Neurological symptoms in COVID-19 patients

Altunışık, Erman; Sayıner, Hakan Sezgin; Aksöz, Selçuk; ÇİL, Elif; Ozgenc, G

doi:10.4149/bll_2021_004

Cited by 10 publications

(9 citation statements)

References 20 publications

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“…suggested to serve as an alternative pathway for viral entry into the CNS. 7,8 During COVID-19 infections, chemosensory symptoms, such as olfactory dysfunction (OD), may occur as a form of viral prodroma or may present concurrently with the development of other disease symptoms. 9 Anosmia or hyposmia, often accompanied by changes in taste, is now recognized as a common symptom that can assist in the diagnosis of COVID-19.…”

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confidence: 99%

Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study

Altunışık¹,

Baykan

Şahin

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Anosmia or hyposmia, often accompanied by changes in taste, is recognized as a common symptom that can assist in the diagnosis of coronavirus disease 2019 . The pathogenesis of olfactory dysfunction in COVID-19is not yet fully understood. MR imaging represents a useful anatomic imaging method for the evaluation of olfactory dysfunction associated with varying etiologies, including viral infection, trauma, and neurodegenerative processes. This case-control study was conducted to compare quantitative measurements of olfactory anatomic structures between patients diagnosed with COVID-19 associated with persistent olfactory dysfunction and healthy controls. MATERIALS AND METHODS:This study has a retrospective design. Cranial MR imaging was performed on all participants in both the patient and control groups. The bilateral olfactory bulb volume, olfactory tract length, and olfactory sulcus depth were measured in all patients.RESULTS: A total of 116 people aged 18-60 years, including 36 patients diagnosed with COVID-19 and 80 controls, were included in the study. All measured values were compared between the patient and control groups. The right, left, and total olfactory bulb volume values were significantly lower in the patient group than in the control group. The patient group also had significantly lower right and left olfactory sulcus depth and olfactory tract length values compared with those in the control group.CONCLUSIONS: MR imaging findings can be used to demonstrate olfactory injury in patients with COVID-19. The olfactory pathway may represent an alternative route for virus entry into the central nervous system.

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confidence: 99%

Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study

Altunışık¹,

Baykan

Şahin

et al. 2021

AJNR Am J Neuroradiol

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“…It is unlikely that all olfactory neurons will die immediately after COVID-19 infection in every infected individual. As illustrated by Altunisik et al, 28 a small number of infected individuals suffer from complete anosmia. Butowt and von Bartheld 29 determined a significant difference in the prevalence of loss of smell in patients in different populations.…”

Section: Discussionmentioning

confidence: 90%

“…A recent study has described the expression of ACE2 receptors on glial cells neurons and skeletal muscle cells. 28 The authors also reported several post-COVID-19 manifestations, including neurological symptoms in 31.37% of patients (the most common neurological symptom was headache in ~20% of the patients).…”

Section: Discussionmentioning

confidence: 94%

Infectivity of Human Olfactory Neurons to SARS-CoV-2: A Link to Anosmia

Bagasra¹,

Pandey²,

Sanamandra³

et al. 2021

Oman Med J

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Objectives: We sought to determine whether SARS-CoV-2 infections are associated with anosmia and if this virus infects other neuronal cells. We utilized male and female olfactory neuronal cell lines and other olfactory cell lines to determine the viral targets. Methods: We used four undifferentiated and two partially differentiated human developing neuronal cell lines. Infectivity was confirmed by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), immunofluorescence assay (IFA) probing with anti-SARS-CoV-2 antibody, evaluation of cytopathic effects, and neurite formation. We induced partial differentiation of all cell lines (since both olfactory cell lines were terminally differentiated) with retinoic acid (RA) to determine whether differentiation was a factor in viral permissiveness. The expression of serine protease, transmembrane serine protease 2 (TMPRSS2), and angiotensin-converting enzyme II (ACE2) receptors were examined by RT-qPCR and IFA to determine the mechanism of viral entry. Results: Four to five days after exposure, both olfactory cell lines exhibited morphological evidence of infection; IFA analyses indicated that ~30% of the neurons were SARS-CoV-2 positive. At two weeks, 70–80% were positive for SARS-CoV-2 antigens. The partially differentiated (CRL-2266 and CRL-2267) and undifferentiated cell lines (CRL-2142, CRL-2149, CRL-127, and CDL-2271) were essentially non-permissive. After RA treatment, only CRL-127 exhibited slight permissiveness (RT-qPCR). The TMPRSS2 receptor showed high expression in olfactory neurons, but low expression in RA treated CRL-127. ACE2 exhibited high expression in olfactory neurons, whereas other cell lines showed low expression, including RA-treated cell lines. ACE2 expression slightly increased in CRL-127 post RA-treatment. Conclusions: Our studies confirm neurotropism of SARS-CoV-2 to olfactory neurons with viral entry likely mediated by TMPRSS2/ACE2. Other neuronal cell lines were non-permissive. Our results established that the nerve cells were infected regardless of male or female origin and strengthened the reported association of COVID-19 with loss of smell in infected individuals.

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“…It should be considered that cancer patients may also experience tiredness as accompanying symptoms of the underlying disease and oncological treatment [26]. Altunisik et al showed that COVID-19 patients may have mucle injury [27]. In this regard, muscle injury may cause muscle fatigue.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of COVID-19 positive cancer inpatients in National Cancer Center in Serbia

Stepanović

Arsenijević

Stanković

et al. 2021

J Infect Dev Ctries

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Introduction: The outbreak of COVID-19 has had an impact on global healthcare as well as on radiotherapy practice in many countries. This study aimed to identify clinical characteristics of Coronavirus Disease 2019 (COVID-19) infected cancer inpatients, as well as what impact this infection had on radiation treatment of the patients. Methodology: In this retrospective study, we included cancer inpatients with laboratory confirmed COVID-19 infection during the radiotherapy or chemoradiation in April 2020 in National Cancer Research Center in Serbia. Data were obtained from the medical records between 1 April and 1 July 2020. Results: A total of 49 COVID-19 infected cancer inpatients were included. The most frequently reported cancers were head and neck cancers, in twenty-three patients (46.8%). Lymphopenia was present in 77.5% of the patients. Red blood cells, haemoglobin and platelets were significantly lower during incubation or diagnosis of COVID-19. Twenty-seven (55.1%) patients did not finish radiotherapy. The age of patients who finished radiotherapy after COVID-19 infection was significantly lower compared to the patients who did not finish radiotherapy (60.5 ± 7.8 vs. 68.6 ± 11.2; p < 0.005). Conclusions: COVID-19 infected cancer patients in radiotherapy practice show similar symptoms and demographic characteristics as the general population infected with SARS-CoV-2 virus. Patients with head and neck cancers may be susceptible to infection with COVID-19. Old age and male gender may be risk factors for discontinuation of radiotherapy in COVID-19 infected cancer patients.

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Neurological symptoms in COVID-19 patients

Cited by 10 publications

References 20 publications

Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study

Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study

Infectivity of Human Olfactory Neurons to SARS-CoV-2: A Link to Anosmia

Clinical analysis of COVID-19 positive cancer inpatients in National Cancer Center in Serbia

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