Does SARS-CoV-2 infection cause chronic neurological complications?

Hascup, Erin R.; Hascup, Kevin N.

doi:10.1007/s11357-020-00207-y

Cited by 71 publications

(90 citation statements)

References 11 publications

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“…Finally, cognitive complaint, which was reported in five of our patients, has also been reported in a French cohort [10] where a dysexecutive syndrome was noted in 36% of the cases. The underlying mechanism is still unclear but a potential neurodegeneration is being proposed [34]. Two important observations of COVID-19 influencing factors can be drawn in our study.…”

Section: Discussionmentioning

confidence: 58%

Characteristics, onset, and evolution of neurological symptoms in patients with COVID-19

et al. 2020

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Background A wide range of neurological manifestations has been described in COVID-19. Methods In this nationwide retrospective observational study, patients in Tunisia diagnosed with COVID-19 between the 2nd of March and the 16th of May 2020 were contacted by telephone. We collected demographic and clinical data and specified characteristics and evolution of main neurological symptoms. Results Of 1034 confirmed COVID-19 patients, 646 were included (mean age 42.17 years old) and 466 (72.1%) had neurological symptoms. Neurological symptoms were isolated 22.7% ( n = 106). Headache was the most frequent neurological symptom ( n = 279, 41.1%): mainly frontotemporal ( n = 143, 51.1%) and mild or moderate ( n = 165, 59.1%). When associated with fever ( n = 143, 51.3%), headache was more likely to be severe and present at onset. Recovery was reported in 83.2%. Smell and taste impairment were found in 37.9% ( n = 245) and 36.8% ( n = 238) respectively. Among them, 65.3% (156/239) were anosmic and 63.2% (146/231) were ageusic. A complete improvement was found in 72.1% (174/240) of smell impairment and in 76.8% (179/233) of taste impairment. Myalgia ( n = 241, 37.3%) and sleep disturbances ( n = 241, 37.3%) were also frequent. Imported cases had more neurological symptoms ( p = 0.001). In 14.5%, neurological symptoms preceded the respiratory signs (RS). RS were associated with more frequent ( p = 0.006) and numerous ( p < 0.001) neurological symptoms. Conclusions Neurological symptoms in COVID-19 are frequent, can be isolated and present at onset. A total recovery is the most recorded outcome. RS are predictive of neurological symptoms. Studies in to virus and host genetics should be considered to understand the different phenotypes.

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Section: Discussionmentioning

confidence: 58%

Characteristics, onset, and evolution of neurological symptoms in patients with COVID-19

et al. 2020

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“…As stated above, NPS, and specifically apathy, might represent the most relevant symptom of acute COVID-19 infection ( 11 ). Additionally, SARS-CoV-2 infection has been proposed to directly induce neurodegeneration, even though specific studies investigating such mechanisms in the elderly, and specifically in those with a well-defined diagnosis of dementia, are absent ( 73 ). Therefore, NPS might surge/worsen due to a direct effect of SARS-CoV-2, rather than being an indirect consequence of COVID-19 pandemic-related isolation.…”

Section: Limitationsmentioning

confidence: 99%

Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions

et al. 2020

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Background Neuropsychiatric symptoms (NPS) of dementia, such as anxiety, depression, agitation, and apathy, are complex, stressful, and costly aspects of care, and are associated to poor health outcomes and caregiver burden. A steep worsening of such symptoms has been reported during Coronavirus Disease 2019 (COVID-19) pandemic. However, their causes, their impact on everyday life, and treatment strategies have not been systematically assessed. Therefore, the aim of this review is to provide a detailed description of behavioral and psychopathological alterations in subjects with dementia during COVID-19 pandemic and the associated management challenges. Methods A PubMed search was performed focusing on studies reporting alterations in behavior and mood and treatment strategies for elderly patients with dementia, in accordance with PRISMA guidelines. The following search strategy was utilized: (COVID* OR coronavirus OR “corona vir*” OR SARS-CoV-2) AND (dementia OR demented OR dement* OR alzheimer* OR “pick’s disease” OR “lewy body” OR “mild cognitive” OR mild cognitive impairment OR MCI). Results Apathy, anxiety and agitation are the most frequently NPS during the COVID-19 pandemic and are mainly triggered by protracted isolation. Most treatment strategies rely on pharmacotherapy; technology is increasingly utilized with mixed results. Conclusions NPS of dementia during COVID-19 appear to arise from social restrictions occurring as a consequence of the pandemic. Implementation of caregiver support and the presence of skilled nursing home staff are required to restore social interaction and adjust technological support to the patients’ needs.

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“…On a collateral basis, it has also been reported how the SARS-CoV-2 virus can determine, alongside the respiratory infection, a neuroin ammatory state possibly triggering or accelerating neurodegeneration mechanisms and related symptoms including neuropsychiatric ones [17]. This hypothesis, which still needs to be con rmed, could possibly explain long-term indirect neurodegenerative effects in people over 65 years of age.…”

Section: Direct Consequences Of Covid-19 On Elderly Population and Dementioning

confidence: 99%

Direct and indirect neurological, cognitive and behavioral effects of COVID-19 on the normal elderly, Mild-Cognitive-Impairment and Alzheimer’s Disease populations

Iodice

Cassano

Rossini

2020

Preprint

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This article reviews the main articles that have been published so far about the direct and indirect effects of the COVID-19 pandemic on a particularly fragile population represented by the healthy elderly people as well as those with Mild Cognitive Impairment and Alzheimer's disease. Such populations have been among the most affected in the early stages of the pandemic due to the direct effects of the virus and numerous indirect effects now emerge and will have to be carefully assessed over time. The pandemic associated to COVID-19 has shifted most of the health resources to the emergency area and has consequently left the three main medical areas that dealing with the elderly population (oncology, time-dependent diseases and degenerative disease) temporarily “uncovered”. In the phase following the emergency, it will be crucial to guarantee to each area the economic and organizational resources to quickly return to the level of support of the pre-pandemic state. The emergency phase represented an important moment of discussion on the possibilities of telemedicine which will inevitably become increasingly important but all the limits of its use in the elderly population have to be considered. In the post-lockdown recovery phase, alongside the classic medical evaluation, the psychological evaluation must become even more important for doctors caring about people with cognitive decline.

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Does SARS-CoV-2 infection cause chronic neurological complications?

Cited by 71 publications

References 11 publications

Characteristics, onset, and evolution of neurological symptoms in patients with COVID-19

Characteristics, onset, and evolution of neurological symptoms in patients with COVID-19

Neuropsychiatric Symptoms in Elderly With Dementia During COVID-19 Pandemic: Definition, Treatment, and Future Directions

Direct and indirect neurological, cognitive and behavioral effects of COVID-19 on the normal elderly, Mild-Cognitive-Impairment and Alzheimer’s Disease populations

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