Case Report: Neurodegenerative Diseases After Severe Acute Respiratory Syndrome Coronavirus 2 Infection, a Report of Three Cases: Creutzfeldt–Jakob Disease, Rapidly Progressive Alzheimer's Disease, and Frontotemporal Dementia

Abstract

The relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and neurodegenerative diseases is yet to be fully clarified. Rapid worsening and even new-onset cases of those disorders have been reported in association with coronavirus disease 2019 (COVID-19). We describe three cases of neurodegenerative diseases in patients with SARS-CoV-2: a case of Creutzfeldt–Jakob disease during the COVID-19 acute phase, to our knowledge, is the second one described in the literature; a rapidly progressive Alzheimer's Disease; and a patient with frontotemporal dementia, and a quick decline of both cognitive and behavioral domains. This report suggests an association between SARS-CoV-2 infection and a higher probability of developing or accelerating neurodegenerative chronic neurologic conditions. We reinforce the need for a close cognitive follow-up in the aftermath of Sars-Cov2 infection.

Rapid progression of probable Creutzfeldt-Jakob disease with concomitant COVID-19 infection

“…Shortly before, or during, their admission, these patients also tested positive for COVID-19 and experienced associated symptoms ranging from mild (fever, cough) to severe (high oxygen demand, intensive care admission), alongside rapidly progressing dementia and movement disorders which led to a diagnosis of CJD. In most cases, as with the case we present, the patient passed away within 2–4 months of symptom onset 8–13…”

Creutzfeldt-Jakob Disease in a Patient with Previous COVID-19 Infection: “The Virus Caused the Derangement in My Brain”

“…Indeed, the virus has been shown to possess neurotropic and neuroinvasive properties [ 9 ]. A recent case report described the association between SARS-CoV-2 and a higher probability of developing or accelerating neurodegenerative diseases such as CJD in addition to rapidly progressive Alzheimer’s disease and frontotemporal dementia [ 6 ]. Other reports showed an RPD condition occurring directly after COVID-19 infection and patients died a few months later [ 3, 6 ] or 15 days after hospitalization with an atypical clinical phenotype and fulminant evolution [ 8 ].…”

NeuroCOVID-19: a critical review

“…There is an ever-growing list of diseases allegedly associated with COVID-19, which includes esoteric case reports describing SARS-CoV-2 - varicella-zoster meningitis coinfection 36 , COVID-19-associated vestibulopathy 37 , nasopharyngeal swab-associated carotid-artery dissection with retinal ischemia 38 , normal pressure hydrocephalus 39 , cerebral vasculitis 40 , and many other rare neurological syndromes. This list even includes diseases with well-known pathophysiological mechanisms, such as neurodegenerative 41 , metabolic 42 , autoimmune 43 , and infectious 44 diseases. Many of these reports make the case for a theoretical COVID-19-specific disease mechanism in the discussion sections, with mechanicist rationales based on laboratory studies or theoretical reasoning, and with very limited support from clinical studies.…”