Long-Term Brain Disorders in Post Covid-19 Neurological Syndrome (PCNS) Patient.
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ABSTRACT:
SUBMITTER: Nuzzo D
PROVIDER: S-EPMC8066611 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ImportanceNeurological and neuropsychiatric symptoms that persist or develop three months after the onset of COVID-19 pose a significant threat to the global healthcare system. These symptoms are yet to be synthesized and quantified via meta-analysis.ObjectiveTo determine the prevalence of neurological and neuropsychiatric symptoms reported 12 weeks (3 months) or more after acute COVID-19 onset in adults.Data sourcesA systematic search of PubMed, EMBASE, Web of Science, Google Scholar and Scopus was conducted for studies published between January 1st, 2020 and August 1st, 2021. The systematic review was guided by Preferred Reporting Items for Systematic Review and Meta-Analyses.Study selectionStudies were included if the length of follow-up satisfied the National Institute for Healthcare Excellence (NICE) definition of post-COVID-19 syndrome (symptoms that develop or persist ≥3 months after the onset of COVID-19). Additional criteria included the reporting of neurological or neuropsychiatric symptoms in individuals with COVID-19.Data extraction and synthesisTwo authors independently extracted data on patient characteristics, hospital and/or ICU admission, acute-phase COVID-19 symptoms, length of follow-up, and neurological and neuropsychiatric symptoms.Main outcome(s) and measure(s)The primary outcome was the prevalence of neurological and neuropsychiatric symptoms reported ≥3 months post onset of COVID-19. We also compared post-COVID-19 syndrome in hospitalised vs. non-hospitalised patients, with vs. without ICU admission during the acute phase of infection, and with mid-term (3 to 6 months) and long-term (>6 months) follow-up.ResultsOf 1458 articles, 19 studies, encompassing a total of 11,324 patients, were analysed. Overall prevalence for neurological post-COVID-19 symptoms were: fatigue (37%, 95% CI: 24%-50%), brain fog (32%, 9%-55%), memory issues (27%, 18%-36%), attention disorder (22%, 10%-34%), myalgia (18%, 4%-32%), anosmia (12%, 7%-17%), dysgeusia (11%, 4%-17%) and headache (10%, 1%-21%). Neuropsychiatric conditions included sleep disturbances (31%, 18%-43%), anxiety (23%, 13%-33%) and depression (12%, 7%-21%). Neuropsychiatric symptoms substantially increased in prevalence between mid- and long-term follow-up. Compared to non-hospitalised patients, patients hospitalised for acute COVID-19 had reduced frequency of anosmia, anxiety, depression, dysgeusia, fatigue, headache, myalgia, and sleep disturbance at three (or more) months post-infection. Conversely, hospital admission was associated with higher frequency of memory issues (OR: 1.9, 95% CI: 1.4-2.3). Cohorts with >20% of patients admitted to the ICU during acute COVID-19 experienced higher prevalence of fatigue, anxiety, depression, and sleep disturbances than cohorts with <20% of ICU admission.Conclusions and relevanceFatigue, cognitive dysfunction (brain fog, memory issues, attention disorder) and sleep disturbances appear to be key features of post-COVID-19 syndrome. Psychiatric manifestations (sleep disturbances, anxiety, and depression) are common and increase significantly in prevalence over time. Randomised controlled trials are necessary to develop intervention strategy to reduce disease burden.
| S-EPMC8798975 | biostudies-literature
Project description: Not available
| S-EPMC8884477 | biostudies-literature
Project description:Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to a multiorgan disease and subsequently to very different clinical manifestations of coronavirus disease 2019 (COVID-19). In addition to acute symptoms, the long-term complaints in the context of the infection, known as long or post-COVID syndrome, are increasingly attracting attention. With respect to social insurance systems, expert opinions of such problems will become more and more important, whereby neurological and psychiatric symptoms are the most frequent complaints. In addition to the legal principles of the medico-legal assessment with a focus on statutory accident insurance, this overview article discusses the principles of expert assessment and presents landmarks for the expert opinion of the most frequent neurological and psychiatric symptoms occurring in the context of post-COVID syndrome.
| S-EPMC9017073 | biostudies-literature
Project description: Not available
| S-EPMC8447548 | biostudies-literature
Project description:Long lasting symptoms have been reported in a considerable proportion of patients after a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. This condition, defined as either "post-acute coronavirus disease (COVID)," "long COVID," or "long-haul COVID," has also been described in outpatients and in individuals who are asymptomatic during the acute infection. A possible overlap exists between this condition and the functional neurological disorders (FNDs). We report a 23-year-old man who developed, after asymptomatic COVID-19, a complex symptomatology characterized by fatigue, episodic shortness of breath, nocturnal tachycardia, and chest pain. He also complained of attention and memory difficulties, fluctuating limb dysesthesia, and weakness of his left arm. After neurological examination, a diagnosis of FND was made. Notably, the patient was also evaluated at a post-COVID center and received a diagnosis of long COVID-19 syndrome. After 4 months of psychoanalytic psychotherapy and targeted physical therapy in our center for FNDs, dysesthesia and motor symptoms had resolved, and the subjective cognitive complaints had improved significantly. However, the patient had not fully recovered as mild symptoms persisted limiting physical activities. Long-term post COVID symptoms and FNDs may share underlying biological mechanisms, such as stress and inflammation. Our case suggests that functional symptoms may coexist with the long COVID symptoms and may improve with targeted interventions. In patients presenting with new fluctuating symptoms after SARS-CoV-2 infection, the diagnosis of FNDs should be considered, and the positive clinical signs should be carefully investigated.
| S-EPMC8831329 | biostudies-literature
Project description:IntroductionCoronavirus disease 2019 (COVID-19) pandemic, is a newly conducted respiratory disease caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). The current study aims to estimate the neurological diseases which develop after COVID-19 infection.MethodThis is a single center retrospective case series conducted in seven months. the patients were collected in an out-patient clinic. Diagnosis of COVID-19 and the way of diagnosis is confirmed through either polymerase chain reaction (PCR) test for COVID-19 and/or typical findings on chest computed tomography scan (CT scan). Patients developed neurological symptoms after being infected with COVID-19. Symptoms have to be developed within less than 6 months of recovery, or developed during illness and persisted after recovery.ResultA total number of 59 patients infected with SARS-CoV2 were included. The majority of the patients had mild symptoms 32 (54%), 12 (20%) patients developed severe symptoms. Headache was the most common presenting symptom 27(46%) followed by fatigue in 8 (13.5%). The majority of the patients 55 (91.6%) presented with no focal signs. MRI was done for 27 (46%) patients without abnormal finding in 22 cases. Nearly 22 (37.3%) cases were diagnosed as recurrent episodes of migraine or new onset of migraine. All patients were managed according to the underlying pathology, only (28, 47.5%) patients were known to be completely recovered.ConclusionSARS-CoV2 can invade and cause inflammation in the central and peripheral nervous systems. It is responsible for many neurological problems. More studies are necessary to analyze the long term effect of the virus on the nervous system.
| S-EPMC8957714 | biostudies-literature
Project description:BACKGROUNDAfter the initial surge in COVID-19 cases, large numbers of patients were discharged from a hospital without assessment of recovery. Now, an increasing number of patients report postacute neurological sequelae, known as "long COVID" - even those without specific neurological manifestations in the acute phase.METHODSDynamic brain changes are crucial for a better understanding and early prevention of "long COVID." Here, we explored the cross-sectional and longitudinal consequences of COVID-19 on the brain in 34 discharged patients without neurological manifestations. Gray matter morphology, cerebral blood flow (CBF), and volumes of white matter tracts were investigated using advanced magnetic resonance imaging techniques to explore dynamic brain changes from 3 to 10 months after discharge.RESULTSOverall, the differences of cortical thickness were dynamic and finally returned to the baseline. For cortical CBF, hypoperfusion in severe cases observed at 3 months tended to recover at 10 months. Subcortical nuclei and white matter differences between groups and within subjects showed various trends, including recoverable and long-term unrecovered differences. After a 10-month recovery period, a reduced volume of nuclei in severe cases was still more extensive and profound than that in mild cases.CONCLUSIONOur study provides objective neuroimaging evidence for the coexistence of recoverable and long-term unrecovered changes in 10-month effects of COVID-19 on the brain. The remaining potential abnormalities still deserve public attention, which is critically important for a better understanding of "long COVID" and early clinical guidance toward complete recovery.FUNDINGNational Natural Science Foundation of China.
| S-EPMC8876627 | biostudies-literature
Project description:BackgroundClinical investigations have argued for long-term neurological manifestations in both hospitalised and non-hospitalised COVID-19 patients. It is unclear whether long-term neurological symptoms and features depend on COVID-19 severity.MethodsFrom a sample of 208 consecutive non-neurological patients hospitalised for COVID-19 disease, 165 survivors were re-assessed at 6 months according to a structured standardised clinical protocol. Prevalence and predictors of long-term neurological manifestations were evaluated using multivariate logistic regression analyses.ResultsAt 6-month follow-up after hospitalisation due to COVID-19 disease, patients displayed a wide array of symptoms; fatigue (34%), memory/attention (31%) and sleep disorders (30%) were the most frequent. At neurological examination, 40% of patients exhibited neurological abnormalities, such as hyposmia (18.0%), cognitive deficits (17.5%), postural tremor (13.8%) and subtle motor/sensory deficits (7.6%). Older age, premorbid comorbidities and severity of COVID-19 were independent predictors of neurological manifestations in logistic regression analyses.ConclusionsPremorbid vulnerability and severity of SARS-CoV-2 infection impact on prevalence and severity of long-term neurological manifestations.
| S-EPMC8439956 | biostudies-literature
Project description:We investigated the frequency of brain fog in a large cohort of patients with documented coronavirus disease-2019 (COVID-19) who have survived the illness. We also scrutinized the potential risk factors associated with the development of brain fog. Adult patients (18-55 years of age), who were referred to the healthcare facilities anywhere in Fars province from February 19, 2020 to November 20, 2020 were included. All patients had a confirmed COVID-19 diagnosis. In a phone call, at least 3 months after their discharge from the hospital, we obtained their current information. A questionnaire was specifically designed for data collection. In total, 2696 patients had the inclusion criteria; 1680 (62.3%) people reported long COVID syndrome (LCS). LCS-associated brain fog was reported by 194 (7.2%) patients. Female sex (odds ratio [OR]: 1.4), respiratory problems at the onset (OR: 1.9), and intensive care unit (ICU) admission (OR: 1.7) were significantly associated with reporting chronic post-COVID "brain fog" by the patients. In this large population-based study, we report that chronic post-COVID "brain fog" has significant associations with sex (female), respiratory symptoms at the onset, and the severity of the illness (ICU admission).
| S-EPMC8662118 | biostudies-literature
Project description:Introduction Il est désormais admis que les « orteils COVID » sont associés à la pathogenèse du SARS-CoV-2. Les descriptions sont concordantes dans le monde entier, mais le suivi est peu décrit. Nous présentons 4 cas « d’orteils COVID » avec un suivi de plusieurs mois. Matériel et méthodes Entre février 2020 et avril 2021, 4 cas de plus de 3 mois ont été suivis rétrospectivement dans notre clinique dermatologique. Résultats Le premier patient était une femme de 19 ans sans antécédent médical. Deux mois après l’apparition des symptômes de la COVID-19, des lésions acrales de type engelures apparaissaient sur les orteils. Elle se plaignait de démangeaisons. Il n’y avait pas d’aggravation avec le froid. La sérologie SARS-CoV-2 était positive, et la recherche d’anticorps antinucléaires, de cryoglobuline, de cryofibrinogène, d’agglutinines froides était négative. Les engelures étaient encore visibles à 4 mois. Le deuxième patient était une femme de 18 ans en bonne santé. Deux semaines après l’apparition des signes de la COVID-19, des engelures asymptomatiques apparaissaient sur les orteils et les doigts. L’infection par le SARS-Cov-2 était confirmée par PCR nasopharyngée. En outre, on observait une éruption urticarienne transitoire et indolore du tronc, des genoux et des mains, exacerbée par la chaleur et disparaissant avec le froid. La biologie montrait des anticorps antinucléaires positifs avec une fluorescence nucléolaire, et un facteur rhumatoïde. Les engelures étaient encore visibles à 3 mois. Le troisième patient était une femme de 60 ans en bonne santé. Peu après les signes de la COVID-19 avec des symptômes typiques légers, apparaissaient des engelures indolores des orteils. Elle notait une exacerbation par la chaleur, mais pas d’aggravation par le froid. Un épisode de nécrose digitale fut observé et les engelures disparaissaient après cinq mois. Le 4e cas était une femme de 20 ans qui souffrait de symptômes compatibles avec la COVID-19. Cependant, aucune PCR nasopharyngée n’était réalisée et la sérologie était négative. Deux mois plus tard, des engelures et une érythromélalgie apparaissaient sur les orteils. Aucune autre cause n’était trouvée. Les symptômes persistaient après 10 mois, avec à certains endroits une évolution nécrotique superficielle. Discussion Notre petite série de cas montre une durée d’évolution des engelures de 3 à 10 mois. La symptomatologie varie de l’absence de douleur à l’incapacité fonctionnelle, avec parfois une évolution nécrotique. Nos données montrent une longue durée de ces symptômes. À ce jour, les « orteils COVID » n’ont pas été intégrés dans le concept de « long COVID » représentant les complications persistantes de la COVID-19 ; et aucun syndrome acral aigu pédiatrique n’a eu cette durée d’évolution. Nous suggérons de définir les orteils chroniques de la COVID-19 comme une entité distincte des formes aiguës survenant au cours de l’infection.
| S-EPMC8603690 | biostudies-literature