Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management

Zhou, Yifan; Li, Wei; Wang, David; Mao, Ling; Jin, Huijuan; Li, Yanan; Hong, Candong; Chen, Shengcai; Chang, Jiang; He, Quanwei; Wang, Mengdie; Hu, Bo

doi:10.1136/svn-2020-000398

Cited by 62 publications

(65 citation statements)

References 13 publications

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“…However, on visuomotor tasks, the patient took significantly more time than controls of similar age. His visual acuity and visual fields were tested in less than eight minutes in the ward with the help of the MRF-n, and was found to be normal [1][2][3][4][5][6] (Figure 2A-2B). The patient was also asked to perform three short visuomotor tasks borrowed from the Lee Ryan Eye Hand Coordination Test battery (SLURP)] as a rapid (less than five minutes) baseline measure of fine visually driven motor and executive function skills (Figure 7).…”

Section: Figure 5: Immune Cell Graphmentioning

confidence: 99%

First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization

Wijeratne¹,

Sales²,

Nguyen³

et al. 2020

Cureus

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A case of a 75-year-old man with COVID-19, severe neurological symptoms (acute stroke-like symptoms and signs and full recovery after a prolonged hospital stay), and intracranial hypertension is discussed with an in-depth review of his clinical features, biochemistry, haematology, highlighting the relationship between changes in neutrophil-lymphocyte ratio, C-reactive protein level, D-dimer level, and the clinical onset of acute ischemic stroke-like symptoms in the setting of COVID-19 and major neurological manifestations. This is the first such case reported in Australia to date. This case also illustrates the recovery of a patient with COVID-19 complicated with severe neurological symptoms (acute ischemic stroke-like symptoms) during the prolonged intensive care unit stay (at day 26) followed by slow neurorehabilitation and normal recovery from both respiratory and neurological involvement. The onset of acute stroke-like symptoms appears to be closely associated with changes of neutrophil-lymphocyte ratio and in C-reactive protein, and D-dimer levels.

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Section: Figure 5: Immune Cell Graphmentioning

confidence: 99%

First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization

Wijeratne¹,

Sales²,

Nguyen³

et al. 2020

Cureus

View full text Add to dashboard Cite

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“…Since the pathogenesis of SARS-CoV2 first began to emerge, numerous other clinical system manifestations have been identified. Neurological manifestations of SARS-CoV 2 infection were first reported in a series of patients in Wuhan, China by Zhou et al (2). Acute ischemic stroke (AIS) was diagnosed in 5% of the cases (2).…”

Section: Introductionmentioning

confidence: 99%

“…Neurological manifestations of SARS-CoV 2 infection were first reported in a series of patients in Wuhan, China by Zhou et al (2). Acute ischemic stroke (AIS) was diagnosed in 5% of the cases (2). However, a much lower rate of only 0.9% imaging confirmed AIS i.e., 32/3,556 total patients case number with COVID-19 was reported in New York USA (3).…”

Section: Introductionmentioning

confidence: 99%

Acute Ischemic Stroke in COVID-19: A Case-Based Systematic Review

2020

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Corona virus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is recognized as a global pandemic by WHO 2020 with 5,934 936 infections, 367,166 deaths and affecting over 200 countries as of 30th May 2020. Acute Ischemic Stroke (AIS) in brain is also emerging as an important neurovascular/neurological complication of COVID-19, associated with extreme immune responses leading to dysregulated coagulation system and generalized thrombo-embolic status and increased risk of AIS especially among usually less vulnerable younger adults in this cohort. Thus, in early June 2020, we aimed to review the clinical data on all published cases of COVID-19 and concomitant AIS, with a view to understanding the pertinent clinical, laboratory and imaging features. The neutrophil-lymphocyte ratio (NLR) at time of hospital admission for COVID infection correlates positively with the duration of time before onset of clinical features of AIS. Higher NLR, C-Reactive protein, serum ferritin, D-dimer and fibrinogen levels are associated with poor prognosis of AIS in COVID-19 with 75% of patients dying or being severely disabled at present. Currently it is too early to comment on the long-term outcomes for survivors.

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“…10,11 Another organ system that has been proven to be part of the COVID-19 manifestation is the nervous system, gastrointestinalhepatobiliary system, urology system, cardiovascular and metabolic system, hematology system, reproductive system especially in pregnancy, integument system or mucocutaneous with the actual form of efflorescence typical for other diseases, such as varicella. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] This case series specifically discusses the skin manifestations of COVID-19 disease infections that occur in 3 of 7 cases with close contact in the same environment. Several reports related to the skin manifestation of COVID-19 have been widely discussed abroad, but there are still very few case reports in Indonesia that discuss this.…”

Section: Discussionmentioning

confidence: 99%

Skin manifestation in COVID-19 infection: a thousand appearances (immune response perspective)

2020

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<p>The clinical manifestations of COVID-19 infection are still unclear. The spectrum of the disease is very broad, with many target organs; one of them is skin. Various skin manifestations have been observed in COVID-19 patients. However, the observed skin manifestation was not specific. This following case series aims to provide an overview of skin manifestations in COVID-19 to help recognize the initial symptoms of COVID-19 infection. This case series also compares cases with and without skin manifestations. This case series discusses seven cases, which the patient had close contact, who had been diagnosed with confirmed COVID-19 by polymerise chain reaction (PCR) examination. The clinical symptoms were mild, such as fever, cough, sore throat, myalgia, malaise, headache, and skin lesions. There are few differences in in complete blood laboratories. Radiology features within normal limits. All patients were given a treatment regimen according to the Indonesian lung association recommendations and symptomatic drugs. Three of seven cases had skin manifestation, which two of them had a maculopapular lesion, and the other one had urticaria lesions. Subjective symptoms, such as itching and burning sensation, were reported. The majority of lesions were localized on the upper and lower limb. Also, in this following case series, there is a tendency for complete blood parameters, neutrophil-to-lymphocyte ratio (NLR), and absolute lymphocyte count (ALC) to be lower in mild cases of confirmed COVID-19 with skin manifestations. It can be concluded that COVID-19 infection may result in skin manifestation with various clinical presentations. This important manifestation may help in diagnosing and treating COVID-19 and prevent further transmission.</p>

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Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management

Cited by 62 publications

References 13 publications

First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization

First Australian Case of Good Recovery of a COVID-19 Patient With Severe Neurological Symptoms Post Prolonged Hospitalization

Acute Ischemic Stroke in COVID-19: A Case-Based Systematic Review

Skin manifestation in COVID-19 infection: a thousand appearances (immune response perspective)

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