Neurologic Manifestations of COVID 19

Abstract

Coronavirus disease (COVID-19) caused by a new coronavirus, SARS-CoV-2, , has become a serious health problem throughout the world. Although COVID-19 primarily presents as an acute respiratory tract infection, many neurological findings have also been described in patients. Neurological findings are classified into three groups as central, peripheral nervous system and musculoskeletal system. The most common central nervous system symptom is headache. Encephalitis, encephalopathy, seizures, acute ischemic stroke are also seen. The most common symptoms in the peripheral nervous system are loss of smell and taste. Myalgia, myositis and rhabdomyolysis also can be seen in musculoskeletal system involvement. Awareness of the neurological symptoms by physicians will be beneficial in early diagnosis and treatment of the disease.

Keywords

• COVID-19
• Child
• Neurological findings
• Headache

COVID-19 ve Nörolojik Bulgular

Abstract

Yeni bir koronavirüs olan SARS-CoV-2’nin neden olduğu koronavirüs hastalığı (COVİD-19) dünya genelinde ciddi bir sağlık sorunu haline gelmiştir. COVİD-19 öncelikle akut solunum yolu enfeksiyonu şeklinde kendini gösterse de hastalarda pek çok nörolojik bulgu da tanımlanmıştır. Nörolojik bulgular santral, periferik sinir sistemi ve kas-iskelet sistemi olarak üç grupta sınıflandırılır. En sık görülen santral sinir sistemi bulgusu baş ağrısıdır. Ensefalit, ensefalopati, nöbet, akut iskemik inme de görülmektedir. Periferik sinir sisteminde en sık görülen bulgular koku ve tat kaybı iken kas-iskelet sistemi tutulumunda miyalji, miyozit, rabdomiyoliz görülebilir. Nörolojik bulguların hekimler tarafından bilinmesi hastalığın erken tanı ve tedavisinde fayda sağlayacaktır.

Keywords

• COVID-19
• çocuk
• nörolojik bulgu
• baş ağrısı

References

1. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA Neurol 2020;77:1018-27.
2. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol 2020;77:1-9.
3. Pinna P, Grewal P, Hall JP, Tavarez T, Dafer RM, Garg R, et al. Neurological manifestations and COVID-19: experiences from a tertiary care center at the frontline. J Neurol Sci 2020;415:116969.
4. Pezzini, A., Padovani, A. Lifting the mask on neurological manifestations of COVID-19. Nat Rev Neurol 2020;16:636-44.
5. Xiong W, Mu J, Guo J, Lu L, Liu D, Luo J et al. New onset neurologic events in people with COVID-19 in 3 regions in China. Neurology 2020;95:e1479-e87.
6. Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci 2020;77:8-12.
7. Chen X, Laurent S, Onur OA, Kleineberg NN, Fink GR, Schweitzer F, et al. A systematic review of neurological symptoms and complications of COVID-19. J Neurol. 2021;268:392-402.
8. Guan W, Liang W, Zhao Y, Liang H, Chen Z, Li Y, et al. Comorbidity and its impact on 1,590 patients with COVID–19 in China: A Nationwide Analysis. Eur Respir J 2020;55:2000547.

9. Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, et al. Neurologic Features in Severe SARS-CoV–2 Infection. N Engl J Med 2020;382:2268-70.
10. Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus–2. Int J Infect Dis 2020; 94:55-8.
11. Ye M, Ren Y, Lv T. Encephalitis as a Clinical Manifestation of COVID–19. Brain Behav Immun. 2020;88: 945-6.
12. Pilotto A, Odolini S, Masciocchi S, Comellia A, Volonghi I, Gazzina S et al. Steroid-responsive severe encephalopathy in Coronovirus disease 2019. Ann Neurol 2020;88:423-7.
13. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Grith B. COVID–19–associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology 2020;292:E119-E120.
14. Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19 Lancet Neurol 2020;19:767-83.
15. Khatoon F, Prasad K, Kumar V. Neurological manifestations of COVID-19: available evidences and a new paradigm. J Neurovirol 2020;26:619-30.
16. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID–19): a multicenter European study. Eur Arch Otorhinolaryngol 2020;277:2251-61.
17. Toscano G, Palmerini F, Ravaglia S, Ruiz L, Invernizzi P, Cuzzoni MG, et al. Guillain-Barré Syndrome Associated with SARS-CoV-2. N Engl J Med 2020;382:2574-6.
18. Nepal G, Rehrig JH, Shrestha GS, Shing YK, Yadav JK, Ojha R, et al. Neurologic manifestations of COVID 19. Crit Care 2020;24: 421.
19. Gutiérrez-Ortiz C, Méndez-Guerrero A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero L, Gordo-Mañas et al. Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology 2020;95:e601-5.
20. Lima MA, Silva MTT, Soares CN, Coutinho R, Oliveira HS, Afonso L, et al. Peripheral facial nerve palsy associated with COVID-19 J Neurovirol 2020;26:941-4.
21. Wei H, Yin H, Huang M, Guo Z. The 2019 novel cornoavirus pneumonia with onset of oculomotor nerve palsy: a case study. J Neurol 2020;267:1550–3.
22. Román GC, Spencer PS, Reis J, Buguet A, Faris MEA, Katrak SM, et al. The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries. J Neurol Sci 2020;414: 116884.
23. Jin M, Tong Q. Rhabdomyolysis as Potential Late Complication Associated with COVID-19. Emerg Infect Dis 2020; 6:1618-20.
24. Zimmermann P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J 2020;39:355-68.
25. Stafstrom CE, Jantzie LL. COVID-19: Neurological Considerations in Neonates and Children. Children (Basel) 2020;7: 133.
26. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020;20:689-96.
27. X. Lu, L. Zhang, H. Du, Zhang J, Li Y, Qu J et al, Chinese pediatric novel coronavirus study, SARS-CoV-2 infection in children, N Engl J Med 2020;382:1663-5.
28. Panda PK, Sharawat IK, Panda P, Natarajan V, Bhakat R, Dawman L. Neurological Complications of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-Analysis. J Trop Pediatr 2020;fmaa070.
29. McAbee GN, Brosgol Y, Pavlakis S, Agha Rabia, Gaffoor. Encephalitis associated with COVID-19 infection in an 11-year-old child. Pediatr Neurol 2020;109:94.
30. Garazzino S, Montagnani C, Donà D, Meini A, Felici E, Vergine G, et al. Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020. Euro Surveill 2020;25:2000600.
31. Cura Yayla BC, Özsürekçi Y, Aykaç K, Derin Oygar P, Laçinel Gürlevik S, İlbay S, et al. Characteristics and Management of Children with COVID-19 in Turkey. Balkan Med J 2020;37:341-7.
32. Chen TH. Neurological involvement associated with COVID-19 infection in children. J Neurol Sci 2020;418:117096.
33. Serdaroğlu E, Serdaroğlu A. COVID-19 and neurologic manifestations. Turkiye Klinikleri J Med Sci 2020;40:269-71.
34. Wenting A, Gruters A, van Os Y, Verstraeten S, Valentijn S, Ponds R, et al. COVID-19 Neurological Manifestations and Underlying Mechanisms: A Scoping Review. Front Psychiatry 2020;11:860.