Neurologic complications of coronavirus infections

Nath, Avindra

doi:10.1212/wnl.0000000000009455

Cited by 208 publications

(244 citation statements)

References 16 publications

Supporting

Mentioning

218

Contrasting

Unclassified

Order By: Relevance

“…Recently, there have also been some reports of neurologic presentations earlier in disease. 5 Some may include new-onset seizures 6 b. Are people with epilepsy more predisposed (or vice versa) to COVID-19 infection?…”

Section: Methods For Consensus Statementsmentioning

confidence: 99%

Keeping people with epilepsy safe during the COVID-19 pandemic

et al. 2020

View full text Add to dashboard Cite

ObjectivesTo provide information on the effect of the coronavirus disease of 2019 (COVID-19) pandemic on people with epilepsy and provide consensus recommendations on how to provide the best possible care for people with epilepsy while avoiding visits to urgent care facilities and hospitalizations during the novel coronavirus pandemic. MethodsThe authors developed consensus statements in 2 sections. The first was "How should we/ clinicians modify our clinical care pathway for people with epilepsy during the COVID-19 pandemic?" The second was "What general advice should we give to people with epilepsy during this crisis? The authors individually scored statements on a scale of −10 (strongly disagree) to +10 (strongly agree). Five of 11 recommendations for physicians and 3/5 recommendations for individuals/families were rated by all the authors as 7 or above (strongly agree) on the first round of rating. Subsequently, a teleconference was held where statements for which there was a lack of strong consensus were revised. ResultsAfter revision, all consensus recommendations received a score of 7 or above. The recommendations focus on administration of as much care as possible at home to keep people with epilepsy out of health care facilities, where they are likely to encounter COVID-19 (including strategies for rescue therapy), as well as minimization of risk of seizure exacerbation through adherence, and through ensuring a regular supply of medication. We also provide helpful links to additional helpful information for people with epilepsy and health providers. ConclusionThese recommendations may help health care professionals provide optimal care to people with epilepsy during the coronavirus pandemic.

show abstract

Section: Methods For Consensus Statementsmentioning

confidence: 99%

Keeping people with epilepsy safe during the COVID-19 pandemic

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Most CoVs share a common viral structure, infection potential, and neurotropism [46,47], CoVs are large, enveloped viruses with a large positive-sense, singlestranded RNA genome [48]. CoVs have been associated with CNS diseases such as acute viral encephalopathy, acute disseminated encephalomyelitis, and multiple sclerosis and are increasingly recognized as presenting a neurologic crisis [3,52,53]. In one series of 183 children hospitalized with acute encephalitis, 12% were associated with coronavirus infection [54].…”

Section: Covid-19: Potential Factors Contributing To Icu Deliriummentioning

confidence: 99%

COVID-19: ICU delirium management during SARS-CoV-2 pandemic

et al. 2020

View full text Add to dashboard Cite

The novel coronavirus, SARS-CoV-2-causing Coronavirus Disease 19 , emerged as a public health threat in December 2019 and was declared a pandemic by the World Health Organization in March 2020. Delirium, a dangerous untoward prognostic development, serves as a barometer of systemic injury in critical illness. The early reports of 25% encephalopathy from China are likely a gross underestimation, which we know occurs whenever delirium is not monitored with a valid tool. Indeed, patients with COVID-19 are at accelerated risk for delirium due to at least seven factors including (1) direct central nervous system (CNS) invasion, (2) induction of CNS inflammatory mediators, (3) secondary effect of other organ system failure, (4) effect of sedative strategies, (5) prolonged mechanical ventilation time, (6) immobilization, and (7) other needed but unfortunate environmental factors including social isolation and quarantine without family. Given early insights into the pathobiology of the virus, as well as the emerging interventions utilized to treat the critically ill patients, delirium prevention and management will prove exceedingly challenging, especially in the intensive care unit (ICU). The main focus during the COVID-19 pandemic lies within organizational issues, i.e., lack of ventilators, shortage of personal protection equipment, resource allocation, prioritization of limited mechanical ventilation options, and end-of-life care. However, the standard of care for ICU patients, including delirium management, must remain the highest quality possible with an eye towards long-term survival and minimization of issues related to post-intensive care syndrome (PICS). This article discusses how ICU professionals (e.g., physicians, nurses, physiotherapists, pharmacologists) can use our knowledge and resources to limit the burden of delirium on patients by reducing modifiable risk factors despite the imposed heavy workload and difficult clinical challenges posed by the pandemic.

show abstract

“…En este sentido, el efecto de distracción puede tener una repercusión sanitaria negativa sobre muchos enfermos que se debe tratar de prever (2) . Aunque la presencia de síntomas neurológicos en los pacientes afectados por Covid-19 es aparentemente baja en las series de pacientes (3,4,5,6,7,8) y en dos estudios específicos en pacientes hospitalizados (9) o casos aislados (10) y las consecuencias en el sistema nervioso central a medio y largo plazo no se conocen (11,12,13) , la repercusión sobre el resto de enfermos neurológicos puede ser grande si no se atienden de forma específica, considerando que las enfermedades neurológicas son la principal causa de discapacidad global. El presente artículo no pretende discutir la puesta en marcha o la adaptación de protocolos diagnósticos y/o terapéuticos en las distintas enfermedades neurológicas, lo que ya han hecho muchas sociedades de neurología o grupos de expertos, sino que pretende describir decisiones operativas que se han tomado debido a la situación, como se han hecho en otras especialidades (14,15,16) o como se ha sugerido tras en análisis de situaciones similares (17) El confinamiento ha formado parte de la estrategia para reducir el riesgo de propagación de la enfermedad, y ello ha condicionado la atención médica.…”

Section: Introductionunclassified