SARS-CoV-2 Infection Causes Relapse of Kleine-Levin Syndrome: Case Report and Review of Literature

Marčić, Marino; Marčić, Ljiljana; Marcic, Barbara

doi:10.3390/neurolint13030033

Cited by 12 publications

(4 citation statements)

References 21 publications

(21 reference statements)

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“…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 ). Similarly, SARS-CoV-2 infection triggered an exacerbation of Kleine-Levin syndrome in 2 cases ( 12 , 13 ). These data suggest a potential common immunological action of different viruses on the function of brainstem nuclei involved in sleep-wakefulness regulation.…”

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.

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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.

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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.

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“…As potential neuroimmunological diseases, hypersomnia (narcolepsy, Kleine-Levin syndrome [KLS] and idiopathic hypersomnia [HI] can be triggered by external factors, such as upper airway infection, as occurred with H1N1 influenza or neuroimmunological response to vaccination 40 , 43 , 44 .…”

Section: Sleep Disordersmentioning

confidence: 99%

Long COVID: neurological manifestations - an updated narrative review

Leonel Tavares-Júnior,

Ciurleo,

Formiga

et al. 2024

Dement. neuropsychol.

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ABSTRACT. Infection with the SARS-CoV-2 virus can lead to neurological symptoms in the acute phase and in the Long COVID phase. These symptoms usually involve cognition, sleep, smell disorders, psychiatric manifestations, headache and others. This condition is more commonly described in young adults and women. This symptomatology can follow severe or mild cases of the disease. The importance of this issue resides in the high prevalence of neurological symptoms in the Long COVID phase, which entails significant morbidity in this population. In addition, such a condition is associated with high health care costs, with some estimates hovering around 3.7 trillion US dollars. In this review, we will sequentially describe the current knowledge about the most prevalent neurological symptoms in Long COVID, as well as their pathophysiology and possible biomarkers.

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“…An online survey study revealed that patients with hypersomnia disorder had delayed schedules, longer nighttime sleep, less daytime sleepiness, less fatigue, fewer sleep attacks, and better attention during the pandemic [ 12 , 33 ]; however, COVID-somnia can still occur in such patients. Autoimmune reactions related to the virus can also trigger hypersomnia symptoms [ 34 ] and even aggravate previous hypersomnia disorder, as indicated in case reports [ 35 , 36 ]. One study revealed that during lockdowns, those with NT1 and NT2 exhibited a disturbed circadian rhythm, more fragmented sleep, increased daytime sleepiness and napping, and poorer quality of life; however, other narcoleptic symptoms such as cataplexy, sleep paralysis, and hypnagogic and hypnopompic hallucinations remained unchanged [ 37 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Taiwan’s 2021 COVID-19 lockdown on the symptom severity and quality of life of patients with narcolepsy

Chin

Huang

Tang

et al. 2023

Sleep Biol. Rhythms

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COVID-19 lockdowns can influence the sleep quality and daytime condition of patients with narcolepsy. Using data from our cohort study, we investigated changes in the quality of life and the symptom severity of patients with narcolepsy during Taiwan’s 2021 lockdown and investigated differences by narcolepsy subtype, sex, and age. Patients with type 1 and type 2 narcolepsy (NT1 and NT2, respectively) aged 6–40 years were retrospectively recruited from our narcolepsy cohort study. These patients were regularly evaluated using the Short Form 36 Health Survey questionnaire (SF-36), the Epworth Sleepiness Scale (ESS), the visual analog scale (VAS) for hypersomnolence, the VAS for cataplexy and sleep diary. We compared the differences between the lockdown and the prelockdown periods by narcolepsy subtype, sex, and age. We used a paired t test analysis to compare differences in the SF-36, ESS, VAS scores and data of sleep diary between the prelockdown and lockdown periods ( p 1), and an independent t test analysis was used to compare the changes in different subgroups between the prelockdown and lockdown periods ( p 2). A total of 120 patients with narcolepsy were recruited (mean age 24.22 ± 6.87 years; 58% male); 80 of the patients had NT1 (mean age 25.25 ± 6.79 years; 60% male) and 40 had NT2 (mean age 22.16 ± 6.64, 53% male). During the lockdown period, the ESS score of total patients was decreased ( p = 0.039) and body mass index was increased ( p = 0.02). The NT1 group decreased significantly ( p 1 = 0.017), especially in men ( p 1 = 0.016) and adults ( p 1 = 0.04); scores for the VT domain of the SF-36 increased significantly in male and adult patients with NT2 ( p 1 = 0.048 and 0.012). Additionally, male patients with NT2 exhibited significantly decreased scores in the physical and emotional role functioning domains ( p 1 = 0.028, 0.024). The children and adolescents with NT1 had significantly decreased scores in the general health domain of the SF-36, but no significant change was noted in that of adults ( p 1 = 0.027, p 2 = 0.012). We observed both negative and positive impacts of Taiwan’s 2021 lockdown on patients with narcolepsy. A more flexible but structured daily routine with adequate sleep time should be considered for this population during lockdown and nonlockdown periods.

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SARS-CoV-2 Infection Causes Relapse of Kleine-Levin Syndrome: Case Report and Review of Literature

Cited by 12 publications

References 21 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

Long COVID: neurological manifestations - an updated narrative review

Impact of Taiwan’s 2021 COVID-19 lockdown on the symptom severity and quality of life of patients with narcolepsy

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