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Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)
AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVI...
Source: Journal of Neurology - January 23, 2021 Category: Neurology Source Type: research

Stroke management during the COVID-19 outbreak: challenges and results of a hub-center in Lombardy, Italy
ConclusionEndovascular treatment of stroke presented several challenges during the COVID-19 outbreak. Within the hospital, special pathways can be used to maintain both procedural safety and procedural times.
Source: Neuroradiology - January 7, 2021 Category: Radiology Source Type: research

Neurosurgery in times of a pandemic: a survey of neurosurgical services during the COVID-19 outbreak in the Veneto region in Italy.
CONCLUSIONS: This multicenter study describes the effects of a COVID-19 outbreak on neurosurgical activities in a vast region in Italy. Remodulation of neurosurgical activities has resulted in a significant reduction of elective and emergency surgeries compared to previous years. Most likely this is a combined result of cancellation of elective and postponable surgeries, increase of conservative management, increase in social restrictions, and in patients' fear of accessing hospitals. Curiously, only endovascular procedures for AIS have increased, possibly due to reduced physical activity or increased thrombosis in SARS-Co...
Source: Neurosurgical Focus - December 1, 2020 Category: Neurosurgery Authors: Raneri F, Rustemi O, Zambon G, Del Moro G, Magrini S, Ceccaroni Y, Basso E, Volpin F, Cappelletti M, Lardani J, Ferraresi S, Guida F, Chioffi F, Pinna G, Canova G, d'Avella D, Sala F, Volpin L Tags: Neurosurg Focus Source Type: research

COVID-19 Associated Ischemic Stroke and Hemorrhagic Stroke: Incidence, Potential Pathological Mechanism, and Management
The outbreak of the novel coronavirus infectious disease 2019 (COVID-19) caused by the SARS-CoV-2 virus has rapidly spread around the world. Increasing evidence has suggested that patients with COVID-19 may present neurological symptoms, and cerebrovascular diseases are one of the most frequent comorbidities. The markedly elevated D-dimer levels in patients with acute ischemic stroke suggests that SARS-CoV-2 infection may induce an inflammatory response and trigger a hypercoagulation state, thus leading to acute ischemic stroke. Cardioembolism and atherosclerosis in patients with COVID-19 infection may also increase the ri...
Source: Frontiers in Neurology - October 27, 2020 Category: Neurology Source Type: research

An Example of a Stroke Unit Reshaping in the Context of a Regional Hub and Spoke System in the COVID-19 Era
In conclusion, we were able to manage the new hub-and-spoke system safely and without significant delays. The reshaping of the SU was made possible by the significant reduction of out-patient activity. The consequences of this reduction are still unknown but eventually, this emergency will suggest ways to reconsider the management and the allocation of health system resources.
Source: Frontiers in Neurology - October 15, 2020 Category: Neurology Source Type: research

IJERPH, Vol. 17, Pages 6688: Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review
Gemignani The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complications is n...
Source: International Journal of Environmental Research and Public Health - September 13, 2020 Category: Environmental Health Authors: Graziella Orr ù Ciro Conversano Eleonora Malloggi Francesca Francesconi Rebecca Ciacchini Angelo Gemignani Tags: Review Source Type: research

The potential role of microvascular pathology in the neurological manifestations of coronavirus infection
We present the hypothesis that pre-existing vascular damage (due to aging, cardiovascular disease, diabetes, hypertension or other conditions) facilitates infiltration of the virus into the central nervous system (CNS), increasing neuro-inflammation and the likelihood o f neurological symptoms. We also discuss the role of a neuroinflammatory cytokine profile in both blood–brain barrier dysfunction and macrovascular disease (e.g. ischemic stroke and thromboembolism). Future studies are needed to better understand the involvement of the microvasculature in coronavi rus neuropathology, and to test the diagnostic potential o...
Source: Fluids and Barriers of the CNS - September 9, 2020 Category: Neuroscience Source Type: research

Post-traumatic stress disorder: a differential diagnostic consideration for COVID-19 survivors.
CONCLUSIONS: Heightened risk of PTSD occurred in MERS and SARS survivors. While data concerning COVID-19 is lacking, PTSD is known to occur in patient groups who undergo similar hospital courses, including ICU survivors, patients who are intubated and mechanically ventilated, and those that experience delirium. Research with patients who develop PTSD in the context of mild traumatic brain injury further suggests that PTSD may account for some or all of a patient's subjective cognitive complaints and neuropsychological test performance. Recommendations are provided for assessing PTSD in the context of COVID-19. PMID: 3...
Source: The Clinical Neuropsychologist - August 25, 2020 Category: Psychiatry & Psychology Authors: Kaseda ET, Levine AJ Tags: Clin Neuropsychol Source Type: research

Neurological manifestations of COVID-19: available evidences and a new paradigm
AbstractThe recent pandemic outbreak of coronavirus is pathogenic and a highly transmittable viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). In this time of ongoing pandemic, many emerging reports suggested that the SARS-CoV-2 has inimical effects on neurological functions, and even causes serious neurological damage. The neurological symptoms associated with COVID-19 include headache, dizziness, depression, anosmia, encephalitis, stroke, epileptic seizures, and Guillain-Barre syndrome along with many others. The involvement of the CNS may be related with poor prognosis and disease wo...
Source: Journal of NeuroVirology - August 23, 2020 Category: Neurology Source Type: research

Looking ahead: The risk of neurologic complications due to COVID-19
The rapid spread of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a public health emergency of international concern. The outbreak was characterized as a pandemic by the World Health Organization (WHO) in March 2020. The most characteristic symptom of patients with COVID-19 is respiratory distress. Some patients may also show neurologic signs and symptoms ranging from headache, nausea, vomiting, and confusion to anosmia, ageusia, encephalitis, and stroke. Coronaviruses are known pathogens with neuroinvasive potential. There is increasing evidence that coronavirus i...
Source: Neurology Clinical Practice - August 9, 2020 Category: Neurology Authors: Perez, C. A. Tags: Viral infections, All global neurology, Public health, COVID-19 Commentary Source Type: research

Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19
ConclusionsThe COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.
Source: Clinical Research in Cardiology - August 3, 2020 Category: Cardiology Source Type: research

Lessons from Severe Acute Respiratory Syndrome Coronavirus 2003 Pandemic as Evidence to Advocate for Stroke Public Education During the Current Coronavirus Disease 2019 Pandemic.
CONCLUSIONS: During the SARS pandemic, there was a reduction in the number of stroke admissions, and this was apparent during both the local SARS and worldwide SARS outbreak periods. We should take appropriate steps through public education to minimise the expected reduced stroke admissions during the COVID-19 pandemic, inferred from the findings during the SARS pandemic. PMID: 33164023 [PubMed - in process]
Source: Ann Acad Med Singapo... - August 1, 2020 Category: General Medicine Authors: Riandini T, Tan KB, De Silva DA Tags: Ann Acad Med Singap Source Type: research

COVID-19 and Stroke: Casual or Causal Role?
We present a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors. The patient arrived 1 h after onset of symptoms, was treated with recombinant tissue plasminogen activator (rtPA) with improvement of neurologic deficits, and later developed right foot arterial ischemia (recanalized by balloon catheter angioplasty) and left arm superficial venous thrombosis. A control computed tomography (CT) scan 7 days after onset showed hemorrhagic transformation of ischemic lesion without mass effect. However, respiratory and neurologic conditions improved so that the patient was discharged to ...
Source: Cerebrovascular Diseases - July 7, 2020 Category: Neurology Source Type: research

Less Myocardial Infarction and Stroke Hospitalizations During Middle East Respiratory Syndrome Coronavirus Epidemic in Korea
Viral infections are known to impact coronary disease, and acute myocardial infarction (AMI) may be triggered by the inflammatory cytokine response to infection.1,2 Cytokines promote local inflammation in atherosclerotic plaques within the coronary artery, which can lead to plaque destabilization, rupture, and eventually AMI development. Psychological adversity, depression, stress at home or work, social isolation and loneliness are also known factors contributing to acute vascular event.3 Recent outbreaks of coronavirus (CoV), including severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS) ...
Source: The American Journal of Cardiology - July 2, 2020 Category: Cardiology Authors: Cai De Jin, Moo Hyun Kim, Kwang Min Lee, Jong Sung Park, Dong Sik Jung, Sung-Cheol Yun, Victor Serebruany Source Type: research

COVID-19 Infection and Neurological Complications: Present Findings and Future Predictions
The present outbreak caused by SARS-CoV-2, an influenza virus with neurotropic potential, presents with neurological manifestations in a large proportion of the affected individuals. Disorders of the central and peripheral nervous system are all present, while stroke, ataxia, seizures, and depressed level of consciousness are more common in severely affected patients. People with these severe complications are most likely elderly with medical comorbidities, especially hypertension and other vascular risk factors. However, postinfectious complications are also expected. Neurological disorders as sequelae of influenza viruse...
Source: Neuroepidemiology - July 1, 2020 Category: Epidemiology Source Type: research

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