An insight into the neurological manifestations of COVID-19 in the emergency department

Yıl 2020, Cilt: 2 Sayı: 2, 183 - 186, 26.08.2020

Sohil Pothiawala

Öz

As the COVID-19 pandemic continues to evolve, there is an increasing recognition that patients with COVID-19 infection may present with neurological symptoms as the primary manifestation. These symptoms can be related to Central Nervous System like headache, altered mental status, acute encephalitis, acute stroke, cerebral hemorrhage, seizures; or the peripheral nervous system like anosmia, hypogeusia, muscle pain and weakness, movement disorders, acute myelitis and Guillain–Barré syndrome, etc. In the absence of the classic presentation with fever or respiratory symptoms, an initial neurological presentation serves as a diagnostic dilemma. This review will aid acute care physicians to have a high index of clinical suspicion to consider COVID-19 infection as a differential diagnosis for any patient presenting with primary neurologic manifestations. This will help avoid delayed diagnosis, as well as reduce exposure to health care providers.

Anahtar Kelimeler

neurological manifestations, COVID-19, SARS-CoV-2, emergency department

Kaynakça

• 1. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020; 77(6):683-690. doi:10.1001/jamaneurol.2020.1127
• 2. Desforges M, LeCoupanec A, Dubeau P, Bourgouin A, Lajoie L, Dube M, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 2019, 12(1):14. doi:10.3390/v12010014
• 3. Bohmwald K, Galvez NMS, Ríos M, et al. Neurologic alterations due to respiratory virus infections. Front. Cell. Neurosci 2018; 12:386. Doi: 10.3389/fncel.2018.00386
• 4. Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al.: Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun 2020, 87:18-22. doi: 10.1016/j.bbi.2020.03.031
• 5. Mori I: Transolfactory neuroinvasion by viruses threatens the human brain. Acta Virol. 2015, 59(4):338-49. Doi:10.4149/av_2015_04_338
• 6. Lahiri D, Ardila A. COVID-19 Pandemic: A Neurological Perspective. Cureus 2020; 12(4):e7889. doi:10.7759/cureus.7889
• 7. Baig AM, Khaleeq A, Ali U, et al. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020; 11(7):995-998. doi: 10.1021/acschemneuro.0c00122
• 8. Xiang P, Xu XM, Gao LL, Wang HZ, Xiong HF, Li RH, et al. First case of 2019 novel coronavirus disease with encephalitis. China Xiv 2020; T202003:00015
• 9. Baig AM. Neurological manifestations in COVID-19 caused by SARS-CoV-2. CNS Neurosci Ther 2020; 26(5):499-501. doi: 10.1111/cns.13372
• 10. Suwanwongse K, Shabarek N. Rhabdomyolysis as a Presentation of 2019 Novel Coronavirus Disease. Cureus 2020; 12(4):e7561. doi:10.7759/cureus.7561
• 11. Zhao H, Shen D, Zhou H, et al. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol 2020; 19(5):383-384
• 12. Toscano G, Palmerini F, Ravaglia S, et al. Guillain–Barré Syndrome Associated with SARS-CoV-2. NEJM 2020. doi: 10.1056/NEJMc2009191