The international European Academy of Neurology survey on neurological symptoms in patients with COVID‐19 infection

Moro, Elena; Priori, Alberto; Beghi, Ettore; Helbok, Raimund; Campiglio, Laura; Bassetti, C.; Bianchi, Elisa; Maia, Luı́s F.; Öztürk, Şerefnur; Cavallieri, Francesco; Zedde, Marialuisa; Sellner, Johann; Bereczki, Dániel; Rakuša, Martin; Liberto, Giovanni Di; Sauerbier, Anna; Pisani, Antonio; Macerollo, Antonella; Soffietti, Riccardo; Taba, Pille; Crean, Michael; Twardzik, A.; Oreja‐Guevara, Celia; Bodini, Benedetta; Jenkins, Thomas M.; Oertzen, Tim J. von

doi:10.1111/ene.14407

Cited by 94 publications

(107 citation statements)

References 43 publications

(44 reference statements)

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“…Seizure, headache, PNS disorders and functional neurological disorders (FND) were the main conditions. Similar to other cohorts [ 4 , 6 , 10 ], headache was not uncommon in our study. In addition, we saw eight patients with FND.…”

Section: Discussionsupporting

confidence: 90%

“…There were no neurological complications reported in 81 paediatric patients. The total number of neurological cases associated with COVID-19 was small compared to other studies [ 4 , 6 , 10 ]. This might be related to the peculiar demographics of the local outbreak that involved young healthy migrant workers in large crowded dormitories, many of whom were asymptomatic or had mild infection.…”

Section: Discussionmentioning

confidence: 67%

“…Mao et al documented neurological manifestations in 36.4% (78/214) of COVID-19 patients [ 4 ]. This was followed by reports of central and peripheral nervous systems (PNS) complications [ [5] , [6] , [7] ], including anosmia, ageusia, headache, seizures, cranial neuropathies [ 8 ], myelitis [ 9 ], stroke [ [4] , [5] , [6] , 10 , 11 ], cerebral venous thrombosis [ 12 ], encephalopathy-encephalitis [ 4 , 7 , 10 , 13 , 14 ] and various neuropsychiatric manifestations [ 6 ]. Direct viral neurotropism has been reported rarely.…”

Section: Introductionmentioning

confidence: 99%

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Neurology of COVID-19 in Singapore

Koh

Silva

Quek

et al. 2020

Journal of the Neurological Sciences

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Purpose To describe the spectrum of COVID-19 neurology in Singapore. Method We prospectively studied all microbiologically-confirmed COVID-19 patients in Singapore, who were referred for any neurological complaint within three months of COVID-19 onset. Neurological diagnoses and relationship to COVID-19 was made by consensus guided by contemporaneous literature, refined using recent case definitions. Results 47,572 patients (median age 34 years, 98% males) were diagnosed with COVID-19 in Singapore between 19 March to 19 July 2020. We identified 90 patients (median age 38, 98.9% males) with neurological disorders; 39 with varying certainty of relationship to COVID-19 categorised as: i) Central nervous system syndromes-4 acute disseminated encephalomyelitis (ADEM) and encephalitis, ii) Cerebrovascular disorders-19 acute ischaemic stroke and transient ischaemic attack (AIS/TIA), 4 cerebral venous thrombosis (CVT), 2 intracerebral haemorrhage, iii) Peripheral nervous system-7 mono/polyneuropathies, and a novel group, iv) Autonomic nervous system-4 limited dysautonomic syndromes. Fifty-one other patients had pre/co-existent neurological conditions unrelated to COVID-19. Encephalitis/ADEM is delayed, occurring in critical COVID-19, while CVT and dysautonomia occurred relatively early, and largely in mild infections. AIS/TIA was variable in onset, occurring in patients with differing COVID-19 severity; remarkably 63.2% were asymptomatic. CVT was more frequent than expected and occurred in mild/asymptomatic patients. There were no neurological complications in all 81 paediatric COVID-19 cases. Conclusion COVID-19 neurology has a wide spectrum of dysimmune-thrombotic disorders. We encountered relatively few neurological complications, probably because our outbreak involved largely young men with mild/asymptomatic COVID-19. It is also widely perceived that the pandemic did not unduly affect the Singapore healthcare system.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Neurology of COVID-19 in Singapore

Koh

Silva

Quek

et al. 2020

Journal of the Neurological Sciences

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“…El tamaño de nuestra serie es menor al de otras publicadas, como la de nuestros colegas del registro ALBACOVID 14 , o el estudio multicéntrico madrileño sobre alteraciones del olfato y del gusto publicado al inicio de la pandemia 31 , probablemente en relación con el modelo de hospital (nuestro centro es un hospital pequeño de nivel secundario con 270 camas para una población de 325.000 habitantes aproximadamente, frente a los hospitales terciarios de las publicaciones más amplias) 14 , 31 , 32 , 33 , 34 . Sin embargo, la ventaja de nuestra serie es su homogeneidad: pacientes jóvenes, sin patología neurológica previa, sin apenas otros antecedentes salvo HTA o DM-2, que han sufrido una afectación respiratoria grave, y que han requerido ingreso en UCI.…”

Section: Discussionunclassified

Complicaciones neurológicas en pacientes críticos por SARS-CoV-2

et al. 2020

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Introducción Nos proponemos analizar las complicaciones neurológicas de los pacientes con infección grave por SARS-CoV-2 que han requerido ingreso en unidad de cuidados intensivos (UCI). Pacientes y métodos Estudio descriptivo retrospectivo, observacional, de pacientes consecutivos ingresados en UCI por infección respiratoria grave por SARS-CoV-2 desde el 1 de abril hasta el 1 de junio de 2020. Resultados Registramos 30 pacientes con síntomas neurológicos, 21 hombres (72,40%), edad media: 57,41 años ± 11,61 desviación estándar (DE). Estancia media en UCI: 18,83 ± 14,33 DE. A nivel sindrómico: 28 pacientes (93,33%) con síndrome confusional agudo, 15 (50%) con patología neuromuscular, 5 (16,66%) con cefalea, 4 (13,33%) con patología cerebrovascular y 4 (13,33%) con encefalopatías/encefalitis. Punción lumbar normal en 6 pacientes (20%). La RMN craneal o TAC craneal mostró alteraciones en 20 casos (66,6%). Se realizó EEG en todos los pacientes (100%), alterado en 8 pacientes (26,66%). En 5 de los 15 pacientes con miopatía clínica se ha podido confirmar con ENMG. Hemos encontrado relación entre la mayor edad y los días de ingreso en UCI (p = 0,002; IC 95%: 4,032-6,022; OR: 3,594). Conclusiones La infección grave por COVID-19 afecta mayoritariamente a hombres, similar a lo descrito en otras series. La mitad de nuestros pacientes presenta una miopatía aguda, y casi la totalidad de los pacientes salen de la UCI con síndromes confusionales agudos que evolucionan a una resolución completa, sin correlacionarse con los resultados del EEG o de pruebas de neuroimagen. La mayor edad se asocia con un mayor número de días de estancia en UCI.

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“…Indeed, SARS-CoV-2 is likely to infect the central nervous system early in the disease's course (2). Results from a large survey involving 2,343 European neurologists revealed headache (61.9%), myalgia (50.4%), anosmia (49.2%), ageusia (39.8%), impaired consciousness (29.3%), and psychomotor agitation (26.7%) as the most frequent neurological findings (3). In a recent experiment, viral replication within neurons soon after infection by SARS-CoV-2 in a human-induced pluripotent stem cell (iPSC)-derived BrainSphere model (4), supporting virus neurotropism.…”

mentioning

confidence: 99%