Background The most frequent cause of death in neurosurgical patients is due to the increase in intracranial pressure (ICP); consequently, adequate monitoring of this parameter is extremely important. Objectives In this study, we aimed to analyze the accuracy of noninvasive measurement methods for intracranial hypertension (IH) in patients with traumatic brain injury (TBI). Methods The data were obtained from the PubMed database, using the following terms: intracranial pressure, noninvasive, monitoring, assessment, and measurement. The selected articles date from 1980 to 2021, all of which were observational studies or clinical trials, in English and specifying ICP measurement in TBI. At the end of the selection, 21 articles were included in this review. Results The optic nerve sheath diameter (ONSD), pupillometry, transcranial doppler (TCD), multimodal combination, brain compliance using ICP waveform (ICPW), HeadSense, and Visual flash evoked pressure (FVEP) were analyzed. Pupillometry was not found to correlate with ICP, while HeadSense monitor and the FVEP method appear to have good correlation, but sensitivity and specificity data are not available. The ONSD and TCD methods showed good-to-moderate accuracy on invasive ICP values and potential to detect IH in most studies. Furthermore, multimodal combination may reduce the error possibility related to each technique. Finally, ICPW showed good accuracy to ICP values, but this analysis included TBI and non-TBI patients in the same sample. Conclusions Noninvasive ICP monitoring methods may be used in the near future to guide TBI patients' management.

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Advanced age is a risk factor for severe infection by acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Children, however, often present with milder manifestations of Coronavirus Disease 2019 (COVID-19). Associations have been found between COVID-19 and multisystem inflammatory syndrome in children (MIS-C). Patients with the latter condition present more severe involvement. Adults with comorbidities such as chronic kidney disease (CKD) are more severely affected. This narrative review aimed to look into whether CKD contributed to more severe involvement in pediatric patients with COVID-19. The studies included in this review did not report severe cases or deaths, and indicated that pediatric patients with CKD and previously healthy children recovered quickly from infection. However, some patients with MIS-C required hospitalization in intensive care units and a few died, although it was not possible to correlate MIS-C and CKD. Conversely, adults with CKD reportedly had increased risk of severe infection by SARS-CoV-2 and higher death rates. The discrepancies seen between age groups may be due to immune system and renin-angiotensin system differences, with more pronounced expression of ACE2 in children. Immunosuppressant therapy has not been related with positive or negative effects in individuals with COVID-19, although current recommendations establish decreases in the dosage of some medications. To sum up with, CKD was not associated with more severe involvement in children diagnosed with COVID-19. Studies enrolling larger populations are still required.

Background Persistence of symptoms or development of new symptoms after SARS‐CoV‐2 infection is an increasingly recognized problem and the long‐term post‐COVID‐19 outcome and the effects on cognitive function remain poorly understood. This study aims to investigate the long‐term cognitive effects and impacts of COVID‐19 with a special focus on a population with low education and low socioeconomic status. Method Cross‐sectional cognitive assessment of participants with severe forms of Covid‐19 one year after hospital admission. Until now, 187 of 322 patients underwent TICS‐M for brief telephone cognitive screening one year after hospitalization for COVID‐19 in 3 public hospitals in Belo Horizonte, Brazil. This sample was divided into two groups according to scores on the TICS‐M screening test: with or without cognitive impairment. 26 participants were selected by convenience for neuropsychiatric assessment, namely 13 with abnormal TICS‐M scores (cases) and the other 13 controls. They were submitted to the following tests and scales: Addenbrooke’s Cognitive Examination‐Revised (ACE‐R), Symbol Digit Modalities Test (SDMT), Free and Cued Selective Reminding Test (FCSRT‐IR), Hospital Anxiety and Depression Scale (HADS) and Impact of Events Scale‐Revised (IES‐R). Result There were no significant differences between groups for age, sex, educational level, need for intensive care unit or use of anticholinergics or sedatives. Although the comparison of SDMT between the groups showed no statistical difference (p = 0.999), all participants showed lower performance compared to normative data. Cases presented lower scores than controls in ACE‐R total (p = 0.034) and in the subdomains Attention and Orientation (p = 0.002), as well as in delayed total recall of the FCSRT‐IR (p = 0.039). Moreover, participants with lower HAD‐D scores had worst performance in Attention and Orientation subdomains of the ACE‐R (p = 0.003). Conclusion Our study shows impairment in global cognition, attention, orientation and episodic memory in individuals previously hospitalized for COVID‐19 infection who presented low scores on TICS‐M. Performance in processing speed tests was impaired among both groups in relation to normative data. Cognitive and mood analyses after COVID‐19 infection can provide information for improving healthcare of these individuals.

Background: COVID-19 infection primarily affects the respiratory system despite of short and medium-term cognitive impairment has been increasingly reported. The Modified Telephone Interview for Cognitive Status (TICS-M), validated for cognitive screening after stroke, assesses domains such as orientation, attention/calculation, language, and immediate and delayed episodic memory. Thus, the TICS-M might be useful to remotely screen for cognitive impairment in individuals affected by COVID-19. Method:Cross-sectional multicenter study in Belo Horizonte, Brazil, with participants hospitalized with COVID-19 confirmed by RT-PCR or serology. All patients were aged 18+ years. Clinical and sociodemographic data were obtained through electronic medical records and/or interviews. Cognitive impairment screening was performed one year after hospital admission using the TICS-M, with a cutoff point of 14 out of 39.Result: Ninety-six patients were submitted to the test, of which 50 (52.1%) were women, 72 (75%) were self-declared non-white, 59 (64.15%) did not complete elementary school and the median age was 62 years (interquartile range 49-69). There was no significant association between lower TICS-M scores and sociodemographic data or previous medical history, except for higher educational level that appears to be a protective factor to lower scores on TICS-M (OR 0.089, 95% CI:0,01-0,7, p 0.008), which is demonstrated in Table 1. There was also no association between the scores and the clinical course during hospitalization as displayed in Table 2. Furthermore, length of hospital stay (p = 0.232) and length of stay in Intensive Care Unit (p = 0.565) did not impact the scores. Conclusion:In this study, 15% of the sample had cognitive impairment one year after hospitalization for COVID-19 according to TICS-M. The absence of an association between known risk factors for cognitive deficits and worse scores on the TICS-M might have been influenced by the fact that only 13.5% of our sample did not have comorbidities. Lower education level was the only factor associated with worse scores, which indicates a possible need to adapt the test or the cutoff point for different educational levels.

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