Corpus overview


MeSH Disease

Human Phenotype

Headache (3)

Hypertension (3)

Fever (3)

Cough (2)

Stroke (2)


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    Covid-19 associated Acute Haemorrhagic Leukoencephalomyelitis MESHD

    Authors: Rahul Handa; Satyan Nanda; Atul Prasad; Rajiv Anand; Dhruv Zutshi; Sujata K. Dass; Prabhjeet Kaur Bedi; Aarti Pahuja; Pankaj Kumar Shah; Bipan Sharma

    doi:10.21203/ Date: 2020-08-13 Source: ResearchSquare

    Since the first appearance of Covid-19 in December 2019 in Wuhan, China, the disease has spread TRANS world-wide infecting more than 13 million people and causing approximately five hundred eighty-five thousand deaths. The disease which was initially thought to primarily involve respiratory and cardiovascular system only, over time has been reported to involve central and peripheral nervous system with varying frequency. The importance of identifying neurological symptoms cannot be over emphasised by the fact that loss of sense of smell is now considered as one of the earliest features of Covid-19. Although, impaired consciousness MESHD has been reported in approximately 17% patients with Covid-19, acute haemorrhagic leukoencephalomyelitis MESHD ( AHL MESHD) as its cause has been reported in a very few cases. It is imperative for the emergency and respiratory physicians to be aware of this condition as mostly they are the ones who initially come in contact with the Covid-19 patients, as early diagnosis and aggressive treatment would greatly help in improving the prognosis and reducing the morbidity in this otherwise fatal disease. We herein report a case of acute haemorrhagic leukoencephalomyelitis MESHD secondary to Covid-19 from a tertiary care centre in India. To the best of our knowledge, this is the first case of Covid-19 associated AHL MESHD to be reported from India.

    Central Nervous System Manifestations in COVID-19 Patients: A Systematic Review and Meta-analysis

    Authors: Shahrzad Nazari; Amirhossein Azari Jafari; Seyyedmohammadsadeq Mirmoeeni; Saeid Sadeghian; Mohammad Eghbal Heidari; Siavash Sadeghian; Farhad Asarzadegan; Seyed Mahmoud Puormand; Hamid Ebadi; Davood Fathi; Sahar Dalvand

    doi:10.1101/2020.07.21.20158691 Date: 2020-07-22 Source: medRxiv

    Background: At the end of December 2019, a novel respiratory infection MESHD, initially reported in China, known as COVID-19 initially reported in China, and later known as COVID-19, led to a global pandemic. Despite many studies reporting respiratory infections MESHD as the primary manifestations of this illness, an increasing number of investigations have focused on the central nervous system (CNS) manifestations in COVID-19. In this study, we aimed to evaluate the CNS presentations in COVID-19 patients in an attempt to identify the common CNS features and provide a better overview to tackle this new pandemic. Methods: In this systematic review and meta-analysis, we searched PubMed, Web of Science, Ovid, Embase, Scopus, and Google Scholar. Included studies were publications that reported the CNS features between January 1st, 2020, to April 20th, 2020. The data of selected studies were screened and extracted independently by four reviewers. Extracted data analyzed by using STATA statistical software. The study protocol registered with PROSPERO (CRD42020184456). Results: Of 2353 retrieved studies, we selected 64 studies with 11282 patients after screening. Most of the studies were conducted in China (58 studies). The most common CNS symptom of COVID-19 were Headache HP Headache MESHD (8.69%, 95%CI: 6.76%-10.82%), Dizziness MESHD (5.94%, 95%CI: 3.66%-8.22%), and Impaired consciousness MESHD (1.9%, 95%CI: 1%-2.79%). Conclusions: The growing number of studies have reported COVID-19, CNS presentations as remarkable manifestations that happen. Hence, understanding the CNS characteristics of COVID-19 can help us for better diagnosis and ultimately prevention of worse outcomes.

    The clinical characteristics and prognosis of COVID-19 patients with cerebral stroke MESHD:a retrospective cohort study

    Authors: Xiaolong Yao; Shengwen Liu; Junwen Wang; Kai Zhao; Xiaobing Long; Xuejun He; Huicong Kang; Yiping Yang; Xiaopeng Ma; Pengjie Yue; Kai Shu; Zhouping Tang; Ting Lei; Jihong Liu; Wei Wang; Huaqiu Zhang

    doi:10.21203/ Date: 2020-06-23 Source: ResearchSquare

    Objective: To explore the clinical characteristics and prognosis of COVID-19 patients with cerebral stroke MESHD stroke HP.Methods: In this retrospective study, 2474 patients with COVID-19 were admitted and treated in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan from February 10, 2020, to March 24, 2020. Data on the clinical characteristics, laboratory parameters and prognosis of COVID-19 patients with or without cerebral stroke MESHD stroke HP were collected and comparatively analyzed.Results: Of 2474 COVID-19 patients (61.0±15.7 years; 1235 males TRANS [49.9%]), 113 (4.7%) patients had cerebral stroke MESHD stroke HP, and 25 (1.0%) patients had a new onset of stroke HP stroke MESHD. Eighty-eight (77.9%) patients in the previous stroke HP stroke MESHD group had cerebral ischemia HP cerebral ischemia MESHD, while 25 (22.1%) patients in the new-onset stroke HP stroke MESHD group had cerebral ischemia HP cerebral ischemia MESHD. Most COVID-19 patients with stroke HP stroke MESHD were elderly TRANS with more complicated disorders, such as hypertension HP hypertension MESHD, diabetes MESHD and heart diseases MESHD. Laboratory examinations showed a hypercoagulation status MESHD and elevated serum SERO parameters such as IL-6, cTnI, NT pro-BNP and BUN. Of note, stroke HP stroke MESHD patients revealed a nearly double mortality (12.4% vs 6.9%) to that of patients without stroke HP stroke MESHD. Additionally, age TRANS (≥60 years), fingertip oxygen saturation (<93%) and consciousness disorder MESHD were independent predictors for new cerebral stroke MESHD stroke HP in COVID-19 patients. Interpretation: The high risk of new-onset stroke HP stroke MESHD in COVID-19 patients was older age TRANS combined with fingertip oxygen saturation (<93%) and consciousness disorder MESHD. These patients are more vulnerable to multiple organ dysfunction MESHD and an overactivated inflammatory response, in turn leading to a deteriorated outcome and mortality.

    Neurological manifestations of COVID-19: A systematic review

    Authors: Xiangliang Chen; Sarah Laurent; Oezguer A. Onur; Nina N. Kleineberg; Gereon R. Fink; Finja Schweitzer; Clemens Warnke

    doi:10.21203/ Date: 2020-06-23 Source: ResearchSquare

    Objective: To study the frequency of neurological symptoms MESHD and complications in COVID-19 patients in a systematic review of the literature. Methods: Relevant studies were identified through electronic explorations of PubMed, medRxiv, and bioRxiv. Besides, three Chinese databases were searched. A snowballing method searching the bibliographies of the retrieved references was applied to identify potentially relevant articles. Articles published within one year prior to April 20th, 2020 were screened with no language restriction imposed. Databases were searched for terms related to SARS-CoV-2/COVID-19 and neurological manifestations, using a pre-established protocol registered on the International Prospective Register of Systematic Reviews database (ID: CRD42020187994).Results: A total of 2441 articles were screened for relevant content, of which 92 full-text publications were included in the analyses of neurological manifestations of COVID-19. Headache HP Headache MESHD, dizziness MESHD, taste and smell dysfunctions MESHD, and impaired consciousness MESHD were the most frequently described neurological symptoms, the latter more often among patients with a severe or critical disease MESHD course. To date, only smaller cohort studies or single cases have reported cerebrovascular MESHD events, seizures HP seizures MESHD, meningoencephalitis MESHD, and immune-mediated neurological diseases MESHD, not suitable for quantitative analysis. Conclusions: The most frequent neurological symptoms MESHD reported in association with COVID-19 are non-specific for the infection MESHD with SARS-CoV-2. Although SARS-CoV-2 may have the potential to gain direct access to the nervous system, so far, SARS-CoV-2 was detected in the cerebrospinal fluid in two cases only. Standardized international registries are needed to clarify the clinical relevance of the neuropathogenicity of SARS-CoV-2 MESHD

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

    Authors: Emanuela Keller; Giovanna Brandi; Sebastian Winklhofer; Lukas Imbach; Daniel Kirschenbaum; Karl Joachim Frontzek; Peter Steiger; Sabeth Aurelia Dietler; Marcellina Isabelle Haeberlin; Jan Folkard Willms; Francesca Porta; Adrian Waeckerlin; Irene Alma Abela; Andreas Lutterotti; Christoph Stippich; Ilijas Jelcic

    doi:10.21203/ Date: 2020-05-29 Source: ResearchSquare

    Objective Case series with different clinical presentations indicating central nervous system (CNS) involvement in coronavirus disease MESHD 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 MESHD 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 MESHD 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 TRANS, 67.6 [6.8] years; seven men; two patients died). All eight patients had cardiovascular risk factors, most frequently arterial hypertension HP hypertension MESHD. Two patients presented with lacunar ischemic stroke HP ischemic stroke MESHD and one with status epilepticus HP status epilepticus MESHD in the early phase. As most common presentation, six patients presented with prolonged impaired consciousness MESHD 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 MESHD and in another two with additional small ischemic lesions MESHD. 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 MESHD are common in patients with severe COVID-19. Different mechanisms might be involved. Besides unspecific encephalopathy HP encephalopathy MESHD and encephalitic syndromes MESHD, large vessel strokes HP strokes MESHD 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 MESHD 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.


    Authors: Chia-Ling Kuo; Luke C Pilling; Janice L Atkins; Jane AH Masoli; Joao Delgado; George A Kuchel; David Melzer

    doi:10.1101/2020.05.07.20094409 Date: 2020-05-11 Source: medRxiv

    The novel respiratory disease COVID-19 produces varying symptoms, with fever HP fever MESHD, cough HP cough MESHD, and shortness of breath MESHD being common. In older adults TRANS, we found that pre-existing dementia HP dementia MESHD is a major risk factor (OR = 3.07, 95% CI: 1.71 to 5.50) for COVID-19 severity in the UK Biobank (UKB). In another UK study of 16,749 patients hospitalized for COVID-19, dementia HP dementia MESHD was among the common comorbidities and was associated with higher mortality. Additionally, impaired consciousness MESHD, including delirium HP delirium MESHD, is common in severe cases. The ApoE e4 genotype is associated with both dementia HP dementia MESHD and delirium HP, with the e4e4 (homozygous) genotype associated with a 14-fold increase in risk of Alzheimer's disease MESHD compared to the common e3e3 genotype, in populations with European ancestries. We therefore aimed to test associations between ApoE e4 alleles and COVID-19 severity, using the UKB data.

    Clinical characteristics of 106 patients with neurological diseases MESHD and co-morbid coronavirus disease MESHD 2019: a retrospective study

    Authors: Rong Yin; Zhiqi Yang; Yaxuan Wei; Yuanming Li; Hui Chen; Zhao Liu; Bo Zhao; Dandan Ma; Meiling Dan; Yingjie Zhang; Xuan Liu; Huiceng Leng; Dawei Xiang

    doi:10.1101/2020.04.29.20085415 Date: 2020-05-05 Source: medRxiv

    Objectives:To describe the clinical characteristics of patients with coronavirus disease MESHD 2019 (COVID-19) with co-morbid neurological symptoms. Design:Retrospective case series. Setting:Huoshenshan Hospital in Wuhan, China. Participants:From 4 February to 14 April 2020, 106 patients with neurological diseases MESHD were enrolled from all patients in the hospital with confirmed COVID-19 and divided into a severe group and a nonsevere group according to their COVID-19 diagnosis. Main outcome measures:Clinical characteristics, laboratory results, imaging findings, and treatment methods were all retrieved through an electronic medical records system and recorded in spreadsheets. Results:The mean (standard deviation, SD MESHD) age TRANS of patients was 72.7 (11.8) years, and 64 patients were male TRANS (60.4%). Among patients with co-morbid neurological diseases MESHD, 81 had a previous cerebral infarction MESHD (76.4%), 20 had dementia HP dementia MESHD (18.9%), 10 had acute cerebral infarction MESHD (9.4%), 5 had sequelae of cerebral haemorrhage MESHD (4.7%), 4 had intracranial mass lesions (3.8%), 3 had epilepsy MESHD (2.8%), 2 had Parkinsons disease MESHD (1.9%), and 1 had myelopathy HP myelopathy MESHD (0.9%). Fever HP Fever MESHD (n = 62, 58.5%) was the most common symptom. The most common neurological symptoms were myalgia HP myalgia MESHD (n = 26, 24.5%), followed by extremity paralysis MESHD paralysis HP (n = 20, 18.9%), impaired consciousness MESHD (n = 17, 16%), and positive focal neurological signs (n = 42, 39.6%). Eight patients (7.5%) died. There were more patients with altered mental status in the severe group than in the non-severe group (6 [10.2%] vs. 0, P = 0.033). The inflammatory response in the severe group was more significant than that in the non-severe group. There were more patients taking anticoagulant drugs (25 [42.4%] vs. 4 [8.5%], P < 0.001) and sedative drugs (22 [37.3%] vs. 9 [19.1%], P = 0.041) in the severe group than in the non-severe group. Amid all 93 patients with cerebrovascular diseases MESHD, only 32 (34.4%) were taking aspirin, 13 (14%) taking clopidogrel, and 33 (35.5%) taking statins. Conclusions:Patients with COVID-19 with co-morbid neurological diseases had an advanced age TRANS, a high rate of severe illness MESHD, and a high mortality rate. Among the neurological symptoms, altered mental status was more common in patients with severe COVID-19 with co-morbid neurological diseases MESHD.

    Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study

    Authors: Ling Mao; Mengdie Wang; Shanghai Chen; Quanwei He; Jiang Chang; Candong Hong; Yifan Zhou; David Wang; Yanan Li; Huijuan Jin; Bo Hu

    doi:10.1101/2020.02.22.20026500 Date: 2020-02-25 Source: medRxiv

    OBJECTIVE: To study the neurological manifestations of patients with coronavirus disease MESHD 2019 (COVID-19). DESIGN: Retrospective case series SETTING: Three designated COVID-19 care hospitals of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China. PARTICIPANTS: Two hundred fourteen hospitalized patients with laboratory confirmed diagnosis of severe acute respiratory syndrome MESHD from coronavirus 2 (SARS-CoV-2) infection MESHD. Data were collected from 16 January 2020 to 19 February 2020. MAIN OUTCOME MEASURES: Clinical data were extracted from electronic medical records and reviewed by a trained team of physicians. Neurological symptoms fall HP into three categories: central nervous system (CNS) symptoms or diseases ( headache HP headache MESHD, dizziness MESHD, impaired consciousness MESHD, ataxia HP ataxia MESHD, acute cerebrovascular disease MESHD, and epilepsy MESHD), peripheral nervous system (PNS) symptoms ( hypogeusia MESHD, hyposmia HP, hypopsia, and neuralgia MESHD), and skeletal muscular symptoms. Data of all neurological symptoms were checked by two trained neurologists. RESULTS: Of 214 patients studied, 88 (41.1%) were severe and 126 (58.9%) were non-severe patients. Compared with non-severe patients, severe patients were older (58.7 {+/-} 15.0 years vs 48.9 {+/-} 14.7 years), had more underlying disorders (42 [47.7%] vs 41 [32.5%]), especially hypertension HP hypertension MESHD (32 [36.4%] vs 19 [15.1%]), and showed less typical symptoms such as fever HP fever MESHD (40 [45.5%] vs 92 [73%]) and cough HP (30 [34.1%] vs 77 [61.1%]). Seventy-eight (36.4%) patients had neurologic manifestations. More severe patients were likely to have neurologic symptoms (40 [45.5%] vs 38 [30.2%]), such as acute cerebrovascular diseases MESHD (5 [5.7%] vs 1 [0.8%]), impaired consciousness MESHD (13 [14.8%] vs 3 [2.4%]) and skeletal muscle injury MESHD (17 [19.3%] vs 6 [4.8%]). CONCLUSION: Compared with non-severe patients with COVID-19, severe patients commonly had neurologic symptoms manifested as acute cerebrovascular diseases MESHD, consciousness impairment and skeletal muscle symptoms MESHD.

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MeSH Disease
Human Phenotype

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