50 years, agitation and epileptic seizures were significantly associated with mental confusion (logistic regression).
CONCLUSION
Headache is frequent in COVID-19, is associated with other symptoms such as fever, sore throat, anosmia, ageusia, and myalgia, and may persist beyond the acute phase of the disease.
Topics: Aged; Ageusia; Anosmia; COVID-19; Cross-Sectional Studies; Female; Headache; Humans; Male; Middle Aged; SARS-CoV-2
PubMed: 34979899
DOI: 10.1186/s10194-021-01367-8 -
Molecular Neurobiology Mar 2021COVID-19, the global threat to humanity, shares etiological cofactors with multiple diseases including Alzheimer's disease (AD). Understanding the common links between... (Review)
Review
COVID-19, the global threat to humanity, shares etiological cofactors with multiple diseases including Alzheimer's disease (AD). Understanding the common links between COVID-19 and AD would harness strategizing therapeutic approaches against both. Considering the urgency of formulating COVID-19 medication, its AD association and manifestations have been reviewed here, putting emphasis on memory and learning disruption. COVID-19 and AD share common links with respect to angiotensin-converting enzyme 2 (ACE2) receptors and pro-inflammatory markers such as interleukin-1 (IL-1), IL-6, cytoskeleton-associated protein 4 (CKAP4), galectin-9 (GAL-9 or Gal-9), and APOE4 allele. Common etiological factors and common manifestations described in this review would aid in developing therapeutic strategies for both COVID-19 and AD and thus impact on eradicating the ongoing global threat. Thus, people suffering from COVID-19 or who have come round of it as well as people at risk of developing AD or already suffering from AD, would be benefitted.
Topics: Acetylcholine; Age Factors; Aged; Aged, 80 and over; Alzheimer Disease; Angiotensin-Converting Enzyme 2; Animals; Anosmia; Apolipoprotein E4; Brain; COVID-19; Cytokine Release Syndrome; Cytokines; Female; Galectins; Humans; Hypoxia; Interleukins; Male; Membrane Proteins; Mice; Receptors, Virus; SARS-CoV-2; Sex Factors; Smoking
PubMed: 33078369
DOI: 10.1007/s12035-020-02177-w -
Frontiers in Bioscience (Scholar... Jun 2021The tale COVID infection pandemic or as far as we might be concerned better, COVID-19, has assaulted society on a worldwide scale. For the unenlightened, the sickness is... (Review)
Review
The tale COVID infection pandemic or as far as we might be concerned better, COVID-19, has assaulted society on a worldwide scale. For the unenlightened, the sickness is brought about by the specific infection Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is only from time to time that we have a pandemic seething on that has carried with itself a particularly humongous size of harm and on each and every front of the human culture, be it clinical, practical, social or pretty much anything. Theemerging coronavirus disease 2019 (COVID-19) has neurological symptoms comparable to that of the Extreme Acute Respiratory Syndrome Coronavirus (SARS-CoV) and MERS-CoV. Medical symptoms such as pain in head, vomiting, nausea, dizziness, muscle pain, anosmia, ageusia, and disorder of consciousness are present in COVID-19 affected people. These signs confirm that the COVID-19 infection affects the nervous system. But nerve affecting manifestations of COVID-19 infection are underreported. Guillain-Barré Syndrome (GBS) is a condition that often arises in various forms. According to the evaluation case reports so far from the start of COVID-19 infection, GBS could be associated with COVID-19 infection. There was a systematic review and published cases that suggested that a broad age range with male predominance was affected. There were respiratory and/or systemic symptoms in most patients and they developed GBS manifestations after COVID-19. However, asymptomatic cases of COVID-19 have also been identified. The distribution of clinical variants and electrophysiological subtypes is close to that of classical GBS, with a higher prevalence of classical sensorimotor form and acute inflammatory demyelinating polyneuropathy. It seems like it is important to pay attention to the neurological effects of COVID-19.
Topics: Anosmia; COVID-19; Guillain-Barre Syndrome; Humans; Pandemics; SARS-CoV-2
PubMed: 34256532
DOI: 10.52586/S555 -
The Canadian Journal of Neurological... Jan 2021Albeit primarily a disease of respiratory tract, the 2019 coronavirus infectious disease (COVID-19) has been found to have causal association with a plethora of... (Review)
Review
BACKGROUND
Albeit primarily a disease of respiratory tract, the 2019 coronavirus infectious disease (COVID-19) has been found to have causal association with a plethora of neurological, neuropsychiatric and psychological effects. This review aims to analyze them with a discussion of evolving therapeutic recommendations.
METHODS
PubMed and Google Scholar were searched from 1 January 2020 to 30 May 2020 with the following key terms: "COVID-19", "SARS-CoV-2", "pandemic", "neuro-COVID", "stroke-COVID", "epilepsy-COVID", "COVID-encephalopathy", "SARS-CoV-2-encephalitis", "SARS-CoV-2-rhabdomyolysis", "COVID-demyelinating disease", "neurological manifestations", "psychosocial manifestations", "treatment recommendations", "COVID-19 and therapeutic changes", "psychiatry", "marginalised", "telemedicine", "mental health", "quarantine", "infodemic" and "social media". A few newspaper reports related to COVID-19 and psychosocial impacts have also been added as per context.
RESULTS
Neurological and neuropsychiatric manifestations of COVID-19 are abundant. Clinical features of both central and peripheral nervous system involvement are evident. These have been categorically analyzed briefly with literature support. Most of the psychological effects are secondary to pandemic-associated regulatory, socioeconomic and psychosocial changes.
CONCLUSION
Neurological and neuropsychiatric manifestations of this disease are only beginning to unravel. This demands a wide index of suspicion for prompt diagnosis of SARS-CoV-2 to prevent further complications and mortality.
Topics: Ageusia; Alzheimer Disease; Angiotensin-Converting Enzyme 2; Anosmia; Brain Diseases; COVID-19; Cerebellar Ataxia; Cerebrovascular Disorders; Comorbidity; Delivery of Health Care; Demyelinating Diseases; Disease Management; Dizziness; Epilepsy; Guillain-Barre Syndrome; Headache; Humans; Hypoxia, Brain; Inflammation; Meningoencephalitis; Muscular Diseases; Myelitis, Transverse; Myoclonus; Nervous System Diseases; Parkinson Disease; Polyneuropathies; SARS-CoV-2; Seizures; Stroke; Viral Tropism
PubMed: 32753076
DOI: 10.1017/cjn.2020.173 -
International Journal of General... 2023This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients.
OBJECTIVE
This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients.
METHODS
This is a cross-sectional study. Patients diagnosed with COVID-19 between 1st October 2020 and 30th June 2021 were randomly selected from a national COVID-19 registry. COVID-19 cases were diagnosed using molecular testing method which measured the viral E gene. The Anosmia Reporting Tool, and a brief version of the questionnaire on olfactory disorders were used to measure the outcomes via telephone interviews. Data were analysed using SPSS 27 statistics software.
RESULTS
A total of 405 COVID-19 adults were included in this study, 220 (54.3%) were males and 185 (45.8%) were females. The mean±SD age of participants was 38.2 ± 11.3 years. Alterations in the sense of smell and taste were reported by 206 (50.9%), and 195 (48.1%) of the patients, respectively. Sex and nationality of participants were significantly associated with anosmia and dysgeusia (p < 0.001) and (p-value=0.001) respectively. Among patients who experienced anosmia and dysgeusia, alterations in eating habits (64.2%), impact on mental wellbeing (38.9%), concerns that the alterations were permanent (35.4%), and physical implications and difficulty performing activities of daily living (34%) were reported.
CONCLUSION
Anosmia and dysgeusia are prevalent symptoms of COVID-19 disease, especially among females. Although transient, anosmia and dysgeusia had considerable impact on patient's life. Neuropsychological implications of COVID-19 in acute infection phase and prognosis of anosmia and dysgeusia in COVID-19 are areas for further exploration.
PubMed: 37333880
DOI: 10.2147/IJGM.S408706 -
Headache Sep 2020To summarize for the trainee audience the possible mechanisms of headache in patients with COVID-19 as well as to outline the impact of the pandemic on patients with... (Review)
Review
OBJECTIVE
To summarize for the trainee audience the possible mechanisms of headache in patients with COVID-19 as well as to outline the impact of the pandemic on patients with headache disorders and headache medicine in clinical practice.
BACKGROUND
COVID-19 is a global pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2, of which a large subset of patients features neurological symptoms, commonly headache. The virus is highly contagious and is, therefore, changing clinical practice by forcing limitations on in-person visits and procedural treatments, more quickly shifting toward the widespread adaptation of telemedicine services.
DESIGN/RESULTS
We review what is currently known about the pathophysiology of COVID-19 and how it relates to possible mechanisms of headache, including indirect, potential direct, and secondary causes. Alternative options for the treatment of patients with headache disorders and the use of telemedicine are also explored.
CONCLUSIONS
Limited information exists regarding the mechanisms and timing of headache in patients with COVID-19, though causes relate to plausible direct viral invasion of the nervous system as well as the cytokine release syndrome. Though headache care in the COVID-19 era requires alterations, the improved preventive treatment options now available and evidence for feasibility and safety of telemedicine well positions clinicians to take care of such patients, especially in the COVID-19 epicenter of New York City.
Topics: Aged, 80 and over; Anosmia; COVID-19; Comorbidity; Cytokine Release Syndrome; Education, Medical, Continuing; Headache; Headache Disorders, Secondary; Humans; Inflammation Mediators; Leukoencephalitis, Acute Hemorrhagic; Migraine Disorders; Neurology; New York City; Pandemics; Physical Distancing; SARS-CoV-2; Telemedicine
PubMed: 32521039
DOI: 10.1111/head.13884 -
CMAJ : Canadian Medical Association... Feb 2021
Observational Study
Topics: Adolescent; Alberta; Anosmia; Asymptomatic Infections; COVID-19; COVID-19 Testing; Child; Child, Preschool; Female; Fever; Headache; Humans; Infant; Infant, Newborn; Male; Nausea; Vomiting
PubMed: 33526549
DOI: 10.1503/cmaj.202065-f -
International Journal of Pediatric... Jan 2023To monitor olfactory/gustatory dysfunction and its relationship to SARS-CoV-2 IgG antibody responses in an adolescent population.
BACKGROUND
To monitor olfactory/gustatory dysfunction and its relationship to SARS-CoV-2 IgG antibody responses in an adolescent population.
METHODS
Adolescents with changes in olfactory/gustatory functions were enrolled in a 15-month study. The patients were evaluated with 1) SNOT-22, 2) pediatric smell wheel, and 3) SARS-CoV-2 antibody testing. The relationship between these scores and length of anosmia, and the amount of SARS-CoV-2 IgG antibodies were assessed. A brain MRI was performed in cases of persistent special sensory symptoms.
RESULTS
Eighteen patients were identified with smell and/or taste complaints. Most of the patients were female (67%) and median age was 15 years (range 11-17). Twelve patients had prior SARS-CoV-2 PCR testing, with only five patients with a positive result. The median SNOT-22 score was 16 (range 0-52) and the median smell wheel score was 6.5 (range 1-11). Patients with taste difficulty were more likely to have a score less than eight. 78% of the patients tested positive for antibodies and there was a strong negative correlation between smell wheel score and antibody level (Spearman, ρ = -0.798, p = 0.002). Five patients underwent MRI scan, and all resulted as normal olfactory bulb structures. 66% received nasal corticosteroids. 11 patients presented in follow up.
CONCLUSIONS
Adolescents presenting to a pediatric ENT clinic during the SARS-CoV-2 pandemic were likely to have prolonged (>6 weeks) symptoms of SARS-CoV-2. The majority do not report positive PCR testing result but do report systemic symptoms including anosmia. This suggests that anosmia may be both a late and prolonged symptom of SARS-CoV-2.
Topics: Humans; Adolescent; Female; Child; Male; SARS-CoV-2; Anosmia; COVID-19; Antibodies, Neutralizing; Antibody Formation; Olfaction Disorders; Smell; Antibodies, Viral; Immunoglobulin G
PubMed: 36463663
DOI: 10.1016/j.ijporl.2022.111403 -
Journal of Neuroinflammation Dec 2023The neurological effects of the coronavirus disease of 2019 (COVID-19) raise concerns about potential long-term consequences, such as an increased risk of Alzheimer's...
BACKGROUND
The neurological effects of the coronavirus disease of 2019 (COVID-19) raise concerns about potential long-term consequences, such as an increased risk of Alzheimer's disease (AD). Neuroinflammation and other AD-associated pathologies are also suggested to increase the risk of serious SARS-CoV-2 infection. Anosmia is a common neurological symptom reported in COVID-19 and in early AD. The olfactory mucosa (OM) is important for the perception of smell and a proposed site of viral entry to the brain. However, little is known about SARS-CoV-2 infection at the OM of individuals with AD.
METHODS
To address this gap, we established a 3D in vitro model of the OM from primary cells derived from cognitively healthy and AD individuals. We cultured the cells at the air-liquid interface (ALI) to study SARS-CoV-2 infection under controlled experimental conditions. Primary OM cells in ALI expressed angiotensin-converting enzyme 2 (ACE-2), neuropilin-1 (NRP-1), and several other known SARS-CoV-2 receptor and were highly vulnerable to infection. Infection was determined by secreted viral RNA content and confirmed with SARS-CoV-2 nucleocapsid protein (NP) in the infected cells by immunocytochemistry. Differential responses of healthy and AD individuals-derived OM cells to SARS-CoV-2 were determined by RNA sequencing.
RESULTS
Results indicate that cells derived from cognitively healthy donors and individuals with AD do not differ in susceptibility to infection with the wild-type SARS-CoV-2 virus. However, transcriptomic signatures in cells from individuals with AD are highly distinct. Specifically, the cells from AD patients that were infected with the virus showed increased levels of oxidative stress, desensitized inflammation and immune responses, and alterations to genes associated with olfaction. These results imply that individuals with AD may be at a greater risk of experiencing severe outcomes from the infection, potentially driven by pre-existing neuroinflammation.
CONCLUSIONS
The study sheds light on the interplay between AD pathology and SARS-CoV-2 infection. Altered transcriptomic signatures in AD cells may contribute to unique symptoms and a more severe disease course, with a notable involvement of neuroinflammation. Furthermore, the research emphasizes the need for targeted interventions to enhance outcomes for AD patients with viral infection. The study is crucial to better comprehend the relationship between AD, COVID-19, and anosmia. It highlights the importance of ongoing research to develop more effective treatments for those at high risk of severe SARS-CoV-2 infection.
Topics: Humans; SARS-CoV-2; COVID-19; Anosmia; Neuroinflammatory Diseases; Alzheimer Disease; Olfactory Mucosa
PubMed: 38098019
DOI: 10.1186/s12974-023-02979-4 -
Brain, Behavior, & Immunity - Health Jul 2023One of the predominant symptoms of the COVID-19 virus is the complete (anosmia) or partial (hyposmia) loss of smell. Anosmia may be a critical neurocognitive symptom...
One of the predominant symptoms of the COVID-19 virus is the complete (anosmia) or partial (hyposmia) loss of smell. Anosmia may be a critical neurocognitive symptom because there is an empirically demonstrated association of anosmia with neurodegenerative diseases like Parkinson's disease, Alzheimer's disease, etc. The present study assessed the neurocognitive disorder patterns in recovered COVID-19 patients who either self-reported anosmia or its absence. Of the 60 adult participants (n = 32 males, n = 28 females; = 20.78 years, range = 18-31 years), 15 reported COVID-19 induced anosmia, 15 reported COVID-19 without anosmia, and 30 reported not having contracted COVID-19. The participants were first administered a 10-item smell test, and analysis of variance revealed significantly better scores for the control group than the other two groups. Further, there was no significant difference in smell scores between the patients who self-reported anosmia or denied it. This statistical pattern was consistent across all neuropsychological tests: short- and long-term verbal memory, digit span, Trail Making, and a self-report 46-item neurocognitive scale. Regardless of the self-report of anosmia or denial, all thirty COVID-19 patients scored significantly poorer than the control group on all of the tests and neurocognitive scale. In summary, the self-report of anosmia appears to be unreliable, and the COVID-19 patients who were found to be anosmic on the initial objective smell test demonstrated poorer neuropsychological performance than controls.
PubMed: 37215309
DOI: 10.1016/j.bbih.2023.100632