Neurological complications of Covid-19: Narrative review
DOI:
https://doi.org/10.37085/jmmv2.n1.2020.pp.29-37Keywords:
Coronavírus, Manifestações neurológicas,, Covid-19, SARS-CoV-2Abstract
A pandemia causada pelo novo coronavírus trouxe consigo grandes desafios para a ciência visto sua alta taxa de transmissão, que gera uma crise nos sistemas de saúde e econômicos de todo o mundo e exige respostas rápidas por parte dos pesquisadores. Sabemos que o receptor para enzima conversora de angiotensina 2 desempenha um papel importante na infecção. Esse receptor também está presente em neurônios e células gliais do córtex motor, porção posterior do giro do cíngulo, paredes dos ventrículos, substância negra, bulbo olfatório, giro temporal médio, núcleo do trato solitário, medula ventrolateral e núcleo dorsal do vago. Motivo pelo qual o mecanismo de neuroinvasão precisa ser melhor crompreendido. Suas manifestações neurológicas podem, muitas vezes, se apresentar na forma de sintomas leves, como hiposmia e ageusia. A partir de revisão da literatura, neste artigo investigamos as repercussões neurológicas da infecção pelo vírus em que foram estudadas as consequências da Covid-19 no sistema nervoso central, a resposta inflamatória causada por sua presença e o estado de hipercoagulabilidade, bem como a forma pela qual se desencadeiam as complicações, desde uma cefaleia até uma encefalopatia ou acidente vascular cerebral.
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References
Wu YC, Chen CS, Chan YJ (2020) The outbreak of COVID-19: An overview. J Chin Med Assoc. 83(3):217-220. doi:10.1097/JCMA.0000000000000270
Li Z, Huang Y, Guo X (2020) The brain, another potential target organ, needs early protection from SARS-CoV-2 neuroinvasion. Sci China Life Sci. 63(5):771-773. doi:10.1007/s11427-020-1690-y
World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it. Published 2020. Accessed June 5, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it
Mao L, Jin H, Wang M, et al. (2020) Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 77(6):683-690. doi:10.1001/jamaneurol.2020.1127
Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology. 201187. doi:10.1148/radiol.2020201187
Hjelmesæth J, Skaare D (2020) Loss of smell or taste as the only symptom of COVID-19. Tidsskr Nor Laegeforen. 140(7). doi:10.4045/tidsskr.20.0287
Morassi M, Bagatto D, Cobelli M, et al. Stroke in patients with SARS-CoV-2 infection: case series. J Neurol. Published online May 2020:1-8. doi:10.1007/s00415-020-09885-2
Das G, Mukherjee N, Ghosh S (2020) Neurological Insights of COVID-19 Pandemic. ACS Chem Neurosci. 11(9):1206-1209. doi:10.1021/acschemneuro.0c00201
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ (2020) COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet (London, England). 395(10229):1033-1034. doi:10.1016/S0140-6736(20)30628-0
Zhang Y, Xiao M, Zhang S, et al. (2020) Coagulopathy and antiphospholipid antibodies in patients with covid-19. N Engl J Med. 382(17):E38. doi:10.1056/NEJMc2007575
Thachil J (2020) The versatile heparin in COVID-19 J Thromb Haemost. (April):1020-1022. doi:10.1111/jth.14821
Panigada M, Bottino N, Tagliabue P, et al. (2020) Hypercoagulability of COVID-19 patients in Intensive Care Unit. A Report of Thromboelastography Findings and other Parameters of Hemostasis. J Thromb Haemost. 00:1–5. doi:10.1111/jth.14850
Carod-Artal FJ (2020) Neurological complications of coronavirus and COVID-19. Rev Neurol. 70(9):311-322. doi:10.33588/RN.7009.2020179
Giacomelli A, Pezzati L, Conti F, et al. (2020) Self-reported Olfactory and Taste Disorders in Patients With Severe Acute Respiratory Coronavirus 2 Infection: A Cross-sectional Study. Clin Infect Dis. doi:10.1093/cid/ciaa330
Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. (2020) Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch oto-rhino-laryngology Off J Eur Fed Oto-Rhino-Laryngological Soc Affil with Ger Soc Oto-Rhino-Laryngology - Head Neck Surg. 6:1-11. doi:10.1007/s00405-020-05965-1
Moriguchi T, Harii N, Goto J, et al. (2020) A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 94:55-58. doi:10.1016/j.ijid.2020.03.062
Ahmad I, Rathore FA (2020) Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci Off J Neurosurg Soc Australas. 77:8-12. doi:10.1016/j.jocn.2020.05.017
Li YC, Bai WZ, Hashikawa T (2020) The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 92(6):552-555. doi:10.1002/jmv.25728
Lauer SA, Grantz KH, Bi Q, et al. (2020) The incubation period of coronavirus disease 2019 (CoVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med. 172(9):577-582. doi:10.7326/M20-0504
Reis PEO, Lima MCB, Reis PEO, Lima MCB (2020) Podemos atuar preventivamente para evitar que os pacientes portadores de COVID-19 evoluam de forma mais grave? J Vasc Bras. 19:3-5. doi:10.1590/1677-5449.200057
Desforges M, Le Coupanec A, Dubeau P, et al. (2019) Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System? Viruses. 12(1). doi:10.3390/v12010014
Hoffmann M, Kleine-Weber H, Schroeder S, et al. (2020) SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 181(2):271-280.e8. doi:10.1016/j.cell.2020.02.052
Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S (2008) Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 82(15):7264-7275. doi:10.1128/JVI.00737-08
Ng Kee Kwong KC, Mehta PR, Shukla G, Mehta AR (2020) COVID-19, SARS and MERS: A neurological perspective. J Clin Neurosci. 77:13-16. doi:10.1016/j.jocn.2020.04.124
Singhal T (2020) A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 87(4):281-286. doi:10.1007/s12098-020-03263-6
Rudler AH, Denneval C, Herson P. Nie X, Fan L, Mu G, et al. (2020) Epidemiological characteristics and incubation period of 7,015 confirmed cases with Coronavirus Disease 2019 outside Hubei Province in China. J Infect Dis. 222(1):26-33. 10.1093/infdis/jiaa211
Montalvan V, Lee J, Bueso T, De Toledo J, Rivas K (2020) Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review. Clin Neurol Neurosurg. 194:105921. doi:10.1016/j.clineuro.2020.105921
Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S (2020) Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA Neurol. doi:10.1001/jamaneurol.2020.2065
Cheng Q, Yang Y, Gao J (2020) Infectivity of human coronavirus in the brain. EBioMedicine. 56:102799. doi:10.1016/j.ebiom.2020.102799
Siegler JE, Heslin ME, Thau L, Smith A, Jovin TG (2020) Falling stroke rates during COVID-19 pandemic at a Comprehensive Stroke Center: Cover title: Falling stroke rates during COVID-19. J stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 29(8):104953. doi:10.1016/j.jstrokecerebrovasdis.2020.104953
Craen A, Logan G, Ganti L (2020) Novel Coronavirus Disease 2019 and Subarachnoid Hemorrhage: A Case Report. Cureus. 12(4):e7846. doi:10.7759/cureus.7846
Jain R, Young M, Dogra S, et al. (2020) COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome. J Neurol Sci. 414:116923. doi:10.1016/j.jns.2020.116923
Romero-Sánchez CM, Díaz-Maroto I, Fernández-Díaz E, et al. (2020) Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology. doi:10.1212/WNL.0000000000009937
Filatov A, Sharma P, Hindi F, Espinosa PS (2020) Neurological Complications of Coronavirus Disease (COVID-19): Encephalopathy. Cureus. 12(3):e7352. doi:10.7759/cureus.7352
Andrea A, Luana B, Silvia DM, Erika S, Massimo DS (2020) New clinical manifestation of COVID-19 related Guillain-Barrè syndrome highly responsive to intravenous immunoglobulins: two Italian cases. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. doi:10.1007/s10072-020-04484-5
Haddadi K, Ghasemian R, Shafizad M (2020) Basal Ganglia Involvement and Altered Mental Status: A Unique Neurological Manifestation of Coronavirus Disease 2019. Cureus. 12(4):e7869. doi:10.7759/cureus.7869
Goh Y, Beh DLL, Makmur A, Somani J, Chan ACY (2020) Pearls and Oy-sters: Facial nerve palsy as a neurological manifestation of Covid-19 infection. Neurology. doi:10.1212/WNL.0000000000009863
Ottaviani D, Boso F, Tranquillini E, et al. (2020) Early Guillain-Barré syndrome in coronavirus disease 2019 (COVID-19): a case report from an Italian COVID-hospital. Neurol Sci Off J Ital Neurol Soc Ital Soc Clin Neurophysiol. 41(6):1351-1354. doi:10.1007/s10072-020-04449-8
Beltrán-Corbellini Á, Chico-García JL, Martínez-Poles J, et al. (2020) Acute-onset smell and taste disorders in the context of COVID-19: a pilot multicentre polymerase chain reaction based case-control study. Eur J Neurol. 0:1-4. doi:10.1111/ene.14273
Hopkins C, Surda P, Whitehead E, Kumar BN (2020) Early recovery following new onset anosmia during the COVID-19 pandemic - an observational cohort study. J Otolaryngol - head neck Surg = Le J d’oto-rhino-laryngologie Chir cervico-faciale. 49(1):26. doi:10.1186/s40463-020-00423-8
Melley LE, Bress E, Polan E (2020) Hypogeusia as the initial presenting symptom of COVID-19. BMJ Case Rep. 13(5). doi:10.1136/bcr-2020-236080
Zanin L, Saraceno G, Panciani PP, et al. (2020) SARS-CoV-2 can induce brain and spine demyelinating lesions. Acta Neurochir (Wien). 162(7):1491-1494. doi:10.1007/s00701-020-04374-x
Al-Olama M, Rashid A, Garozzo D (2020) COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report. Acta Neurochir (Wien). 162(7):1495-1499. doi:10.1007/s00701-020-04402-w
Righi G, Del Popolo G (2020) COVID-19 tsunami: the first case of a spinal cord injury patient in Italy. Spinal cord Ser cases. 6(1):22. doi:10.1038/s41394-020-0274-9
Avula A, Nalleballe K, Narula N, et al. (2020) COVID-19 presenting as stroke. Brain Behav Immun. 87: 115–119. doi: 10.1016/j.bbi.2020.04.077
Juliao Caamaño DS, Alonso Beato R (2020) Facial diplegia, a possible atypical variant of Guillain-Barré Syndrome as a rare neurological complication of SARS-CoV-2. J Clin Neurosci Off J Neurosurg Soc Australas. 77:230-232. doi:10.1016/j.jocn.2020.05.016
Lascano AM, Epiney J-B, Coen M, et al. (2020) SARS-CoV-2 and Guillain-Barré syndrome: AIDP variant with favorable outcome. Eur J Neurol. doi:10.1111/ene.14368
Whittaker A, Anson M, Harky A (2020) Neurological Manifestations of COVID-19: A systematic review and current update. Acta Neurol Scand. 142(1): 14-22. doi:10.1111/ane.13266
Abboud H, Abboud FZ, Kharbouch H, Arkha Y, Abbadi N El, Ouahabi A El (2020) COVID-19 and SARS-Cov-2 Infection: Pathophysiology and Clinical Effects on the Nervous System. World Neurosurg. 140:49-53 . doi:10.1016/j.wneu.2020.05.193
Zhou Y, Li W, Wang D, et al. (2020) Clinical time course of COVID-19, its neurological manifestation and some thoughts on its management. Stroke Vasc Neurol. 5(2):177-179. doi:10.1136/svn-2020-000398
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