Rare complication of COVID-19 presenting as isolated headache

Asif, Rehan; Mahony, Marcella Sinead O'

doi:10.1136/bcr-2020-239275

Cited by 15 publications

(18 citation statements)

References 8 publications

(8 reference statements)

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“…Ischemic stroke-involving anterior circulation with occlusion of large vessels-can occur. It happens mainly in the early stages of convalescence [129,130,133], but it can also appear later [129,130,133,134]. On the other hand, an atypical increase in cases of arterial venous sinus thrombosis (TSA) (from 7.7% to 28.0%) was reported in hospitalized patients with pneumonia and associated with COVID-19 [133].…”

Section: Complications Of Nervous Systemmentioning

confidence: 99%

Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

Andrade

Siqueira

Soares

et al. 2021

Viruses

347

250

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The COVID-19 pandemic has infected millions worldwide, leaving a global burden for long-term care of COVID-19 survivors. It is thus imperative to study post-COVID (i.e., short-term) and long-COVID (i.e., long-term) effects, specifically as local and systemic pathophysiological outcomes of other coronavirus-related diseases (such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)) were well-cataloged. We conducted a comprehensive review of adverse post-COVID health outcomes and potential long-COVID effects. We observed that such adverse outcomes were not localized. Rather, they affected different human systems, including: (i) immune system (e.g., Guillain–Barré syndrome, rheumatoid arthritis, pediatric inflammatory multisystem syndromes such as Kawasaki disease), (ii) hematological system (vascular hemostasis, blood coagulation), (iii) pulmonary system (respiratory failure, pulmonary thromboembolism, pulmonary embolism, pneumonia, pulmonary vascular damage, pulmonary fibrosis), (iv) cardiovascular system (myocardial hypertrophy, coronary artery atherosclerosis, focal myocardial fibrosis, acute myocardial infarction, cardiac hypertrophy), (v) gastrointestinal, hepatic, and renal systems (diarrhea, nausea/vomiting, abdominal pain, anorexia, acid reflux, gastrointestinal hemorrhage, lack of appetite/constipation), (vi) skeletomuscular system (immune-mediated skin diseases, psoriasis, lupus), (vii) nervous system (loss of taste/smell/hearing, headaches, spasms, convulsions, confusion, visual impairment, nerve pain, dizziness, impaired consciousness, nausea/vomiting, hemiplegia, ataxia, stroke, cerebral hemorrhage), (viii) mental health (stress, depression and anxiety). We additionally hypothesized mechanisms of action by investigating possible molecular mechanisms associated with these disease outcomes/symptoms. Overall, the COVID-19 pathology is still characterized by cytokine storm that results to endothelial inflammation, microvascular thrombosis, and multiple organ failures.

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Section: Complications Of Nervous Systemmentioning

confidence: 99%

Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

Andrade

Siqueira

Soares

et al. 2021

Viruses

347

250

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show abstract

“…Cerebrovascular diseases 2 (28.6) (Xiong et al, 2020;Tiwari et al, 2021) 3 (13.6) (Asif and O' Mahony, 2020;Gulko et al, 2020;Dakay et al, 2021) 3 (15.8) (Cavalcanti et al, 2020;de Sousa et al, 2020;Dakay et al, 2021) 19 (31.7) (Al Saiegh et al, 2020;Cavalcanti et al, 2020;Cezar-Junior et al, 2020;Chia et al, 2020;Diaz-Segarra et al, 2020;Fara et al, 2020;Kantonen et al, 2020;Oxley et al, 2020;Pisano et al, 2020;Trifan et al, 2020a,b;Vu et al, 2020;Wang et al, 2020;Al-Mufti et al, 2021;Sabayan et al, 2021;Shah et al, 2021) 31 (43.1) (Agarwal et al, 2020;Anzalone et al, 2020;Cavalcanti et al, 2020;de Almeida Lima et al, 2020;Fabbri et al, 2021;Gupta et al, 2020;Heman-Ackah et al, 2020;Lapergue et al, 2020;Nicholson et al, 2020;Oxley et al, 2020;Patel et al, 2020;…”

Section: Age-associated Neurological Complications Of Covid-19unclassified

Age-Associated Neurological Complications of COVID-19: A Systematic Review and Meta-Analysis

Sullivan

Fischer

2021

Front. Aging Neurosci.

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The outbreak of the novel and highly infectious severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in hundreds of millions of infections and millions of deaths globally. Infected individuals that progress to coronavirus disease-19 (COVID-19) experience upper and lower respiratory complications that range in severity and may lead to wide-spread inflammation and generalized hypoxia or hypoxemia that impacts multiple organ systems, including the central and peripheral nervous systems. Since the SARS-CoV-2 outbreak, multiple reports continue to emerge that detail neurological symptoms, ranging from relatively mild (e.g., impaired taste and/or smell) to severe (e.g., stroke), suggesting SARS-CoV-2 may be neurotropic and/or contribute to nervous system injury through direct and/or indirect mechanisms. To gain insight into the types of neurological complications associated with SARS-CoV-2 infection and their possible relationship with age, sex, COVID-19 severity, and comorbidities, we performed a systematic review of case reports and series published in 2020 – April 4, 2021 of infected patients with neurological manifestations. Meta-analyses were conducted using individual patient data from reports where these data could be extracted. Here, we report neurological injury occurs across the lifespan in the context of infection, with and without known comorbidities, and with all disease severities, including asymptomatic patients. Older individuals, however, are more susceptible to developing life-threatening COVID-19 and cerebrovascular disease (CVD), such as stroke. A mild but inverse correlation with age was seen with CNS inflammatory diseases, such as encephalitis, as well as taste and/or smell disorders. When reported, increased age was also associated with comorbid cardiovascular risk factors, including hypertension, diabetes mellitus, and lipid disorders, but not with obesity. Obesity did correlate with development of critical COVID-19. Discussion into potential pathophysiological mechanisms by which neurological symptoms arise and long-term consequences of infection to the nervous system is also provided.

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“…In addition, CVST related to SARS-CoV-2 infection appears to have an incidence approximately 3 times higher than previously published population incidence (4.5 per 100,000 vs. 1.6 per 100,000) ( 16 ) and seems to have poorer prognosis and higher mortality rate than CVTS from other risk factors (45.5 vs. 15%). A possible explanation could be the more frequent involvement of deep venous sinuses than superficial ones ( 16 ). Our clinical case represents one of the few cases described in the literature of pediatric patients positive for COVID-19 infection and have CVST ( 17 ).…”

Section: Discussionmentioning

confidence: 53%

Case Report: Cerebral Venous Sinus Thrombosis in a Young Child With SARS-CoV-2 Infection: The Italian Experience

et al. 2022

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IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric patients is usually characterized by fever, dry cough, and fatigue, or is asymptomatic and rarely presents with pneumonia. On the other hand, cerebral venous sinus thrombosis (CVST) could be a neurological sequela of the prothrombotic state triggered by coronavirus disease 2019 (COVID-19) both in adults and children.Case ReportWe present a case of a 15-year-old male child who was obese and had mild neurocognitive impairment. He was admitted to the pediatric emergency department and then diagnosed with CVST during SARS-CoV-2 infection.ConclusionDuring the COVID-19 pandemic, in patients presenting with neurological manifestations of CVST (headache, alteration of consciousness, focal deficit, or signs of endocranial hypertension), it is advisable to look for a current or recent infection of SARS-CoV-2, regardless of the presence of respiratory symptoms. In our patient, ongoing SARS-CoV-2 infection represents the only prothrombotic risk factor underlying the neurological disease.

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Rare complication of COVID-19 presenting as isolated headache

Cited by 15 publications

References 8 publications

Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

Age-Associated Neurological Complications of COVID-19: A Systematic Review and Meta-Analysis

Case Report: Cerebral Venous Sinus Thrombosis in a Young Child With SARS-CoV-2 Infection: The Italian Experience

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