SARS‑CoV‑2, multiple sclerosis, and focal deficit in a postpartum woman: A case report

Florea, Anca; Sîrbu, Carmen Adella; Ghinescu, Minerva Claudia; Pleşa, C; Sirbu, Anca Maria; Mitricã, Marian; Ioniţă-Radu, Florentina

doi:10.3892/etm.2020.9524

Cited by 8 publications

(9 citation statements)

References 10 publications

(10 reference statements)

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“…Fifteen case reports and case series reported the occurrence of MS relapse/pseudo-relapse or the onset of a first demyelinating event consistent with MS or CIS in 19 patients ( 57 , 63 , 65 – 69 , 76 – 79 , 81 , 82 , 84 , 86 ). Twelve observational case series and cohort studies documented the occurrence of relapses or pseudo-relapses among patients with a known diagnosis of MS and confirmed diagnosis of COVID-19 ( 58 – 61 , 64 , 71 – 75 , 83 , 85 ).…”

Section: Resultsmentioning

confidence: 99%

“…Most MS/CIS cases received treatment with IVMP 1 gram for 3–5 days ( 57 , 61 , 65 , 68 , 76 , 77 , 79 , 80 , 82 ) and had a favorable outcome ( 57 , 65 , 68 , 77 – 82 ). Treatment of pseudo-relapses was primarily focused on COVID-19 management, with return to baseline neurological status upon infection recovery ( 63 , 69 ).…”

Section: Resultsmentioning

confidence: 99%

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COVID-19 and the risk of CNS demyelinating diseases: A systematic review

et al. 2022

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BackgroundViral infections are a proposed possible cause of inflammatory central nervous system (CNS) demyelinating diseases, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). During the past 2 years, CNS demyelinating events associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported, but causality is unclear.ObjectiveTo investigate the relationship between CNS demyelinating disease development and exacerbation with antecedent and/or concurrent SARS-CoV-2 infection.MethodsA systematic literature review of all publications describing either a new diagnosis or relapse of CNS demyelinating diseases (MS, NMOSD, MOGAD) in association with SARS-CoV-2 infection was performed utilizing PRISMA guidelines. Descriptive statistics were used for data analysis, using a case analysis approach.ResultsSixty-seven articles met the inclusion criteria for the study. Most of the reported cases of NMOSD (n = 13, 72.2% of reported cases) and MOGAD (n = 27, 96.5% of reported cases) were of new disease onset, presenting with typical clinical and radiographic features of these conditions, respectively. In contrast, reported MS cases varied amongst newly diagnosed cases (n = 10, 10.5% of reported cases), relapses (n = 63, 66.4%) and pseudo-relapses (n = 22, 23.2%). The median duration between COVID-19 infection and demyelinating event onset was 11.5 days (range 0–90 days) in NMOSD, 6 days (range−7 to +45 days) in MOGAD, and 13.5 days (range−21 to +180 days) in MS. Most cases received high-dose corticosteroids with a good clinical outcome.ConclusionBased upon available literature, the rate of CNS demyelinating events occurring in the setting of preceding or concurrent SARS-CoV-2 infection is relatively low considering the prevalence of SARS-CoV-2 infection. The clinical outcomes of new onset or relapsing MS, NMOSD, or MOGAD associated with antecedent or concurrent infection were mostly favorable. Larger prospective epidemiological studies are needed to better delineate the impact of COVID-19 on CNS demyelinating diseases.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

et al. 2022

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“…She was discharged after two consecutive negative PCRs. After two weeks, PCR, IgG, and IgM for SARS-CoV-2 were negative, along with the remission of the neurological deficit [127].…”

Section: Does Infection Of Sars-cov-2 May Be An Actual Neurodegeneratmentioning

confidence: 98%

“…Women with MS in the postpartum period are even more vulnerable to relapses and infections. Another case report of SARS-CoV-2 infection in a 40-year-old woman with recurrent RRMS demonstrated that the relapse of MS began right after SARS-CoV-2 infection [127]. Five weeks postpartum, the patient complained of paresthesia and disability in the right limbs, with the onset two weeks before.…”

Section: Does Infection Of Sars-cov-2 May Be An Actual Neurodegeneratmentioning

confidence: 99%

The Impact of SARS-CoV-2 Infection on the Development of Neurodegeneration in Multiple Sclerosis

Dziedzic

Saluk‐Bijak

Miller

et al. 2021

IJMS

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The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a global challenge. Currently, there is some information on the consequences of COVID-19 infection in multiple sclerosis (MS) patients, as it is a newly discovered coronavirus, but its far-reaching effects on participation in neurodegenerative diseases seem to be significant. Recent cases reports showed that SARS-CoV-2 may be responsible for initiating the demyelination process in people who previously had no symptoms associated with any nervous system disorders. It is presently known that infection of SARS-CoV-2 evokes cytokine storm syndrome, which may be one of the factors leading to the acute cerebrovascular disease. One of the substantial problems is the coexistence of cerebrovascular disease and MS in an individual’s life span. Epidemiological studies showed an enhanced risk of death rate from vascular disabilities in MS patients of approximately 30%. It has been demonstrated that patients with severe SARS-CoV-2 infection usually show increased levels of D-dimer, fibrinogen, C-reactive protein (CRP), and overactivation of blood platelets, which are essential elements of prothrombotic events. In this review, the latest knowledge gathered during an ongoing pandemic of SARS-CoV-2 infection on the neurodegeneration processes in MS is discussed.

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“…This is particularly true regarding the neurologic manifestations associated with this type of viral infection. Neurological events linked to COVID-19 infection range from mild to severe, life-threatening complications [ 2 ]. Myalgia, headache, dizziness, encephalopathy, anosmia, and dysgeusia appear to be more common, while stroke, seizures, sensory deficits, motor deficits, ataxia, and movement disorders have also been reported, but with a lower prevalence [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Still Surprising Us—A Rare Movement Disorder Induced by Infection

Sîrbu¹,

Popescu²,

Ștefan

et al. 2022

Brain Sciences

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Background: Many neurological manifestations are part of COVID-19 infections, including movement disorders, but a clinical picture closely resembling stiff-person syndrome has not yet been described. Case presentation: We report a case of a stiff-person-like syndrome in the context of COVID-19 infection. A 79-year-old woman, with no prior history of diseases, presented global reversible stiffness associated with SARS-CoV-2 infection. We aim to shed light on several particularities regarding this clinical picture and its evolution in close relationship with the infectious disease progression, with full regression of symptoms and signs once the infectious process ceased. The impairment of speech and motility caused the wrong diagnosis of stroke in the Emergency Room. In addition, we would also like to emphasize the concomitant rhabdomyolysis, closely linked to the grade of muscle rigidity. Conclusions: We would like to raise awareness regarding this clinical setting and its association with SARS-COV-2 infection, to aid in its future recognition and management. To our knowledge, this is the first case of a stiff-person-like syndrome to be described in association with COVID-19 infection.

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SARS‑CoV‑2, multiple sclerosis, and focal deficit in a postpartum woman: A case report

Cited by 8 publications

References 10 publications

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

COVID-19 and the risk of CNS demyelinating diseases: A systematic review

The Impact of SARS-CoV-2 Infection on the Development of Neurodegeneration in Multiple Sclerosis

COVID-19 Still Surprising Us—A Rare Movement Disorder Induced by Infection

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