LitCovid-sentences  

PMC:7799377 / 22780-37392 JSONTXT 3 Projects

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Id Subject Object Predicate Lexical cue
T153 0-45 Sentence denotes COVID-19 and specific neurological conditions
T154 46-188 Sentence denotes Neurological manifestations of COVID-19 may be mild and diffuse, such as headache and myalgia or severe, such as intracranial infections [50].
T155 189-311 Sentence denotes While severe neurological symptoms have been reported and are associated with worse outcomes, they appear to be rare [50].
T156 312-537 Sentence denotes It is important in this connection to note that COVID-19 may cause specific neurological symptoms, exacerbate preexisting neurological conditions, or unmask preexisting neurological conditions that had not yet been diagnosed.
T157 538-664 Sentence denotes Any number of infections can unmask an undiagnosed neurological condition, resulting in their overt emergence or exacerbation.
T158 665-830 Sentence denotes Thus, a portion of COVID-associated neurological and neuromuscular symptoms may be unmasked in the pandemic rather than directly caused by the SARS-CoV-2 virus [70].
T159 831-1424 Sentence denotes In a study from the United Kingdom of 43 patients with a confirmed COVID-19 diagnosis or where the diagnosis of COVID-19 was deemed ‘probable’ or ‘possible’ based on World Health Organization criteria, 10/43 patients had encephalopathy with delirium/psychosis and no abnormalities on magnetic resonance imaging or in cerebrospinal fluid, 12/43 exhibited inflammatory syndromes of the central nervous system, including encephalitis, 8/43 had ischemic stroke, 8/43 had peripheral neurological disorders (predominantly Guillain-Barré syndrome), and 5/43 with miscellaneous central disorders [71].
T160 1425-1520 Sentence denotes These neurological disorders were similar to those associated with other coronavirus epidemics.
T161 1521-1722 Sentence denotes An online network of rapid-response case report notifications in the United Kingdom was launched in April and collected 23 days of data in April 2020 about COVID-19 patients with neurological symptoms.
T162 1723-1788 Sentence denotes A total of 153 cases were reported that met clinical definitions.
T163 1789-2028 Sentence denotes The median patient age was 71 years (range 23–94, interquartile range 58–79) with 62% presenting with a cerebrovascular event, 74% with ischemic stroke, 12% with intracerebral hemorrhage, and 1% with central nervous system vasculitis [72].
T164 2029-2361 Sentence denotes In the ALBACOVID registry study of 841 hospitalized COVID-19 patients in Spain evaluated in March 2020, 57% had some neurological symptom(s), with myalgia, headache, and dizziness more likely to occur early in the diseases; neurological complication were the main cause of death in 4% of the decedents in this study population [73].
T165 2362-2556 Sentence denotes Patients with confirmed or suspected COVID-19 may have preexisting neurological conditions or be at elevated risk for them, for example, patients with atrial fibrillation are at risk for stroke.
T166 2557-2686 Sentence denotes Certain motor neuron diseases, such as amyotrophic lateral sclerosis, may put patients at elevated risk for infection in general.
T167 2687-2841 Sentence denotes Of particular concern are patients with muscular dystrophies associated with weakness of ventilator muscles or cardiomyopathy who are exposed to COVID-19.
T168 2842-2957 Sentence denotes In such cases, patients may recover from COVID-19 but not go back to their baseline neuromuscular functioning [70].
T169 2959-2973 Sentence denotes Encephalopathy
T170 2974-3168 Sentence denotes Encephalopathy, which often presents in infectious disease patients as delirium, is a brain disorder that causes acute or subacute dysfunction in terms of consciousness or altered mental states.
T171 3169-3322 Sentence denotes The elderly, people with cognitive deficits, and people with hypertension are elevated risk for developing an altered mental state with COVID-19 [52,74].
T172 3323-3475 Sentence denotes Cerebral edema, a dangerous condition which can cause elevated intracranial pressure and encephalopathy, has been identified in COVID-19 decedents [75].
T173 3476-3639 Sentence denotes Those with a history of neurological damage and acute respiratory distress are at elevated risk for developing encephalopathy as the initial COVID-19 symptom [76].
T174 3640-3788 Sentence denotes The risk becomes greater as the COVID-19 becomes more severe; altered consciousness occurs in 2.4% of mild and 15% of severe COVID-19 patients [52].
T175 3789-3899 Sentence denotes The risk for delirium, like the risk for worse outcomes with COVID-19, is also associated with older age [77].
T176 3900-4024 Sentence denotes The use of sedatives, which is common in critically ill patients, may also be associated with the risk for delirium [78,79].
T177 4025-4288 Sentence denotes Social distancing mandated for COVID-19 may actually contribute to the rate of delirium of certain COVID-19 patients, who may feel desperate and panicked as they are isolated, separated from family, alone, and/or denied religious support from a clergyperson [77].
T178 4289-4609 Sentence denotes Delirium in hospitalized COVID-19 patients may be the result of direct CNS invasion, induction of CNS inflammatory mediators, a secondary effect of other organ system failures, the effect of sedation, the result of prolonged mechanical ventilation, a psychological manifestation, or caused by environmental factors [77].
T179 4610-4876 Sentence denotes In cases of COVID-19, it is thought that delirium caused by direct invasion of the virus into the CNS is relatively rare, but possible, and would likely be accompanied by seizures, altered states of consciousness, or signs of increased intracranial pressure [39,46].
T180 4877-4977 Sentence denotes The rates and presentation of encephalopathy and delirium in COVID-19 patients has not been studied.
T181 4978-5167 Sentence denotes Delirium in COVID-19 patients may be under-reported to date, indeed delirium is thought to be widely under-reported for various conditions unless it is being specifically monitored [79–82].
T182 5168-5246 Sentence denotes Case studies of COVID-19-associated delirium appear in the literature [83,84].
T183 5247-5371 Sentence denotes Acute necrotizing encephalopathy, although relatively rare, has also been diagnosed in a hospitalized COVID-19 patient [85].
T184 5372-5551 Sentence denotes Overall, ICU patients on mechanical ventilation have rates of delirium as high as 70% to 75%, and delirium is associated with mortality and long-term cognitive impairment [86–88].
T185 5552-5685 Sentence denotes The causes of COVID-19-associated encephalopathy may involve multiple factors, including metabolic causes, hypoxia, and drug therapy.
T186 5686-5779 Sentence denotes Symptomatic treatment involves antipyretics, anticonvulsants, and treatment for hypoxia [21].
T187 5780-5939 Sentence denotes Early signs of delirium in COVID-19 patients might suggest CNS involvement and, as such, might indicate heightened risk for impending respiratory failure [77].
T188 5940-6185 Sentence denotes In a study of 27 pediatric COVID-19 patients with multisystem inflammatory syndrome, 15% (n = 4) exhibited new-onset neurological symptoms, such as encephalopathy, headaches, brainstem, and cerebellar signs, weak muscles, and poor reflexes [89].
T189 6186-6376 Sentence denotes Cerebrospinal fluid testing in two patients were acellular; three patients underwent nerve conduction and electromyographical studies, which revealed mild myopathic and neuropathic deficits.
T190 6377-6476 Sentence denotes All four patients improved, two of whom made a complete recovery over the course of the study [89].
T191 6478-6507 Sentence denotes Guillain-Barré syndrome (GBS)
T192 6508-6588 Sentence denotes GBS typically involves demyelination and presents in both upper and lower limbs.
T193 6589-6767 Sentence denotes While there is no clear evidence to date associating the SARS-CoV-2 virus with GBS, other viral infections, such as influenza and the Epstein-Barr virus, have been linked to GBS.
T194 6768-6937 Sentence denotes The association is based on the idea that there can be molecular mimicry between certain viral proteins and the gangliosides and other proteins on the peripheral nerves.
T195 6938-7051 Sentence denotes This can result in an ‘innocent bystander attack’ against the myelin sheath or axon of the peripheral nerve [70].
T196 7052-7247 Sentence denotes GBS is a complex disorder and has been recognized as a para-infectious neurological disease, and has associations with the Zika virus that were documented during the 2015–2016 Zika epidemic [90].
T197 7248-7317 Sentence denotes It is not known if the coronavirus can damage peripheral nerves [44].
T198 7318-7670 Sentence denotes The literature reports on several cases that suggest a link between COVID-19 and GBS [91–94], for example, the case of a 62-year-old COVID patient with GBS; however it is unclear if this patient, who had comorbid lymphopenia and thrombocytopenia, developed GBS and COVID-19 independently but concurrently, or if COVID-19 might have caused the GBS [95].
T199 7671-7794 Sentence denotes It must likewise be considered that COVID-19-associated neurological manifestations may emerge after the initial infection.
T200 7795-7913 Sentence denotes Thus, while there is currently no evidence that COVID-19 can cause GBS, it is an area worthy of further investigation.
T201 7914-8143 Sentence denotes It should be noted in this context that clinicians may sometimes observe peripheral neuropathies, for example based around the ulna, that have to do with prolonged intubation periods in a position that impinges the cubital canal.
T202 8145-8181 Sentence denotes Myopathy and neuromuscular disorders
T203 8182-8379 Sentence denotes Myalgia and fatigue are common symptoms of COVID-19 and a study of COVID-19 patients found 44% to 70% of hospitalized patients had these symptoms and 33% had increased creatine kinase (CK) [10,96].
T204 8380-8607 Sentence denotes However, the nature of the rapid outbreak and spread of the virus did not allow for thorough workup of such COVID-19 patients that might have included electromyography testing, muscle imaging, or histopathological examinations.
T205 8608-8718 Sentence denotes Myalgia occurred in about a third of SARS patients [97], and rhabdomyolysis has been observed as well [47,98].
T206 8720-8732 Sentence denotes Encephalitis
T207 8733-8810 Sentence denotes Encephalitis or inflammation of the brain may be caused by a viral infection.
T208 8811-8923 Sentence denotes The symptoms of encephalitis include fever, headache, seizures, altered consciousness, and behavioral disorders.
T209 8924-9064 Sentence denotes A case report from China describes encephalitis in a male patient with COVID-19 with no traces of the SARS-CoV-2 in his cerebrospinal fluid.
T210 9065-9211 Sentence denotes His main symptom was altered consciousness but the condition was self-limiting and the patient recovered from both COVID-19 and encephalitis [99].
T211 9212-9333 Sentence denotes Although unusual, patients with COVID-19 may present with encephalitis rather than the typical respiratory symptoms [57].
T212 9334-9399 Sentence denotes COVID-19 patients with encephalitis may also experience seizures.
T213 9400-9511 Sentence denotes In particular, it is important to note that nonconvulsive status epilepticus (NCSE) may occur in such patients.
T214 9512-9704 Sentence denotes The Salzburg Consensus Criteria for Nonconvulsive Status Epilepticus was published in 2015 and provides terminology definitions and identified specific EEG tracings associated with NCSE [100].
T215 9705-9856 Sentence denotes NCSE may be evident on electroencephalography (EEG), so that continuous EEG monitoring may be appropriate for critically ill patients in general [101].
T216 9857-9926 Sentence denotes In comatose patients, NCSE has a prevalence between 5% and 48% [102].
T217 9927-9989 Sentence denotes Its prevalence specifically in COVID-19 patients is not known.
T218 9991-10009 Sentence denotes Cephalgia/headache
T219 10010-10202 Sentence denotes Early reports out of Wuhan described headache and decreased responsiveness of patients as an early indicator of potential neurologic involvement associated with the SARS-CoV-2 infection [103].
T220 10203-10286 Sentence denotes Headaches have been reported in 11% to 34% of hospitalized COVID-19 patients [104].
T221 10287-10433 Sentence denotes Among COVID-19 patients who developed symptoms, the incidence of headache is 6% to 10% and headache was often among the presenting symptoms [104].
T222 10434-10611 Sentence denotes Initial reports of the so-called ‘COVID-19 headache’ describe bilateral cephalgia characterized by pulsating pain in the temporoparietal region, forehead, or periorbital region.
T223 10612-10726 Sentence denotes Such headaches were limited to active periods of the COVID-19 infection and resisted conventional analgesia [104].
T224 10727-10881 Sentence denotes While it is plausible that these headaches relate to the viral invasion, they may also be a byproduct of cytokine storm or have some other etiology [105].
T225 10883-10920 Sentence denotes Critical-illness polyneuropathy (CIP)
T226 10921-11008 Sentence denotes Acute neuropathy or CIP may develop in patients suffering a number of severe illnesses.
T227 11009-11076 Sentence denotes CIP typically remits as the patient recovers from the illness [44].
T228 11077-11346 Sentence denotes Signs and symptoms of CIP include reduced compound muscle action potentials amplitude, abnormal spontaneous unilateral activities in the diaphragmatic needle electromyography evaluation, abnormal F responses, and an abnormal H reflex on electrodiagnostic studies [106].
T229 11347-11483 Sentence denotes The pathogenesis of CIP is not well elucidated and may involve a systemic inflammatory response to sepsis that damages the nerves [107].
T230 11484-11536 Sentence denotes Its prevalence among COVID-19 patients is not known.
T231 11538-11564 Sentence denotes Cerebrovascular conditions
T232 11565-11654 Sentence denotes Vascular comorbidities seem to pose a risk factor for worse outcomes with COVID-19 [108].
T233 11655-11738 Sentence denotes Stroke is emerging as an increasingly important adverse event in COVID-19 patients.
T234 11739-12065 Sentence denotes From a retrospective single-center study in China (n = 221), risk factors for stroke in COVID-19 patients appear to be: older age, more severe COVID-19, history of hypertension, diabetes, cerebrovascular diseases, and any marked inflammatory or pro-coagulant response, such as a high C-reactive protein or D-dimer level [108].
T235 12066-12156 Sentence denotes Cerebrovascular conditions may present as neurological symptoms in COVID-19 patients [21].
T236 12158-12205 Sentence denotes Parkinson’s disease (PD) and movement disorders
T237 12206-12389 Sentence denotes The etiology of PD likely involves the interplay of genetic and environmental factors, but viruses have been implicated in causing parkinsonism and other movement disorders [109,110].
T238 12390-12737 Sentence denotes In a study using the cerebrospinal fluid of 67 patients (20 with PD, 29 without PD but with another neurological disorder, and 18 healthy controls), the PD patients had a significantly higher mean cerebrospinal fluid antibody response to two specific coronaviruses (MHV-JHM and MHV-A59) than controls or patients with other neurological disorders.
T239 12738-12854 Sentence denotes It was theorized that some strain of coronavirus might contribute over the long term to the development of PD [110].
T240 12855-13084 Sentence denotes This may relate to the epidemiological observation that people who live on farms or grow up in farming communities have a higher risk of developing PD than others, possible due to zoonotic transmission of coronaviruses [111,112].
T241 13085-13255 Sentence denotes There is no compelling evidence to suggest that patients with PD are more likely to contract COVID-19 or that they are at elevated risk for worse COVID-19 outcomes [113].
T242 13256-13420 Sentence denotes However, PD is associated with decreased respiratory function, which might contribute to respiratory distress in any number of infections, including COVID-19 [114].
T243 13421-13638 Sentence denotes Furthermore, PD is comorbid with a number of disorders, including cerebrovascular disease, heart failure, and coronary artery disease, any of which would elevate risk of worse outcomes if COVID-19 was contracted [22].
T244 13640-13660 Sentence denotes Pulmonary conditions
T245 13661-13881 Sentence denotes It has been postulated that the neuroinvasion of the brain’s medulla oblongata region by the SARS-CoV-2 virus might impair cardiorespiratory control centers and, in that way, lead to respiratory distress and failure [4].
T246 13882-14009 Sentence denotes The literature reports a COVID-19 patient who lost the involuntary process of breathing and suffered respiratory failure [115].
T247 14010-14151 Sentence denotes ACE-2 receptors are expressed abundantly in the body, even in the brain, and particularly in the brain stem which controls respiration [116].
T248 14152-14304 Sentence denotes In the event that the SARS-CoV-2 virus might enter the microcirculatory system of the brain, it may access ACE-2 receptors in the capillary endothelium.
T249 14305-14434 Sentence denotes In such a situation, the virus can cause damage to the endothelium itself, enter the brain, and cause neuronal destruction [116].
T250 14435-14612 Sentence denotes Better understanding is urgently needed to elucidate the role of the SARS-CoV-2 virus in the brain and to risk-stratify patients who may be suffering COVID-related brain damage.