Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases

McEntire, Caleb R.S.; Song, Kun; McInnis, Robert; Rhee, John Y.; Young, Michael J.; Williams, E. Kendall; Wibecan, Leah; Nolan, Neal M.; Nagy, Amanda; Gluckstein, Jeffrey; Mukerji, Shibani S.; Mateen, Farrah J.

doi:10.3389/fneur.2021.634827

Cited by 48 publications

(62 citation statements)

References 240 publications

(147 reference statements)

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“…A recent outbreak of the novel coronavirus disease (COVID-19), which spread rapidly worldwide in just a few months, has become one of the most socially significant infections, along with influenza and smallpox ( McEntire et al, 2021 ). The causative agent of COVID-19 is a positive single-stranded RNA virus of Coronaviridae found in the genus Betacoronavirus, which also includes severe acute respiratory syndrome-related coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) (with 80 and 50% nucleotide homology, respectively) ( Kim et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The Tissue Distribution of SARS-CoV-2 in Transgenic Mice With Inducible Ubiquitous Expression of hACE2

Dolskiy

Gudymo

Taranov

et al. 2022

Front. Mol. Biosci.

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The novel coronavirus disease COVID-19 has become one of the most socially significant infections. One of the main models for COVID-19 pathogenesis study and anti-COVID-19 drug development is laboratory animals sensitive to the virus. Herein, we report SARS-CoV-2 infection in novel transgenic mice conditionally expressing human ACE2 (hACE2), with a focus on viral distribution after intranasal inoculation. Transgenic mice carrying hACE2 under the floxed STOP cassette [(hACE2-LoxP(STOP)] were mated with two types of Cre-ERT2 strains (UBC-Cre and Rosa-Cre). The resulting offspring with temporal control of transgene expression were treated with tamoxifen to induce the removal of the floxed STOP cassette, which prevented hACE2 expression. Before and after intranasal inoculation, the mice were weighed and clinically examined. On Days 5 and 10, the mice were sacrificed for isolation of internal organs and the further assessment of SARS-CoV-2 distribution. Intranasal SARS-CoV-2 inoculation in hACE2-LoxP(STOP)×UBC-Cre offspring resulted in weight loss and death in 6 out of 8 mice. Immunostaining and focus formation assays revealed the most significant viral load in the lung, brain, heart and intestine samples. In contrast, hACE2-LoxP(STOP) × Rosa-Cre offspring easily tolerated the infection, and SARS-CoV-2 was detected only in the brain and lungs, whereas other studied tissues had null or negligible levels of the virus. Histological examination revealed severe alterations in the lungs, and mild changes were observed in the brain tissues. Notably, no changes were observed in mice without tamoxifen treatment. Thus, this novel murine model with the Cre-dependent activation of hACE2 provides a useful and safe tool for COVID-19 studies.

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Section: Introductionmentioning

confidence: 99%

The Tissue Distribution of SARS-CoV-2 in Transgenic Mice With Inducible Ubiquitous Expression of hACE2

Dolskiy

Gudymo

Taranov

et al. 2022

Front. Mol. Biosci.

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“…Influenza viruses primarily cause respiratory illness in humans. Two forms of central nervous system involvement associated with influenza virus in children and adults are influenzaassociated encephalopathy (IAE) and acute necrotizing encephalopathy (ANE) or acute necrotizing encephalopathy of childhood (ANEC) (19,20). Although initial reports tended to consider IAE and ANE/C together, the current understanding is that ANE is specific, with a characteristic clinico-radiological signature.…”

Section: Introductionmentioning

confidence: 99%

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

et al. 2022

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The direct impact and sequelae of infections in children and adults result in significant morbidity and mortality especially when they involve the central (CNS) or peripheral nervous system (PNS). The historical understanding of the pathophysiology has been mostly focused on the direct impact of the various pathogens through neural tissue invasion. However, with the better understanding of neuroimmunology, there is a rapidly growing realization of the contribution of the innate and adaptive host immune responses in the pathogenesis of many CNS and PNS diseases.The balance between the protective and pathologic sequelae of immunity is fragile and can easily be tipped towards harm for the host. The matter of immune privilege and surveillance of the CNS/PNS compartments and the role of the blood-brain barrier (BBB) and blood nerve barrier (BNB) makes this even more complex. Our understanding of the pathogenesis of many post-infectious manifestations of various microbial agents remains elusive, especially in the diverse African setting. Our exploration and better understanding of the neuroimmunology of some of the infectious diseases that we encounter in the continent will go a long way into helping us to improve their management and therefore lessen the burden.Africa is diverse and uniquely poised because of the mix of the classic, well described, autoimmune disease entities and the specifically “tropical” conditions. This review explores the current understanding of some of the para- and post-infectious autoimmune manifestations of CNS and PNS diseases in the African context. We highlight the clinical presentations, diagnosis and treatment of these neurological disorders and underscore the knowledge gaps and perspectives for future research using disease models of conditions that we see in the continent, some of which are not uniquely African and, where relevant, include discussion of the proposed mechanisms underlying pathogen-induced autoimmunity. This review covers the following conditions as models and highlight those in which a relationship with COVID-19 infection has been reported: a) Acute Necrotizing Encephalopathy; b) Measles-associated encephalopathies; c) Human Immunodeficiency Virus (HIV) neuroimmune disorders, and particularly the difficulties associated with classical post-infectious autoimmune disorders such as the Guillain-Barré syndrome in the context of HIV and other infections. Finally, we describe NMDA-R encephalitis, which can be post-HSV encephalitis, summarise other antibody-mediated CNS diseases and describe myasthenia gravis as the classic antibody-mediated disease but with special features in Africa.

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“…Numerous infectious diseases with pandemic and epidemic potential can cause neurological symptoms in their course [2]. With an increasing number of patients, neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection also became apparent, with the first study from Wuhan showing that this could apply to one in every three cases [3].…”

Section: Introductionmentioning

confidence: 99%

Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality

Wnuk

Sawczyńska

Kęsek

et al. 2021

Neurol Neurochir Pol.

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Objectives. To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. Material and methods.We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology.Results. During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5-88.5] vs. 63.5 [51-77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). www.journals.viamedica.pl/neurologia_neurochirurgia_polska Marcin Wnuk et al., Neurological symptoms in COVID-19 Conclusions. Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality.

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Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases

Cited by 48 publications

References 240 publications

The Tissue Distribution of SARS-CoV-2 in Transgenic Mice With Inducible Ubiquitous Expression of hACE2

The Tissue Distribution of SARS-CoV-2 in Transgenic Mice With Inducible Ubiquitous Expression of hACE2

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality

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