Narcolepsy following <scp>COVID</scp>‐19: A case report and review of potential mechanisms

Roya, Yazdani; Farzaneh, Barzkar; Mostafa, Almasi‐Dooghaee; Mahsa, Shojaie; Babak, Zamani

doi:10.1002/ccr3.7370

Cited by 3 publications

(2 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moldofsky and Patcar ( 7 ) showed an association between myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and SARS-CoV-1 infection, with five of 22 patients showing excessive sleepiness confirmed by MLST. To date, two cases of narcolepsy triggered by SARS-CoV-2 infection have also been described ( 9 , 10 ). Viral components used in vaccines may also trigger central hypersomnia, similar to the increased risk of narcolepsy shown with H1N1 vaccination ( 10 ), or the reported recurrence of severe hypersomnia after a SARS-CoV-2 vaccine in a patient previously treated for post-Epstein-Barr virus hypersomnia ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Post-COVID central hypersomnia, a treatable trait in long COVID: 4 case reports

Morelli-Zaher,

Vremaroiu-Coman,

Coquoz

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

IntroductionFatigue is the most commonly reported post-COVID symptom. A minority of patients also report excessive daytime sleepiness, which could be a target for treatment.MethodsAmong 530 patients with a post-COVID condition, those with excessive daytime sleepiness were systematically assessed for objective central hypersomnia, with exclusion of all cases not clearly attributable to SARS-CoV-2 infection.ResultsFour cases of post-COVID central hypersomnia were identified, three fulfilling the criteria of the 3rd International Classification of Sleep Disorders for idiopathic hypersomnia, and one for type II narcolepsy. We report here their clinical history, sleep examination data and treatment, with a favorable response to methylphenidate in three cases and spontaneous resolution in one case.ConclusionWe highlight the importance of identifying cases of post-COVID central hypersomnia, as it may be a treatable trait of a post-COVID condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Post-COVID central hypersomnia, a treatable trait in long COVID: 4 case reports

Morelli-Zaher,

Vremaroiu-Coman,

Coquoz

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…These findings suggest that other infections or vaccinations, like COVID-19, have the potential to also trigger narcolepsy. A case report by Roya et al [25] describes NT1 onset following COVID-19 recovery. Pandemrix-related narcolepsy has been associated with a diagnostic delay of up to a decade, with previous misdiagnoses including anemia, asthma, psychosocial problems, depression, and unspecified tiredness [26].…”

Section: Discussionmentioning

confidence: 99%

SPHYNCS: The Use of the Swiss Narcolepsy Scale in a New Cohort of Patients with Narcolepsy and Its Borderland and Review of the Literature

Zub,

Warncke,

van der Meer

et al. 2023

CTN

View full text Add to dashboard Cite

Introduction and aims: Narcolepsy type 1 (NT1) is a central disorder of hypersomnolence (CDH) characterized by excessive daytime sleepiness and cataplexy. The Swiss Narcolepsy Scale (SNS), which includes the updated and short (sSNS) versions, has recently been introduced as a reliable diagnostic tool for identifying NT1. This study aims to assess the validity of the SNS scales in a new cohort of patients with CDH, while also introducing the French and Italian versions of the SNS and providing a summary of the existing literature on SNS. Materials and methods: The current study is based on the international Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (iSPHYNCS) which aims to identify new biomarkers for CDH. Diagnostic accuracy of the SNS was assessed by calculating sensitivity, specificity, positive predictive value, and negative predictive value. Results: In our population, 108 participants with suspected CDH (including 28 NT1 patients) and 14 healthy controls completed the scale. Original SNS, updated SNS and sSNS scores showed a high sensitivity (86%, 89% and 79%, respectively) and high specificity (96%, 90% and 95%, respectively) for diagnosing NT1 compared to other CDH. The French version was completed by 5 participants, and the Italian version by 8 participants. Regarding previous studies, the SNS has now been assessed in six different populations, involving a total of 1247 subjects (including 326 with narcolepsy with cataplexy/NT1), suggesting high sensitivity (85–100%) and specificity (86–100%) of the SNS for the diagnosis of NT1. Conclusion: The SNS is a simple screening tool validated in seven languages (German, English, French, Italian, Dutch, Turkish and Japanese), demonstrating high sensitivity and specificity for the diagnosis of NT1.

show abstract

Risk of Neurologic or Immune-Mediated Adverse Events After COVID-19 Diagnosis in the United States

Fisher,

Lindaas,

Muthuri

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Many neurologic or immune-mediated conditions have been evaluated as potential adverse events (AEs) in coronavirus disease 2019 (COVID-19) vaccine safety surveillance. To contextualize United States (US) surveillance findings, it is important to quantify the risk of neurologic or immune-mediated AEs associated with COVID-19 diagnosis among adults in the US before the introduction of COVID-19 vaccines. Methods Cohort and self-controlled risk interval (SCRI) designs were used in 2 US administrative claims data sources—Merative™ MarketScan® Commercial Database (ages 18–64 years) and Medicare fee-for-service data (ages ≥ 65 years). AEs included Guillain-Barré syndrome (GBS), Bell’s palsy, encephalitis/encephalomyelitis, narcolepsy, immune thrombocytopenia (ITP), and transverse myelitis; each was analyzed separately with AE-specific exclusion criteria. The cohort (study period, 1 April 2020-10 December 2020) included adults with a COVID-19 diagnosis and a matched comparator group. Inverse probability of treatment-weighted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. The SCRI (study period, 1 June 2020-10 December 2020) used a risk window after COVID-19 diagnosis and pre- and postexposure reference windows within individuals with a COVID-19 diagnosis and the AE. Relative incidences (RIs) and 95% CIs were estimated with seasonality-adjusted conditional Poisson regression models accounting for outcome-dependent observation windows. SCRI analyses were not performed for encephalitis/encephalomyelitis because of high case fatality rates. Results The study observed a consistent association between COVID-19 diagnosis and GBS: MarketScan HR = 9.57 (95% CI, 1.23–74.74), RI = 8.53 (95% CI, 2.45–29.7); Medicare HR = 1.97 (95% CI, 1.04–3.74), RI = 4.63 (95% CI, 1.78–12.01). For ITP, the association was weaker, but still consistently elevated: MarketScan HR = 2.06 (95% CI, 1.20–3.53), RI = 1.74 (95% CI, 1.01-3.00); Medicare HR = 1.36 (95% CI, 1.18–1.57), RI = 1.91 (95% CI, 1.60–2.28). For all remaining AEs, there was no consistent evidence of an association with COVID-19, with estimates that were generally modest, imprecise, and/or varying by study design. Conclusions COVID-19 diagnoses were associated with an increased risk of GBS and ITP in both data sources and study designs. Although increased risks of other neurologic/immune-mediated AEs cannot be ruled out, no consistent associations with COVID-19 were observed.

show abstract

Narcolepsy following COVID‐19: A case report and review of potential mechanisms

Abstract: The immune activation in COVID-19 may trigger narcolepsy in vulnerable patients. We suggest clinicians carefully evaluate patients with post-COVID fatigue and hypersomnia for primary sleep disorders, specifically narcolepsy.

Cited by 3 publications

References 41 publications

Post-COVID central hypersomnia, a treatable trait in long COVID: 4 case reports

Post-COVID central hypersomnia, a treatable trait in long COVID: 4 case reports

SPHYNCS: The Use of the Swiss Narcolepsy Scale in a New Cohort of Patients with Narcolepsy and Its Borderland and Review of the Literature

Risk of Neurologic or Immune-Mediated Adverse Events After COVID-19 Diagnosis in the United States

Contact Info

Product

Resources

About