Demyelinating Disease of the Central Nervous System Concurrent With COVID-19

Karşıdağ, Sibel; Sahin, Şevki; Ateş, Miruna Florentina; Çınar, Nilgün; Kendirli, Sude

doi:10.7759/cureus.17297

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…Most MS/CIS cases received treatment with IVMP 1 gram for 3–5 days ( 57 , 61 , 65 , 68 , 76 , 77 , 79 , 80 , 82 ) and had a favorable outcome ( 57 , 65 , 68 , 77 – 82 ). Treatment of pseudo-relapses was primarily focused on COVID-19 management, with return to baseline neurological status upon infection recovery ( 63 , 69 ).…”

Section: Resultsmentioning

confidence: 99%

“…The neurotrophic features of the Coronavirus family have been previously reported for the Middle East respiratory syndrome coronavirus (MERS-COV) and SARS-COV-1, and similar evidence has been occasionally reported for SARS-CoV-2 ( 88 – 91 ). However, the fact that the SARS-CoV-2 PCR test in the CSF was negative in many of the reported cases ( 25 , 35 , 37 , 39 , 40 , 42 , 44 , 66 , 68 , 77 – 79 , 81 ) would argue against this mechanism of direct pathogenicity. Conversely, some evidence favors the theory of para-infectious or post-infectious immune-mediated etiology.…”

Section: Discussionmentioning

confidence: 95%

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COVID-19 and the risk of CNS demyelinating diseases: A systematic review

et al. 2022

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BackgroundViral infections are a proposed possible cause of inflammatory central nervous system (CNS) demyelinating diseases, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). During the past 2 years, CNS demyelinating events associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported, but causality is unclear.ObjectiveTo investigate the relationship between CNS demyelinating disease development and exacerbation with antecedent and/or concurrent SARS-CoV-2 infection.MethodsA systematic literature review of all publications describing either a new diagnosis or relapse of CNS demyelinating diseases (MS, NMOSD, MOGAD) in association with SARS-CoV-2 infection was performed utilizing PRISMA guidelines. Descriptive statistics were used for data analysis, using a case analysis approach.ResultsSixty-seven articles met the inclusion criteria for the study. Most of the reported cases of NMOSD (n = 13, 72.2% of reported cases) and MOGAD (n = 27, 96.5% of reported cases) were of new disease onset, presenting with typical clinical and radiographic features of these conditions, respectively. In contrast, reported MS cases varied amongst newly diagnosed cases (n = 10, 10.5% of reported cases), relapses (n = 63, 66.4%) and pseudo-relapses (n = 22, 23.2%). The median duration between COVID-19 infection and demyelinating event onset was 11.5 days (range 0–90 days) in NMOSD, 6 days (range−7 to +45 days) in MOGAD, and 13.5 days (range−21 to +180 days) in MS. Most cases received high-dose corticosteroids with a good clinical outcome.ConclusionBased upon available literature, the rate of CNS demyelinating events occurring in the setting of preceding or concurrent SARS-CoV-2 infection is relatively low considering the prevalence of SARS-CoV-2 infection. The clinical outcomes of new onset or relapsing MS, NMOSD, or MOGAD associated with antecedent or concurrent infection were mostly favorable. Larger prospective epidemiological studies are needed to better delineate the impact of COVID-19 on CNS demyelinating diseases.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 95%

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

et al. 2022

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“…SARS-CoV-2 can invade the CNS either through immune-mediated processes or direct invasion ( Karsidag et al, 2021 ; Kim et al, 2017 ). Infection results from hematogenous or neuronal retrograde dissemination via disruption of the nasal epithelial barrier or cribriform plate ( Ismail and Salama, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, began as a rampant pandemic in 2020 and remains a severe public health crisis today, affecting millions worldwide ( WHO, 2022 ). Among the reported post-infectious sequelae, the prevalence of neurological manifestations associated with COVID-19 infection is estimated between 35 and 85% and includes various inflammatory and demyelinating disorders ( Chou et al, 2021 ; Nolen et al, 2022 ; Karsidag et al, 2021 ). Viral organisms often display neurotropic and invasive properties, such that an infection can lead to acute and long-term neurologic complications ( Desforges et al, 2019 ; Kim et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…Viral organisms often display neurotropic and invasive properties, such that an infection can lead to acute and long-term neurologic complications ( Desforges et al, 2019 ; Kim et al, 2017 ). Central nervous system (CNS) injury in these circumstances can result either from an autoimmune response towards the virus or directly due to inoculation of the CNS; this is most true of respiratory viruses, including coronaviruses (CoV), with ample evidence of their presence in the brain or cerebrospinal fluid (CSF) ( Karsidag et al, 2021 ; Desforges et al, 2019 ; Wu et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Central nervous system (CNS) inflammatory demyelinating diseases (IDDs) associated with COVID-19: A case series and review

Feizi

Sharma

Pasham

et al. 2022

Journal of Neuroimmunology

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Understanding autoimmune response after SARS-CoV-2 infection and the pathogenesis/mechanisms of long COVID

Guo,

Shang,

et al. 2024

Medical Review

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COVID-19 posed a major challenge to the healthcare system and resources worldwide. The popularization of vaccines and the adoption of numerous prevention and control measures enabled the gradual end of the COVID-19 pandemic. However, successive occurrence of autoimmune diseases in patients with COVID-19 cannot be overlooked. Long COVID has been the major focus of research due to the long duration of different symptoms and the variety of systems involved. Autoimmunity may play a crucial role in the pathogenesis of long COVID. Here, we reviewed several autoimmune disorders occurring after COVID-19 infection and the pathogenesis of long COVID.

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Demyelinating Disease of the Central Nervous System Concurrent With COVID-19

Cited by 11 publications

References 20 publications

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

Central nervous system (CNS) inflammatory demyelinating diseases (IDDs) associated with COVID-19: A case series and review

Understanding autoimmune response after SARS-CoV-2 infection and the pathogenesis/mechanisms of long COVID

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