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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    The clinical spectrum of encephalitis MESHD encephalitis HP in COVID-19 disease MESHD: the ENCOVID multicentre study

    Authors: Andrea Pilotto; Stefano Masciocchi; Irene Volonghi; Elisabetta del Zotto; Eugenio Magni; Valeria De Giuli; Francesca Caprioli; Nicola Rifino; Maria Sessa; Michele Gennuso; Maria Sofia Cotelli; Marinella Turla; Ubaldo Balducci; Sara Mariotto; Sergio Ferrari; Alfonso Ciccone; Fabrizio Fiacco; Alberto Imarisio; Barbara Risi; Alberto Benussi; Emanuele Foca'; Francesca Caccuri; Matilde Leonardi; Roberto Gasparotti; Francesco Castelli; Gianluigi Zanusso; Alessandro Pezzini; Alessandro Padovani

    doi:10.1101/2020.06.19.20133991 Date: 2020-06-20 Source: medRxiv

    Background: Several preclinical and clinical investigations have argued for nervous system involvement in SARS-CoV-2 infection MESHD. Some sparse case reports have described various forms of encephalitis MESHD encephalitis HP in COVID-19 disease MESHD, but very few data have focused on clinical presentations, clinical course, response to treatment and outcomes yet. Objective: to describe the clinical phenotype, laboratory and neuroimaging findings of encephalitis MESHD encephalitis HP associated with SARS-CoV-2 infection MESHD, their relationship with respiratory function and inflammatory parameters and their clinical course and response to treatment. Design: The ENCOVID multicentre study was carried out in 13 centres in northern Italy between February 20th and May 31st, 2020. Only patients with altered mental status and at least two supportive criteria for encephalitis MESHD encephalitis HP with full infectious screening, CSF, EEG, MRI data and a confirmed diagnosis of SARS-CoV-2 infection MESHD were included. Clinical presentation and laboratory markers, severity of COVID-19 disease MESHD, response to treatment and outcomes were recorded. Results: Out of 45 cases screened, twenty-five cases of encephalitis MESHD encephalitis HP positive for SARS-CoV-2 infection MESHD with full available data were included. The most common symptoms at onset TRANS were delirium MESHD delirium HP (68%), aphasia MESHD aphasia HP/ dysarthria MESHD dysarthria HP (24%) and seizures MESHD seizures HP (24%). CSF showed hyperproteinorrachia and/or pleocytosis in 68% of cases whereas SARS-CoV-2 RNA by RT-PCR resulted negative. Based on MRI, cases were classified as ADEM (n=3), limbic encephalitis MESHD encephalitis HP (LE, n=2), encephalitis MESHD encephalitis HP with normal imaging (n=13) and encephalitis MESHD encephalitis HP with MRI alterations (n=7). ADEM and LE cases showed a delayed onset compared to the other encephalitis MESHD encephalitis HP (p=0.001) and were associated with previous more severe COVID-19 respiratory involvement. Patients with MRI alterations exhibited worse response to treatment and final outcomes compared to other encephalitis MESHD encephalitis HP. Conclusions and relevance: We found a wide clinical spectrum of encephalitis MESHD encephalitis HP associated with COVID19 infection MESHD, underlying different pathophysiological mechanisms. Response to treatment and final outcome strongly depended on specific CNS-manifestations.

    Cytokine Release Syndrome MESHD-Associated Encephalopathy HP in Patients with COVID-19

    Authors: Peggy Perrin; Nicolas Collongues; Seyyid Baloglu; Dimitri Bedo; Xavier Bassand; Thomas Lavaux; Gabriela Gautier; Nicolas Keller; Stephane Kremer; Samira Fafi-Kremer; Bruno Moulin; Ilies Benotmane; Sophie Caillard

    id:10.20944/preprints202006.0103.v1 Date: 2020-06-07 Source: preprints.org

    Severe disease MESHD and uremia MESHD are risk factors for neurological complications of coronavirus disease MESHD-2019 (COVID-19). An in-depth analysis of a case series was conducted to describe the neurological manifestations of patients with COVID-19 and gain pathophysiological insights that may guide clinical decision-making – especially with respect to the cytokine release syndrome MESHD (CRS). Extensive clinical, laboratory, and imaging phenotyping was performed in five patients. Neurological presentation included confusion MESHD confusion HP, tremor MESHD tremor HP, cerebellar ataxia MESHD ataxia HP, behavioral alterations, aphasia MESHD aphasia HP, pyramidal syndrome MESHD, coma MESHD coma HP, cranial nerve palsy, dysautonomia, and central hypothyroidism HP hypothyroidism MESHD. Neurological disturbances were remarkably accompanied by laboratory evidence of CRS. SARS-CoV-2 was undetectable in the cerebrospinal fluid. Hyperalbuminorachy and increased levels of the astroglial protein S100B were suggestive of blood SERO-brain barrier (BBB) dysfunction. Brain MRI findings comprised evidence of acute leukoencephalitis (n = 3, of whom one with a hemorrhagic form), cytotoxic edema MESHD edema HP mimicking ischemic stroke HP stroke MESHD (n = 1), or normal results (n = 2). Treatment with corticosteroids and/or intravenous immunoglobulins was attempted – resulting in rapid recovery from neurological disturbances in two cases. Patients with COVID-19 can develop neurological manifestations that share clinical, laboratory, and imaging similarities with those of chimeric antigen receptor-T cell-related encephalopathy HP. The pathophysiological underpinnings appear to involve CRS, endothelial activation, BBB dysfunction, and immune-mediated mechanisms.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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