Long-Term Brain Disorders in Post Covid-19 Neurological Syndrome (PCNS) Patient

Nuzzo, Domenico; Cambula, Gaetano; Bacile, Ignazio; Rizzo, Manfredi; Gallucci, M.; Mangiapane, Paola; Picone, Pasquale Massimo; Giacomazza, Daniela; Scalisi, Luca

doi:10.3390/brainsci11040454

Cited by 42 publications

(58 citation statements)

References 25 publications

(20 reference statements)

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“…Additionally, the severe impact of COVID-19 stressors seems to translate into a post-COVID-19 syndrome beyond the current binary diagnostics that include comorbid depression, anxiety, PTSD, and executive function deficits. Studies of COVID-19 patients discovered a persistent post-COVID-19 infection syndrome that included negative neurological, neuropsychiatric, and cognitive impacts (e.g., Ayoubkhani et al, 2021 ; Garg et al, 2021 ; Nuzzo et al, 2021 ; Oronsky et al, 2021 ; Pavli et al, 2021 ; Wijeratne & Crewther, 2020 ). In addition, post-COVID-19 infection syndrome included increased suicide risk (Sher, 2021 ) and addiction (Håkansson, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type

Kira

Shuwiekh

Ashby

et al. 2021

Int J Ment Health Addiction

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COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals’ previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73–86, 2001; Kira, Torture, 14:38–44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-021-00577-0.

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Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type

Kira

Shuwiekh

Ashby

et al. 2021

Int J Ment Health Addiction

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“…In this case, abnormal arterial vasoconstriction and immune-mediated dysfunction most probably caused cerebral autoregulatory failure; IVIG administration resulted in the subsidence of symptoms, which is consistent with an autoimmune mechanism, triggered by COVID-19 [ 70 ]. In addition, in a previously healthy 56-year-old man with persistent neurological disorders, including short-duration epileptic seizures, and deep depression almost six months after COVID-19, CNS MRI revealed numerous hyperintense focal areas in the periventricular and subcortical white matter and in semioval centers, compatible with gliotic outcomes in association with microvascular injuries [ 71 ]. Endothelial injury, either due to virus invasion or in the context of profound inflammation increased levels of coagulation factors, hypoxia, due to respiratory impairment or anti-platelel factor 4 (PF4)-immune complexes, has been implicated in acute COVID-19 pathogenesis, predisposing to coagulopathy and thromboembolic complications in large blood vessels and microcirculation [ 53 , 72 , 73 ].…”

Section: Pathogenesis Of Post-covid Syndromementioning

confidence: 99%

Post-COVID Syndrome: An Insight on Its Pathogenesis

2021

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Post-COVID syndrome is increasingly recognized as a new clinical entity in the context of SARS-CoV-2 infection. Symptoms persisting for more than three weeks after the diagnosis of COVID-19 characterize the post-COVID syndrome. Its incidence ranges from 10% to 35%, however, rates as high as 85% have been reported among patients with a history of hospitalization. Currently, there is no consensus on the classification of post-COVID syndrome. We reviewed the published information on post-COVID syndrome, putting emphasis on its pathogenesis. The pathogenesis of post-COVID syndrome is multi-factorial and more than one mechanism may be implicated in several clinical manifestations. Prolonged inflammation has a key role in its pathogenesis and may account for some neurological complications, cognitive dysfunction, and several other symptoms. A multisystem inflammatory syndrome in adults (MIS-A) of all ages has been also described recently, similarly to multisystem inflammatory syndrome in children (MIS-C). The post-infectious inflammatory pathogenetic mechanism of MIS-A is supported by the fact that its diagnosis is established through serology in up to one third of cases. Other pathogenetic mechanisms that are implicated in post-COVID syndrome include immune-mediated vascular dysfunction, thromboembolism, and nervous system dysfunction. Although the current data are indicating that the overwhelming majority of patients with post-COVID syndrome have a good prognosis, registries to actively follow them are needed in order to define the full clinical spectrum and its long-term outcome. A consensus-based classification of post-COVID syndrome is essential to guide clinical, diagnostic, and therapeutic management. Further research is also imperative to elucidate the pathogenesis of post-COVID syndrome.

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“…Despite the fact that neurological manifestations of COVID-19 are not yet fully investigated, some patients after a severe infection, frail people in particular, have CNS involvement for a long time [ 59 ]. A precise and targeted study of neurological symptoms can clarify the role played by the virus in causing prolonged neurological manifestations.…”

Section: Discussionmentioning

confidence: 99%

Post-Acute COVID-19 Neurological Syndrome: A New Medical Challenge

Nuzzo

Vasto

Scalisi³

et al. 2021

JCM

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In December 2019, in Wuhan (China), a highly pathogenic coronavirus, named SARS-CoV-2, dramatically emerged. This new virus, which causes severe pneumonia, is rapidly spreading around the world, hence it provoked the COVID-19 pandemic. This emergency launched by SARS-CoV-2 also had, and still has, devastating socio-economic aspects. Assessing the impact of COVID-19 on vulnerable groups of people is crucial for the adaptation of governments’ responses. Growing scientific evidence suggests that it is essential to keep the attention on people after acute SARS-CoV-2 infection; indeed, some clinical manifestations are frequently present even after recovery. There is consensus on the need to define which symptoms persist after the infection and which disabilities may arise after COVID-19. Recent reviews, case reports, and original contributions suggest that various organs may be affected, and neurological symptoms are present in about one third of patients with COVID-19. Neurological complications after severe COVID-19 infection might include delirium, brain inflammation, stroke, and nerve damage. In the recent pandemic, neurologists and neurobiologists have a chance to study key features of infection neurology. Furthermore, the psychological impact of the pandemic should not be underestimated, although there is currently no definition for this condition.

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Long-Term Brain Disorders in Post Covid-19 Neurological Syndrome (PCNS) Patient

Cited by 42 publications

References 25 publications

The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type

The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type

Post-COVID Syndrome: An Insight on Its Pathogenesis

Post-Acute COVID-19 Neurological Syndrome: A New Medical Challenge

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