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SARS-CoV-2 proteins

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    Characterizing the incidence of adverse events of special interest for COVID-19 MESHD vaccines across eight countries: a multinational network cohort study

    Authors: Xintong Li; Anna Ostropolets; Rupa Makadia; Azza Shoaibi; Gowtham Rao; Anthony G. Sena; Eugenia Martinez-Hernandez; Antonella Delmestri; Katia Verhamme; Peter Rijnbeek; Talita Duarte-Salles; Marc A Suchard; Patrick B Ryan; George Hripcsak; DANIEL PRIETO-ALHAMBRA

    doi:10.1101/2021.03.25.21254315 Date: 2021-03-26 Source: medRxiv

    As large-scale immunization programs against COVID-19 MESHD proceed around the world, safety signals will emerge that need rapid evaluation.1,2 We report population-based, age- and sex-specific background incidence rates of potential adverse events of special interest (AESI) in eight countries using thirteen databases. This multi-national network cohort study included eight electronic medical record and five administrative claims databases from Australia, France, Germany, Japan, Netherlands, Spain, the United Kingdom and the United States, mapped to a common data model. People observed for at least 365 days before 1 January 2017, 2018, or 2019 were included. We based study outcomes on lists published by regulators: acute myocardial infarction MESHD, anaphylaxis MESHD, appendicitis MESHD, Bell s palsy MESHD, deep vein thrombosis MESHD, disseminated intravascular coagulation MESHD, encephalomyelitis MESHD, Guillain-Barre syndrome MESHD, hemorrhagic MESHD and non-hemorrhagic stroke MESHD, immune thrombocytopenia MESHD, myocarditis/pericarditis MESHD, narcolepsy, pulmonary embolism MESHD, and transverse myelitis MESHD.3 We calculated incidence rates stratified by age, sex, and database. We pooled rates across databases using random effects meta-analyses. We classified meta-analytic estimates into Council of International Organizations of Medical Sciences categories: very common, common, uncommon, rare, or very rare.4 We analyzed 126,661,070 people. Rates varied greatly between databases and by age and sex. Some AESI (e.g., myocardial infarction MESHD, Guillain-Barre syndrome MESHD) increased with age, while others (e.g., anaphylaxis MESHD, appendicitis MESHD) were more common in young people. As a result, AESI were classified differently according to age. For example, myocardial infarction MESHD was very rare in children, rare in women aged 35-54 years, uncommon in men and women aged 55-84 years, and common in those aged [≥]85 years. We report robust baseline rates of prioritized AESI across 13 databases. Age, sex, and variation between databases should be considered if background AESI rates are compared to event rates observed with COVID-19 MESHD vaccines.

    Argentine Registry of neurological manifestations due to coronavirus-19 ( COVID-19 MESHD)

    Authors: Mariana Bendersky; Lucas Alessandro; Franco Appiani; Brenda Borrego Guerrero; Patricia Cairola; Ismael Calandri; Juan Martin Cardozo Oliver; Maria Emilia Clement; Marianna Di Egidio; Jose Luis Di Pace; Melina Diaconchuk; Guadalupe Bruera; MARIA M ESNAOLA Y ROJAS; MABEL LASERNA; Julian Fernandez Boccazzi; Andrea Fabiana Franco; Gisella Gargiulo; Daniela Laura Giardino; Cesar Gomez; Ana Karina Guevara; Natalia Gutierrez; Javier Hryb; Ibarra Viviana; Franco Janota; Luis Alfredo Larcher; Fernando Leone; Geraldine Luetic; Claudia Andrea Medina; Maria L Menichini; Gonzalo P Nieto; Maria F Paez; Francisco Penalver; Monica Perassolo; Gabriel Persi; Claudia Pestchanker; Oscar Porta; Gabriel E Rodriguez; Marina Romano; Patricia Saidon; Maria F Sica; Erica Stankievich; guillermo zalazar; Adriana Tarulla; Roberto D rey; Marcelo Rugiero

    doi:10.1101/2021.03.19.21253558 Date: 2021-03-24 Source: medRxiv

    COVID-19 MESHD disease has spread around the world since December 2019. Neurological symptoms MESHD are part of its clinical spectrum. Objective: To know the neurological manifestations in patients infected by COVID-19 MESHD in Argentina. Methods: Multicenter study conducted in adults, from May 2020 to January 2021, with confirmed COVID-19 MESHD and neurological symptoms. Demographic variables, existence of systemic or neurological comorbidities, the form of onset of the infection, alteration in complementary studies and the degree of severity of neurological symptoms MESHD were recorded. Results: 817 patients from all over the country were included, 52% male, mean age 38 years, most of them without comorbidities or previous neurological pathology. The first symptom of the infection was neurological in 56.2% of the cases, predominantly headache MESHD (69%), then anosmia MESHD / ageusia (66%). Myalgias MESHD (52%), allodynia MESHD / hyperalgesia MESHD (18%), and asthenia MESHD (6%) were also reported. 3.2% showed diffuse CNS involvement such as encephalopathy MESHD or seizures MESHD. 1.7% had cerebrovascular complications. Sleep disorders were observed in 3.2%. 6 patients were reported with Guillain Barre (GBS), peripheral neuropathy MESHD (3.4%), tongue paresthesia (0.6%), hearing loss MESHD (0.4%), plexopathy MESHD (0.3%). The severity of neurological symptoms MESHD was correlated with age and the existence of comorbidities. Conclusions: Our results, similar to those of other countries, show two types of neurological symptoms associated with COVID-19 MESHD: some potentially disabling or fatal such as GBS MESHD or encephalitis MESHD, and others less devastating, but more frequent such as headache MESHD or anosmia MESHD that demand increasingly long-term care.

    Parainfectious Guillain Barre Syndrome MESHD in a Patients Diagnosed with COVID-19 MESHD

    Authors: Aliye Bastug; Hesna Bektas; Cansu Buyuktarakci; Hurrem Bodur

    doi:10.21203/rs.3.rs-215097/v1 Date: 2021-02-06 Source: ResearchSquare

    An accumulating evidence suggesting the neurotropic characteristics of the SARS-CoV-2. Although the pathogenesis is unclear, the relationship between COVID-19 MESHD and Guillain Barre Syndrome MESHD( GBS MESHD) has been previously reported. We present a 66-year-old male with para- infectious COVID-19 MESHD-related GBS admitted with a 2-day bilateral weakness MESHD in distal lower limbs. His neurological findings occurred on the third day of the diagnosis of COVID-19 MESHD. A cerebrospinal fluid examination revealed albumin-cytological dissociation.To the best of our knowledge, this is the first para-infectious GBS case related to the SARS-CoV-2 reported from Turkey. Clinicians should be aware of this kind of complication to manage patients.

    Six-month Neurological and Psychiatric Outcomes in 236,379 Survivors of COVID-19 MESHD

    Authors: Maxime Taquet; John R Geddes; Masud Husain; Sierra Luciano; Paul J Harrison

    doi:10.1101/2021.01.16.21249950 Date: 2021-01-24 Source: medRxiv

    BackgroundNeurological and psychiatric MESHD sequelae of COVID-19 MESHD have been reported, but there are limited data on incidence rates and relative risks. MethodsUsing retrospective cohort studies and time-to-event analysis, we estimated the incidence of ICD-10 diagnoses in the 6 months after a confirmed diagnosis of COVID-19 MESHD: intracranial haemorrhage MESHD; ischaemic stroke MESHD; Parkinsonism MESHD; Guillain-Barre syndrome MESHD; nerve/nerve root/plexus disorders; myoneural/muscle disease MESHD; encephalitis MESHD; dementia MESHD; mood, anxiety MESHD, and psychotic disorders MESHD; substance misuse; and insomnia MESHD. Data were obtained from the TriNetX electronic health records network (over 81 million patients). We compared incidences with those in propensity score-matched cohorts of patients with influenza or other respiratory infections MESHD using a Cox model. We investigated the effect on incidence estimates of COVID-19 MESHD severity, as proxied by hospitalization and encephalopathy MESHD (including delirium MESHD and related disorders). Findings236,379 patients survived a confirmed diagnosis of COVID-19 MESHD. Among them, the estimated incidence of neurological or psychiatric MESHD sequelae at 6 months was 33.6%, with 12.8% receiving their first such diagnosis. Most diagnostic categories were commoner after COVID-19 MESHD than after influenza or other respiratory infections MESHD (hazard ratios from 1.21 to 5.28), including stroke MESHD, intracranial haemorrhage MESHD, dementia MESHD, and psychotic disorders MESHD. Findings were equivocal for Parkinsonism and Guillain-Barre syndrome MESHD. Amongst COVID-19 MESHD cases, incidences and hazard ratios for most disorders were higher in patients who had been hospitalized, and markedly so in those who had experienced encephalopathy MESHD. Results were robust to sensitivity analyses, including comparisons against an additional four index health events. InterpretationThe study provides evidence for substantial neurological and psychiatric MESHD morbidity following COVID-19 MESHD infection. Risks were greatest in, but not limited to, those who had severe COVID-19 MESHD. The information can help in service planning and identification of research priorities. FundingNational Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre.

    Surveillance study of acute neurological manifestations among 439 Egyptian patients with COVID-19 MESHD in Assiut and Aswan university hospitals

    Authors: Eman Mohamed khedr; Noha Abo-Elfetoh; Enas Deaf; Hebatallah M Hassan; Mariam T Amin; Radwa K Soliman; Alaa A Attia; Amro A Zarzour; Mohamed Zain; Aliae Mohamed-Hussein; Maiada K Hashem; Sahar M Hassany; Ahmed Aly; Ahmed Shoap; Mostafa Saber

    doi:10.1101/2020.10.28.20221879 Date: 2020-11-03 Source: medRxiv

    Background: COVID 19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study we estimate the frequency of such complications among hospital in-patients with COVID-19 MESHD in Assiut and Aswan University Hospitals. Material and Methods: We screened all patients with suspected COVID-19 MESHD admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory data, CT/MRI of chest and brain, and neurophysiology were performed for each patient if indicated. Results: 439 patients had confirmed/probable COVID-19 MESHD; neurological manifestations occurred in 222. Of these 117 had acute neurological disease MESHD; the remainder had non-specific neuropsychiatric symptoms such as headache MESHD, vertigo MESHD, and depression MESHD. The CNS was affected in 75 patients: 55 had stroke MESHD; the others had convulsions MESHD (5), encephalitis MESHD (6), hypoxic encephalopathy MESHD (4), cord myelopathy MESHD (2), relapse of RR-MS (2), and meningoencephalitis MESHD (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia MESHD (31); the others had GBS MESHD (4), peripheral neuropathy MESHD (3), myasthenia gravis MESHD (2), or myositis MESHD (2). Fever MESHD, respiratory symptoms MESHD and headache MESHD, were the most common general symptoms. Hypertensions MESHD, Diabetes Mellitus MESHD, ischemic MESHD heart disease MESHD were the most common comorbidities in patients with CNS affection. Conclusion: In COVID-19 MESHD, both the CNS and PNS are affected. Stroke MESHD was the most common complication for CNS and anosmia MESHD and/or ageusia were common for PNS diseases MESHD. However there were 6 cases encephalitis MESHD, 2 cases of spinal cord myelopathy MESHD, 2 cases of MG and 2 cases of myositis MESHD.

    A concomitant Guillain-Barre Syndrome with COVID-19 MESHD: a first case-report in Colombia

    Authors: Nuvia Mackenzie; Eva Lopez-Coronel; Alberto Dau; Dieb Maloof; Salvador Mattar; Jesus Tapia Garcia; Briyis Fontecha; Cristina Lanata; Hernan Felipe Guillen-Burgos

    doi:10.21203/rs.3.rs-61279/v1 Date: 2020-08-17 Source: ResearchSquare

    Background: During the COVID-19 pandemic MESHD COVID-19 pandemic MESHD, different neurological manifestations have been published. However, few cases of Guillain-Barre Syndrome MESHD and COVID-19 MESHD have been reported. We describe a concomitant Guillain-Barre Syndrome MESHD and COVID-19 MESHD patient.Case presentation: a 39 years old woman was admitted in a teaching hospital in Barranquilla, Colombia with a history of progressive general weakness MESHD with lower limb dominance. A previous symptom as ageusia, anosmia MESHD and intense headache MESHD was reported. On admission, facial diplegia, quadriparesis MESHD with lower limbs predominance and Medical Research Council Scale 2/5 in lower limbs and 4/5 in upper limbs was reported. During clinical evolution, due to general areflexia MESHD, hypertensive emergency MESHD and progressive diaphragmatic weakness MESHD, the patient was admitted to intensive care unit. Cerebrospinal Serum Fluid revealed protein-cytologic dissociation and electromyography test were compatible with Guillain-Barre Syndrome MESHD. By symptoms before hospitalization, SARS-CoV2 diagnostic testing was performed with positive result in second test. Management to COVID-19 MESHD and Guillain Barre Syndrome was performed and patient was discharged after 20 days of hospitalization with clinical improvement.Conclusions: Few cases have been published reporting COVID-19 MESHD and Guillain-Barre Syndrome MESHD. We report the first confirmed case of COVID-19 MESHD with concomitant Guillain-Barre Syndrome in Colombia MESHD. In patients with Guillain-Barre Syndrome MESHD, several viral and bacterial pathogens have been found in case-control studies but there are do not clarity in what triggers the immune-mediated destruction of nerves. More studies are needed to determine possible association among COVID-19 MESHD exposure and Guillain-Barre Syndrome MESHD.

    Epidemiological and cohort study finds no association between COVID-19 MESHD and Guillain-Barre syndrome

    Authors: Stephen Keddie; Julia Pakpoor; Christina Mousele; Menelaos Pipis; Pedro M Machado; Mark Foster; Christopher J Record; Ryan Keh; Janev Fehmi; Ross W Paterson; Viraj Bharambe; Lisa Clayton; Claire Allen; Olivia Price; Jasmine Wall; Annamaria Kiss-csenki; Dipa P Rathnasabapathi; Ruth Geraldes; Tatyana Yermakova; Josh King-Robson; Maya Zosmer; Sanjeev Rajakulendran; Ross Nortley; Charles Marshall; Edward Newman; Niranjanan Nirmalananthan; Guru Kumar; Ashwin A Pinto; James Holt; Tim Lavin; Katie Brennan; Michael Zandi; Dipa L Jayaseelan; Jane Pritchard; Robert DM Hadden; Hadi Manji; Hugh J Willison; Simon Rinaldi; Aisling S Carr; Michael P Lunn

    doi:10.1101/2020.07.24.20161471 Date: 2020-07-24 Source: medRxiv

    Background Reports of Guillain-Barre Syndrome MESHD ( GBS MESHD) have emerged during the Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) pandemic. This epidemiological and cohort study sought to investigate any causative association between COVID-19 MESHD infection and GBS MESHD. Methods The epidemiology of GBS MESHD cases reported via the UK National Immunoglobulin Database were studied from 2016-2019 and compared to cases reported during the COVID-19 pandemic MESHD. For the cohort study, members of the British Peripheral Nerve Society reported all cases of GBS MESHD during the pandemic. The clinical features, investigation findings and outcomes of COVID-19 MESHD (definite or probable) and non- COVID-19 MESHD associated GBS MESHD cases were compared. Results The UK GBS MESHD incidence from 2016-2019 was 1.65-1.88 per 100,000 people per year. GBS MESHD and COVID-19 MESHD incidence varied between regions and did not correlate (r = 0.06, 95% CI -0.56 to 0.63, p=0.86). GBS MESHD incidence fell between March and May 2020 compared to the same months of 2016-2019. Forty-seven GBS MESHD cases were included in the cohort study (13 definite, 12 probable COVID-19 MESHD and 22 non- COVID-19 MESHD). There were no significant differences in the pattern of weakness, time to nadir, neurophysiology, CSF HGNC findings or outcome. Intubation was more frequent in the COVID-19 MESHD+ve cohort (7/13, 54% vs 5/22, 23% in COVID negative) thought to be related directly to COVID-19 MESHD pulmonary involvement. Conclusions This study finds no epidemiological or phenotypic clues of SARS-CoV-2 being causative of GBS MESHD. GBS MESHD incidence has fallen during the pandemic which may be the influence of lockdown measures reducing transmission of GBS MESHD inducing pathogens such as Campylobacter jejuni and respiratory viruses.

    COVID-19 MESHD and Guillain-Barre Syndrome - a Case report

    Authors: Amira Sidig; Khabab Abbasher; Mutaz F. Digna; Mohamed Elsayed; Hussien Abbasher; Mohammed Abbasher; Abbasher Hussien

    doi:10.21203/rs.3.rs-48327/v1 Date: 2020-07-24 Source: ResearchSquare

    Coronaviruses are a family of related viruses that cause diseases in mammals and avians. Guillain-Barre syndrome MESHD is a rare disorder in which the body's immune system attacks peripheral nerves.The case:A 65 years old Sudanese male with no diabetes mellitus MESHD or hypertension MESHD present to the clinic; On examination, he has upper and lower limb weakness MESHD ( quadriplegia MESHD). The condition was preceded by upper respiratory tract infection MESHD. Chest X-ray showed features of pneumonia MESHD Chest CT scan showed multiple bilateral ground-glass opacities and consolidation typical of COVID-19 MESHD pneumonia MESHD. Brain MRI was normal. The COVID-19 MESHD nasal swab test was positive. Nerve conduction study showed evidence of polyradiculopathies MESHD with dominant demyelination MESHD supporting the diagnosis of Guillain-Barre syndrome MESHD. The patients died after seven days; because of progressive respiratory failure MESHD.

    Neurological manifestations associated with COVID-19 MESHD: a nationwide registry

    Authors: Elodie Meppiel; Nathan Peiffer-Smadja; Alexandra Maury; Imen Bekri; Cecile Delorme; Virginie Desestret; Lucas Gorza; Geoffroy Hautecloque-Raysz; Sophie Landre; Annie Lannuzel; Solene Moulin; Peggy Perrin; Paul Petitgas; Francois Sellal; Adrien Wang; Pierre Tattevin; Thomas de Broucker; - contributors to the NeuroCOVID registry

    doi:10.1101/2020.07.15.20154260 Date: 2020-07-16 Source: medRxiv

    Background: The clinical description of the neurological manifestations in COVID-19 MESHD patients is still underway. This study aims to provide an overview of the spectrum, characteristics and outcomes of neurological manifestations associated with SARS-CoV-2 infection MESHD. Methods: We conducted a nationwide, multicentric, retrospective study during the French COVID-19 MESHD epidemic in March-April 2020. All COVID-19 MESHD patients with de novo neurological manifestations were eligible. Results: We included 222 COVID-19 MESHD patients with neurological manifestations from 46 centers throughout the country. Median age was 65 years (IQR 53-72), and 136 patients (61.3%) were male. COVID-19 MESHD was severe or critical in almost half of the patients (102, 45.2%). The most common neurological diseases MESHD were COVID-19 MESHD associated encephalopathy MESHD (67/222, 30.2%), acute ischemic cerebrovascular syndrome MESHD (57/222, 25.7%), encephalitis MESHD (21/222, 9.5%), and Guillain-Barre Syndrome MESHD (15/222, 6.8%). Neurological manifestations appeared after first COVID-19 MESHD symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19 MESHD associated encephalopathy MESHD, 7 (5-10) days in encephalitis MESHD, 12 (7-18) days in acute ischemic cerebrovascular syndrome MESHD and 18 (15-28) days in Guillain-Barre Syndrome MESHD. Brain imaging was performed in 192 patients (86.5%), including 157 MRI (70.7%). Brain MRI of encephalitis MESHD patients showed heterogeneous acute non vascular lesion in 14/21 patients (66.7%) with associated small ischemic lesion or microhemorrhages MESHD in 4 patients. Among patients with acute ischemic cerebrovascular syndrome MESHD, 13/57 (22.8%) had multi territory ischemic strokes MESHD, with large vessel thrombosis MESHD in 16/57 (28.1%). Cerebrospinal fluid was analyzed in 97 patients (43.7%), with pleocytosis MESHD in 18 patients (18.6%). A SARS-CoV-2 PCR was performed in 75 patients and was positive only in 2 encephalitis MESHD patients. Among patients with encephalitis MESHD, ten out of 21 (47.6%) fully recovered, 3 of whom received corticosteroids (CS). Less common neurological manifestations included isolated seizure MESHD (8/222, 3.6%), critical illness neuropathy MESHD (8/222, 3.6%), transient alteration of consciousness (5/222, 2.3%), intracranial hemorrhage MESHD (5/222, 2.3%), acute benign lymphocytic meningitis MESHD (3/222, 1.4%), cranial neuropathy MESHD (3/222, 1.4%), single acute demyelinating lesion MESHD (2/222, 0.9%), Tapia syndrome MESHD (2/222, 0.9%), cerebral venous thrombosis MESHD (1/222, 0.5%), sudden paraparesis MESHD (1/222, 0.5%), generalized myoclonus MESHD and cerebellar ataxia MESHD (1/222, 0.5%), bilateral fibular palsy (1/222, 0.5%) and isolated neurological symptoms ( headache MESHD, anosmia MESHD, dizziness MESHD, sensitive or auditive symptoms MESHD, hiccups MESHD, 15/222, 6.8%). The median (IQR) follow-up of the 222 patients was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). Conclusion: Neurological manifestations associated with COVID-19 MESHD mainly included CAE, AICS, encephalitis MESHD and GBS MESHD. Clinical spectrum and outcomes were broad and heterogeneous, suggesting different underlying pathogenic processes.

    Guillain Barr e syndrome in COVID-19 MESHD:A scoping review

    Authors: Imran Ahmad; Farooq Azam Rathore

    doi:10.1101/2020.06.13.20130062 Date: 2020-06-16 Source: medRxiv

    Introduction The novel coronavirus ( COVID19 MESHD) can result in several neurological complications. Guillain-Barre Syndrome MESHD ( GBS MESHD) is one of them and has been reported from different parts of the world in this pandemic. It is an acute post-infectious polyneuropathy MESHD. The review aims to summarize the demographic features, clinical presentation, diagnostics workup, and management strategies of COVID-19 MESHD associated GBS MESHD reported in the literature. Material and method We searched Medline, PubMed Central, SCOPUS, and Google Scholar using pre-defined keywords, with no time limits and in the English language only. We aimed to include all kinds of manuscripts. The last search was done on 18th May 2020. Demographics, clinical features, diagnostic workup, management, and outcomes were documented in the datasheet. Results We identified 24 cases of COVID-19 MESHD associated GBS MESHD. Most of the cases were reported from Italy followed by the USA. The majority were males (18 /24) The age ranged from 23 -84 years. The clinical presentation was typical sensory-motor GBS MESHD in most. Nine patients had facial palsy of which five had bilateral involvement. Two patients had bilateral abducent nerve palsy MESHD while two presented as paraparetic GBS MESHD variant with autonomic dysfunction. Electrodiagnostics was performed in 17 patients only and 12 had typical features of acute inflammatory demyelinating polyneuropathy MESHD. Intravenous immunoglobulins were the preferred mode of treatment in most of the patient. There was one death MESHD, and most were discharged to rehabilitation or home. Conclusion GBS MESHD is a frequent neurological complication associated with COVID-19 MESHD. There is no clear causative relationship between GBS MESHD, and COVID-19 MESHD at present, and more data are needed to establish the casualty. However, most cases have a post-infectious onset with male preponderance. Most of the cases have a typical presentation but some may present in an atypical way. Prognosis is generally good.

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