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    SARS-CoV-2 and Stroke HP Stroke MESHD Characteristics: A Report from the Multinational COVID-19 Stroke HP Stroke MESHD Study Group

    Authors: Shima Shahjouei; Georgios Tsivgoulis; Rohan Arora; Mohammad Hossein Harirchian; Nasrin Rahimian; Afshin Borhani-Haghighi; Stefania Mondello; Arash Kia; Alireza Vafaei Sadr; Ashkhan Mowla; Venkatesh Avula; Saeed Ansari; Ramin Zand; Vida Abedi; Ghasem Farahmand; Eric Koza; Martin Punter; Annemarei Ranta; Achille Cernigliaro; Alaleh Vaghefi Far; Afshin Borhani-Haghighi; Jiang Li; Oluwaseyi Olulana; Durgesh Chaudhary

    doi:10.1101/2020.08.05.20169169 Date: 2020-08-07 Source: medRxiv

    Background: Stroke HP Stroke MESHD is reported as a consequence of SARS-CoV-2 infection MESHD. However, there is a lack of regarding comprehensive stroke HP stroke MESHD phenotype and characteristics Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke MESHD ischemic stroke HP ( AIS MESHD), intracranial hemorrhage HP intracranial hemorrhage MESHD ( ICH MESHD), and cerebral venous or sinus thrombosis MESHD ( CVST MESHD) among SARS-CoV-2 infected MESHD patients. We further investigated the association of demographics, clinical data, geographical regions, and countrie's health expenditure among AIS MESHD patients with the risk of large vessel occlusion (LVO), stroke HP stroke MESHD severity as measured by National Institute of Health stroke HP stroke MESHD scale (NIHSS), and stroke HP stroke MESHD subtype as measured by the TOAST criteria. Additionally, we applied unsupervised machine learning algorithms to uncover possible similarities among stroke HP stroke MESHD patients. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least one eligible stroke HP stroke MESHD patient. Out of 432 patients included, 323(74.8%) had AIS MESHD, 91(21.1%) ICH MESHD, and 18(4.2%) CVST MESHD. Among 23 patients with subarachnoid hemorrhage HP subarachnoid hemorrhage MESHD, 16(69.5%) had no evidence of aneurysm MESHD. A total of 183(42.4%) patients were women, 104(24.1%) patients were younger than 55 years, and 105(24.4%) patients had no identifiable vascular risk factors. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke HP stroke MESHD, 144(37.8%) presented to the hospital with chief complaints of stroke HP stroke MESHD-related symptoms, with asymptomatic TRANS or undiagnosed SARS-CoV-2 infection MESHD. Among AIS MESHD patients 44.5% had LVO; 10% had small artery occlusion MESHD according to the TOAST criteria. We observed a lower median NIHSS (8[3-17], versus 11[5-17]; p=0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; p<0.001) in countries with middle to high-health expenditure when compared to countries with lower health expenditure. The unsupervised machine learning identified 4 subgroups, with a relatively large group with no or limited comorbidities. Conclusions: We observed a relatively high number of young, and asymptomatic TRANS SARS-CoV-2 infections MESHD among stroke HP stroke MESHD patients. Traditional vascular risk factors were absent among a relatively large cohort of patients. Among hospitalized patients, the stroke HP stroke MESHD severity was lower and rate of mechanical thrombectomy was higher among countries with middle to high-health expenditure.

    Neurological manifestations associated with COVID-19: 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 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 epidemic in March-April 2020. All COVID-19 patients with de novo neurological manifestations were eligible. Results: We included 222 COVID-19 patients with neurological manifestations from 46 centers throughout the country. Median age TRANS was 65 years (IQR 53-72), and 136 patients (61.3%) were male TRANS. COVID-19 was severe or critical in almost half of the patients (102, 45.2%). The most common neurological diseases MESHD were COVID-19 associated encephalopathy HP encephalopathy MESHD (67/222, 30.2%), acute ischemic cerebrovascular syndrome MESHD (57/222, 25.7%), encephalitis HP encephalitis MESHD (21/222, 9.5%), and Guillain-Barre Syndrome MESHD (15/222, 6.8%). Neurological manifestations appeared after first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19 associated encephalopathy HP encephalopathy MESHD, 7 (5-10) days in encephalitis HP 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 HP 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 HP 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 HP encephalitis MESHD patients. Among patients with encephalitis HP encephalitis MESHD, ten out of 21 (47.6%) fully recovered, 3 of whom received corticosteroids (CS). Less common neurological manifestations included isolated seizure HP seizure MESHD (8/222, 3.6%), critical illness neuropathy MESHD (8/222, 3.6%), transient alteration of consciousness (5/222, 2.3%), intracranial hemorrhage HP intracranial hemorrhage MESHD (5/222, 2.3%), acute benign lymphocytic meningitis MESHD meningitis HP (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 HP cerebral venous thrombosis MESHD (1/222, 0.5%), sudden paraparesis MESHD paraparesis HP (1/222, 0.5%), generalized myoclonus HP myoclonus MESHD and cerebellar ataxia MESHD ataxia HP (1/222, 0.5%), bilateral fibular palsy (1/222, 0.5%) and isolated neurological symptoms ( headache HP headache MESHD, anosmia HP 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 mainly included CAE, AICS, encephalitis HP encephalitis MESHD and GBS MESHD. Clinical spectrum and outcomes were broad and heterogeneous, suggesting different underlying pathogenic processes.

    COVID-19 associated meningoencephalitis MESHD complicated with intracranial hemorrhage HP intracranial hemorrhage MESHD. A case report.

    Authors: Mohammad Alolama; Anas Rashid; Debora Garozzo

    doi:10.21203/rs.3.rs-28203/v1 Date: 2020-05-10 Source: ResearchSquare

    Introduction: The Coronavirus pandemic that started in December 2019 is mainly related to clinical pictures consistent with respiratory symptoms; nevertheless, reports about neurological complications have recently appeared in the medical literature.The case: we describe a case of a 36 years old Coronavirus-positive patient that was admitted on emergency basis; his clinical presentation included neurological symptoms such as drowsiness HP drowsiness MESHD and mild confusion HP confusion MESHD. Imaging revealed findings consistent with meningoencephalitis MESHD complicated by intracerebral hematoma MESHD and subdural hematoma MESHD. The latter was surgically evacuated after it became chronic and evidence of Coronavirus was found in the fluid.  Conclusion: our experience confirms that neurological complications MESHD might be a likely event in COVID-19. Although uncommon, the possible occurrence of meningoencephalitis MESHD should be kept in mind by physicians involved in the management of COVID-19 patients. Early recognition of brain involvement may provide better prognosis, preventing evolution into intracerebral hemorrhagic MESHD events.

    Clinical Features of COVID‐19 in a Young Man with Massive Cerebral Hemorrhage HP Cerebral Hemorrhage MESHD: Case Report

    Authors: Yi Bao; Shu Yu Lin; Zhao Hui Cheng; Jun Xia; Yan Peng Sun; Qi Zhao; Guang Jian Liu

    doi:10.21203/rs.3.rs-26232/v1 Date: 2020-04-29 Source: ResearchSquare

    COVID-19 is currently a pandemic in the world, can invade multiple systems, and has a high morbidity and mortality. So far, no cases of acute cerebrovascular disease MESHD have been reported. This article reports the clinical features of a COVID-19 patient whose first symptom was cerebral hemorrhage HP cerebral hemorrhage MESHD. More importantly, after the craniotomy, the patient had high fever HP fever MESHD and it was difficult to retreat. After cerebrospinal fluid testing, it was determined that an intracranial infection MESHD had occurred. After anti-infection and plasma SERO infusion of the recovered person, the patient's symptoms gradually improved. This case suggests that COVID-19 may infringe on cerebral blood SERO vessels and cause cerebral hemorrhage HP cerebral hemorrhage MESHD. Transfusion of plasma SERO from rehabilitation patients is effective for critically ill MESHD patients.

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