Locked-In with COVID-19

Avula, Akshay; Gill, Arshpal; Nassar, Ra'ed; Nalleballe, Krishna; Siddamreddy, Suman; Chalhoub, Michel

doi:10.1016/j.jocn.2020.07.014

Cited by 12 publications

(12 citation statements)

References 27 publications

(32 reference statements)

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“…Although the CSF RBC count was only reported for 61/430 (14%) patients [ 22 , 28 , 29 , 31 , 35 , 39 , 40 , 44 , 73 , 74 , 77 , 78 , 81 , 89 , 92 , 102 , 110 , 118 , [120] , [121] , [122] , [123] , 128 , 133 , 134 , [138] , [139] , [140] , 156 , 165 , 166 , [172] , [173] , [174] , [175] , [176] , 180 , 184 , 188 , 191 , 192 , 198 , 202 , 204 , 208 , 215 , 220 , 225 , 227 , 233 , 241 , 242 , 246 ], the CSF white blood cell (WBC) count was provided for 409/430 (95%) patients, 270 (66%) of whom had >0 cells/μL, >1 WBC:1,000 RBC or were noted to have “pleocytosis” ( Fig. 3 ) [ [5] , [6] , [7] , [8] , 10 , 13 , [15] , [16] , [17] , [18] ...…”

Section: Resultsmentioning

confidence: 99%

“…Autoimmune antibodies were tested in the CSF of 72/430 (17%) patients (60 (83%) of whom were encephalopathic or comatose, 4 (6%) of whom were paraparetic, 3 (4%) of whom had seizures, 3 (4%) of whom had cerebellar symptoms, 1 (1%) of whom had parkinsonism and 1 (1%) of whom was locked-in) [ 10 , 25 , 30 , 34 , 44 , 45 , 74 , 122 , 135 , 136 , 141 , 148 , 154 , 164 , 169 , 171 , 177 , 182 , 185 , 186 , 191 , 193 , 194 , [205] , [206] , [207] , 209 , 213 , 215 , 216 , 220 , 233 , 234 , 242 , 245 , 246 ]. Of the 72 patients who had autoimmune antibodies tested in the CSF, 4 (6%) had positive autoimmune antibodies [ 30 , 169 , 171 , 205 ].…”

Section: Resultsmentioning

confidence: 99%

“…As is evident by the fact that 303/430 (70%) patients we identified had CSF SARS-CoV-2 PCR testing performed, it is feasible to perform PCR testing for SARS-CoV-2 in CSF [ [5] , [6] , [7] , [8] , [9] , [10] , 15 , 17 , 22 , 24 , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [68] , [69] , [70] , [71] , 73 , 74 , [76] , [77] , [78] , 81 , 84 , 88 , 89 , 95 , 97 , 98 , 101 , 103 , 105 , 108 , 109 , 111 , 113 , 116 , 119 , 122 , 123 , 125 ,…”

Section: Discussionmentioning

confidence: 99%

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Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

150

152

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We sought to review the literature on cerebrospinal fluid (CSF) testing in patients with COVID-19 for evidence of viral neuroinvasion by SARS-CoV-2. Methods: We performed a systematic review of Medline and Embase between December 1, 2019 and November 18, 2020 to identify case reports or series of patients who had COVID-19 diagnosed based on positive SARS-CoV-2 polymerase chain reaction (PCR) or serologic testing and had CSF testing due to a neurologic symptom. Results: We identified 242 relevant documents which included 430 patients with COVID-19 who had acute neurological symptoms prompting CSF testing. Of those, 321 (75%) patients had symptoms that localized to the central nervous system (CNS). Of 304 patients whose CSF was tested for SARS-CoV-2 PCR, there were 17 (6%) whose test was positive, all of whom had symptoms that localized to the central nervous system (CNS). The majority (13/17, 76%) of these patients were admitted to the hospital because of neurological symptoms. Of 58 patients whose CSF was tested for SARS-CoV-2 antibody, 7 (12%) had positive antibodies with evidence of intrathecal synthesis, all of whom had symptoms that localized to the CNS. Of 132 patients who had oligoclonal bands evaluated, 3 (2%) had evidence of intrathecal antibody synthesis. Of 77 patients tested for autoimmune antibodies in the CSF, 4 (5%) had positive findings. Conclusion: Detection of SARS-CoV-2 in CSF via PCR or evaluation for intrathecal antibody synthesis appears to be rare. Most neurological complications associated with SARS-CoV-2 are unlikely to be related to direct viral neuroinvasion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Lewis

Frontera

Placantonakis

et al. 2021

Journal of the Neurological Sciences

150

152

View full text Add to dashboard Cite

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“…Coagulopathy has been reported in 19% of patients in a retrospective cohort study from China [ 3 ]. Multiple case reports and case series of COVID-19 patients presenting with stroke have emerged [ 1 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Cerebral venous thrombosis has also been reported in a patient who eventually tested positive for COVID-19 [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and stroke, a case series and review of literature

Elkhider

Ibrahim

Sharma

et al. 2020

Brain, Behavior, & Immunity - Health

Self Cite

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Background Corona Virus Disease 2019 (COVID-19) cases continue to increase around the World. Typical symptoms include fever and respiratory illness but a constellation of multisystem involvement including central nervous system (CNS) and peripheral nervous system (PNS) have been reported with COVID-19. Acute ischemic strokes (AIS) have also been reported as a complication. Methodology We analyzed patient characteristics, clinical outcomes, laboratory results and imaging results of four patients with COVID-19 who had AIS. Results All four patients were =< 60 years , had hypoxemic respiratory failure secondary to pneumonia, elevated D-dimer and inflammatory markers. Conclusion Ischemic strokes are known complications in patients with severe COVID-19.

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“…Prominent clinical features of COVID-19, such as hypoxia or respiratory distress, cause delirium [ 23 , 24 ] and sudden cardiac arrest, which could create complications for COVID-19 treatment for people with ADRD [ 25 ]. In particular, the higher risk of delirium with COVID-19 could be misdiagnosed as a form of dementia and therefore affect immediate treatment [ 26 , 27 ]. Furthermore, memory problems at late-stage ADRD, which, for example, make safety instructions difficult to remember [ 28 , 29 ] and also make clearly understanding the messages of cocooning and self-isolation difficult [ 30 , 31 ], are deteriorating the capabilities of this group of people to combat the pandemic.…”

Section: Covid-19 and People With Adrdmentioning

confidence: 99%

Home-Based Care for People with Alzheimer’s Disease and Related Dementias (ADRD) during COVID-19 Pandemic: From Challenges to Solutions

Rahman

Ramic

et al. 2020

IJERPH

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There has been supporting evidence that older adults with underlying health conditions form the majority of the fatal cases in the current novel coronavirus disease (COVID-19) pandemic. While the impact of COVID-19 is affecting the general public, it is clear that these distressful experiences will be magnified in older adults, particularly people living with Alzheimer’s disease and related dementia (ADRD), making them the most vulnerable group during this time. People with differing degrees of ADRD are especially susceptible to the virus, not only because of their difficulties in assessing the threat or remembering the safety measures, but also because of the likelihood to be subject to other risk factors, such as lack of proper care and psychological issues. Therefore, in this article, we will discuss the challenges related to home-based care for people with ADRD during a pandemic and propose a formulation of systematic solutions to address these challenges and to alleviate the social and economic impact resulting from the crisis.

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Locked-In with COVID-19

Abstract: Highlights Locked in Syndrome is a tragic disease. Most commonly caused by damage to ventral brain stem. This is the first case of LIS secondary to COVID-19.

Cited by 12 publications

References 27 publications

Cerebrospinal fluid in COVID-19: A systematic review of the literature

Cerebrospinal fluid in COVID-19: A systematic review of the literature

COVID-19 and stroke, a case series and review of literature

Home-Based Care for People with Alzheimer’s Disease and Related Dementias (ADRD) during COVID-19 Pandemic: From Challenges to Solutions

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