Two patients with acute meningo-encephalitis concomitant to SARS-CoV-2 infection

Bernard‐Valnet, Raphaël; Pizzarotti, Beatrice; Anichini, Angelica; Demars, Yoris; Russo, Enrico; Schmidhauser, Marie; Cerutti‐Sola, Jonathan; Rossetti, Andrea O.; Pasquier, Renaud Du

doi:10.1101/2020.04.17.20060251

Cited by 53 publications

(71 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…• Neurological signs: ischemic or hemorrhagic stroke, musculoskeletal disorders, impaired consciousness, 42,43 Guillain-Barré syndrome, acute hemorrhagic necrotizing encephalopathy, 44,45 acute meningoencephalitis, 46 and acute disseminated encephalomyelitis. 47 It is worth mentioning a recently reported striking series of young patients with largevessel stroke as presenting feature of COVID-19.…”

Section: Extra-respiratory Manifestationsmentioning

confidence: 99%

The Hydra-Headed Coronaviruses: Implications of COVID-19 for Homeopathy

Waisse¹,

Oberbaum

Frass³

2020

Homeopathy

View full text Add to dashboard Cite

Successful homeopathic prescriptions are based on careful individualization of symptoms, either for an individual patient or collectively in the case of epidemic outbreaks. The ongoing COVID-19 pandemic was initially represented as a severe acute respiratory illness, with eventual dramatic complications. However, over time it revealed to be a complex systemic disease with manifestations derived from viral-induced inflammation and hypercoagulability, thus liable to affect any body organ or system. As a result, clinical presentation is variable, in addition to variations associated with several individual and collective risk factors. Given the extreme variability of pathology and clinical manifestations, a single, or a few, universal homeopathic preventive Do not split medicine(s) do not seem feasible. Yet homeopathy may have a relevant role to play, inasmuch as the vast majority of patients only exhibit the mild form of disease and are indicated to self-care at home, without standard monitoring, follow-up, or treatment. For future pandemics, homeopathy agencies should prepare by establishing rapid-response teams and efficacious lines of communication.

show abstract

Section: Extra-respiratory Manifestationsmentioning

confidence: 99%

The Hydra-Headed Coronaviruses: Implications of COVID-19 for Homeopathy

Waisse¹,

Oberbaum

Frass³

2020

Homeopathy

View full text Add to dashboard Cite

show abstract

“…Singles cases with COVID-19 and meningo-encephalitis, one case with acute necrotizing encephalopathy and one with acute disseminated encephalomyelitis (ADEM) have been described (2,3,5,(7)(8)(9)(10)(11). Neuroinvasion is hypothesized to occur via hematogenous or neuronal route as over the olfactory nerve (29).…”

Section: Encephalitismentioning

confidence: 99%

“…Neuroinvasion is hypothesized to occur via hematogenous or neuronal route as over the olfactory nerve (29). In two cases with neuropsychological symptoms, one of them with status epilepticus, lymphocytic pleocytosis but negative RT-PCR for SARS-CoV-2 was found in the CSF (2). In another case suffering from disorientation and hallucinations, CSF analysis also revealed lymphocytosis (3).…”

Section: Encephalitismentioning

confidence: 99%

See 1 more Smart Citation

Central Nervous System Disorders in Severe SARS-CoV-2 Infection: detailed clinical work-up of eight cases

Keller

Brandi

Winklhofer

et al. 2020

Preprint

View full text Add to dashboard Cite

Objective Case series with different clinical presentations indicating central nervous system (CNS) involvement in coronavirus disease 2019 (COVID-19) have been published. Comprehensive work-ups including clinical characteristics, laboratory, electroencephalography (EEG), neuroimaging and cerebrospinal fluid (CSF) findings are needed to understand the mechanisms.DesignWe evaluated 32 consecutive patients with severe SARS-CoV-2 infection treated at a tertiary care centre from March 09 to April 03, 2020 for concomitant severe central nervous system (CNS) symptoms occurring during their critical disease state. Those with CNS disorders were examined in detail regarding clinical characteristics and undergoing additional examinations, e.g. computed tomography (CT), magnetic resonance imaging (MRI), (EEG), (CSF) analysis and autopsy if they had died.ResultsOf 32 critically ill patients with COVID-19 eight (18%) had severe CNS involvement (mean [SD] age, 67.6 [6.8] years; seven men; two patients died). All eight patients had cardiovascular risk factors, most frequently arterial hypertension. Two patients presented with lacunar ischemic stroke and one with status epilepticus in the early phase. As most common presentation, six patients presented with prolonged impaired consciousness after termination of analgosedation. In all but one with delayed wake-up, neuroimaging or autopsy showed multiple cerebral microbleeds, in three of them with additional subarachnoid haemorrhage and in another two with additional small ischemic lesions. In three patients intracranial vessel wall sequence MRI was performed, for the first time to our knowledge. All cases showed contrast-enhancement of vessel walls in large and middle-sized cerebral arteries, suggesting vascular wall pathologies with an inflammatory component. CSF analysis showed normal cells counts and chemistry. RT-PCRs for SARS-CoV-2 in CSF were all negative, and no intrathecal SARS-CoV-2 specific IgG synthesis was detectable.ConclusionsCNS disorders are common in patients with severe COVID-19. Different mechanisms might be involved. Besides unspecific encephalopathy and encephalitic syndromes, large vessel strokes might occur early after disease onset. In a later phase, microbleeds and microinfarctions indicate potential CNS small vessel disease. MRI vessel wall contrast enhancement suggests cerebral vascular wall pathologies with an inflammatory component. CNS disorders associated with COVID-19 may lead to long-term disabilities aggravating socio-economic damage. The mechanisms have to be investigated urgently in order to develop preventive and therapeutic neuroprotective strategies.

show abstract

“…Thirty-one patients experienced a cerebrovascular complication, with 27 ischemic strokes [11,[19][20][21][22][23], 3 hemorrhagic strokes [11,15,23] and 1 cerebral venous sinus thrombosis [11]. There were 15 patients with GBS [13,14,[24][25][26][27][28][29][30] or its variants, 6 reported as encephalitis [12,18,[31][32][33], one with seizures [34], one with acute hemorrhagic necrotizing encephalopathy [16] one reported as transverse myelitis [35], and one reported as ADEM [36]. Nine of these cases were reported as fatal.…”

mentioning

confidence: 99%

Neurological Complications of COVID-19: A Systematic Review of Literature

Sriwastava

Srivastava

Kataria

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: To study the nature and frequency of occurrence of “significant” neurological complications in coronavirus disease-2019 (COVID-19) via a systematic review of the literature.Methods: We screened all articles resulting from a search of PubMed, Cochrane, Google Scholar and Scopus, using the keywords "COVID-19 and CNS", "SARS-CoV-2 and CNS”, “COVID-19 and neurological manifestation”, “SARS2 and neurological manifestation” and “COVID-19 and Brain” looking for reports of significant neurological manifestations that would potentially have an impact on the outcome.Results: Twenty-six articles met the inclusion criteria. The significant neurological diagnoses reported were stroke, Guillain Barre Syndrome (GBS) and its variants, encephalitis, seizures, acute hemorrhagic necrotizing encephalopathy, acute disseminated encephalomyelitis (ADEM) and transverse myelitis. Although stroke, predominantly ischemic, was observed in ~ 6% of COVID-19 patients from Wuhan, China, mortality in this cohort was 38%. Of the 24 pooled patients with reports of etiology, 17 had large vessel occlusions. GBS occurred in 5/1200 (0.4%) of the COVID-19 cohort from Italy. One of the six reported encephalitis cases, the ADEM case and the report of transverse myelitis do not have data for conclusive diagnosis.Conclusion: The most frequent significant neurological association with COVID-19 is stroke, predominantly ischemic. In a cohort from Wuhan, China, this was as frequent as ~ 6%, with a 38% mortality. Most common reported etiology is large vessel occlusion. Other reported significant neurological complications are GBS/variants, encephalitis, seizures and acute hemorrhagic necrotizing encephalopathy. The reports of ADEM and transverse myelitis lacked diagnostically conclusive data.

show abstract

Two patients with acute meningo-encephalitis concomitant to SARS-CoV-2 infection

Cited by 53 publications

References 6 publications

The Hydra-Headed Coronaviruses: Implications of COVID-19 for Homeopathy

The Hydra-Headed Coronaviruses: Implications of COVID-19 for Homeopathy

Central Nervous System Disorders in Severe SARS-CoV-2 Infection: detailed clinical work-up of eight cases

Neurological Complications of COVID-19: A Systematic Review of Literature

Contact Info

Product

Resources

About