LitCovid-sentences  

PMC:7799377 / 6265-20962 JSONTXT 3 Projects

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Id Subject Object Predicate Lexical cue
T47 0-7 Sentence denotes Results
T48 8-241 Sentence denotes Far more is known and reported on neurological complications with SARS and MERS than for COVID-19 although the nature of the pandemic and the clinicians reporting from the front lines is rapidly generating a large body of literature.
T49 242-519 Sentence denotes In a systematic review that identified COVID-19 cases with neurological complications (n = 82), the mean age of the patient was 62.3 years, 37.8% were female, and 48.8% developed cerebrovascular insults, 28% neuromuscular disorders, and 23% encephalitis or encephalopathy [16].
T50 521-572 Sentence denotes Viral entry and potential neurological consequences
T51 573-834 Sentence denotes The viruses associated with both SARS and COVID-19 enter the brain via a process involving the angiotensin-converting enzyme (ACE)-2 receptors located in the CNS [17–19], unlike the MERS virus, which gains entry via the plasma membrane or in the endosomes [20].
T52 835-950 Sentence denotes ACE-2 receptors are expressed in many parts of the body and are particularly densely expressed in the nasal mucosa.
T53 951-1155 Sentence denotes Coronaviruses that enter the body via the nasal mucosa may disrupt the nasal endothelium, cross the epithelial barrier, and then directly enter the lymphatic or circulatory system, accessing the CNS [21].
T54 1156-1264 Sentence denotes The SARS-CoV has been detected in the brain, and it is thought entry occurred by way of the olfactory nerve.
T55 1265-1451 Sentence denotes Since there have been studies that located the SARS-CoV virus in the CNS but not the lung, it suggests that there is a direct pathway from the olfactory point of entry into the CNS [22].
T56 1452-1717 Sentence denotes Alternatively, a high viral load in the brain following a pulmonary infection might mean the virus entered the brain from the respiratory system; e.g., the vagus nerve links the respiratory system to the nucleus ambiguous and solitary tract nuclei of the brainstem.
T57 1718-1881 Sentence denotes It has been speculated that the cardiorespiratory center of the brain may be involved in the severe acute respiratory distress in some patients with COVID-19 [23].
T58 1882-2120 Sentence denotes The more common form of respiratory failure in COVID-19 patients is Type 1 (gas exchange dysfunction resulting in hypoxia and low levels of carbon dioxide), which is more likely to be associated with pneumonia than brain dysfunction [24].
T59 2121-2350 Sentence denotes Type 2 respiratory failure, which involves both hypoxia and high levels of carbon dioxide due to ventilatory failure would be more suggestive of neurological dysfunction, and this occurs less frequently in COVID-19 patients [25].
T60 2351-2571 Sentence denotes Any viral invader of the CNS creates stress within the body, because the host must balance its natural immune response to destroy the pathogen while, at the same time, minimizing damage to nearby nonrenewable cells [26].
T61 2572-2713 Sentence denotes Once in the CNS, viruses that affect neurons are far more dangerous than viruses that target the leptomeninges, which can restore themselves.
T62 2714-2851 Sentence denotes The CNS has a highly nuanced system of responses to viruses, which can cause considerable harm to the body should it become uncontrolled.
T63 2852-3066 Sentence denotes Coronaviruses such as the SARS-CoV-2 can enter the body via the nasal mucosa and may disrupt the nasal endothelium, cross the epithelial barrier, and then enter the CNS via the lymphatic or circulatory system [21].
T64 3067-3250 Sentence denotes The blood-brain barrier has a pore size of about 1 nm and coronaviruses are substantially larger [9], and this likely protects the brain from coronavirus invasion in many individuals.
T65 3251-3511 Sentence denotes However, neuroinvasive viruses can cross the blood-brain barrier by brain viremia, inflammatory processes (making microvascular endothelial cells vulnerable), or infecting leukocytes that then cross the blood-brain barrier in the manner of a Trojan horse [27].
T66 3512-3715 Sentence denotes The entry of the virus via the olfactory endothelium with transit of the virus across the cribriform plate would allow the virus to enter the brain by circumventing the blood-brain barrier entirely [27].
T67 3716-4074 Sentence denotes In theory at least, the coronavirus could invade the CNS using a passive mechanism such as hematogenous spread; in this case, the virus goes dormant and is carried toward the CNS, only to re-activate at some point to infect endothelial cells of the blood-brain barrier or infect leukocytes that then act as the reservoir for further viral dissemination [28].
T68 4075-4199 Sentence denotes The neurological symptoms associated with the H1N1 influenza virus had earlier been explained by an autoimmunity model [29].
T69 4200-4411 Sentence denotes The autoimmunity model of coronavirus infection of the CNS, likewise unproven, maintains that neural tissues and blood vessels perceive both viral and myelin antigens as the same because of autoreactive T-cells.
T70 4412-4492 Sentence denotes Autoimmunity would be limited to patients who were genetically predisposed [29].
T71 4493-4707 Sentence denotes The SARS-CoV-2 associated with COVID-19 belongs to the same clade of beta-coronaviruses as the MERS-CoV and the SARS-CoV viruses, although its homological sequence more closely resembles SARS-CoV than MERS-CoV [2].
T72 4708-4930 Sentence denotes The respiratory symptoms that occur in genetically related beta-coronaviruses, such as MERS-CoV and SARS-CoV are similar, two infections with which the global healthcare community has had years of clinical experience [30].
T73 4931-5077 Sentence denotes While it cannot be stated unequivocally that the neurological symptoms of these viral infections will be the same, it forms a good starting point.
T74 5079-5114 Sentence denotes Middle eastern respiratory syndrome
T75 5115-5268 Sentence denotes MERS was first identified in September 2012 in a 60-year-old man in Jeddah, Saudi Arabia, who presented with pneumonia complicated by renal failure [31].
T76 5269-5430 Sentence denotes Sporadic cases were reported outside of the Middle East up until 2015, when an outbreak in South Korea occurred with 186 confirmed infections and 38 deaths [32].
T77 5431-5572 Sentence denotes MERS has established associations with encephalomyelitis, vasculitis, Guillain-Barré syndrome (GBS), and encephalitis of the brain stem [21].
T78 5573-5726 Sentence denotes The clinical course of MERS ranges from asymptomatic cases (about 4%) to severe pneumonia with multiorgan involvement and negative patient outcomes [15].
T79 5727-5897 Sentence denotes While pulmonary, gastrointestinal, renal, and hematological complications have been reported in MERS patients, there are fewer reports of neurological complications [15].
T80 5898-5990 Sentence denotes In fact, the MERS-CoV virus has never been isolated from neural tissue in human beings [28].
T81 5991-6213 Sentence denotes In a study of 737 hospitalized MERS patients in South Korea, the most commonly reported symptoms were respiratory symptoms (13.6%), fever (11.1%), fatigue (11.1%), myalgia (9.2%), and gastrointestinal symptoms (7.5%) [32].
T82 6214-6350 Sentence denotes In a study of 23 MERS patients from South Korea, 17.4% experienced neurological symptoms either during or following MERS treatment [33].
T83 6351-6463 Sentence denotes These neurological complications occurred about two to three weeks after the onset of respiratory symptoms [33].
T84 6464-6586 Sentence denotes A study from Saudi Arabia (n = 70) reported that 24.7% of MERS patients experienced confusion and 8.6% had a seizure [34].
T85 6587-6688 Sentence denotes In this study, fever was present in 61.4% of patients, dyspnea occurred in 60%, an 54.3% had a cough.
T86 6689-6828 Sentence denotes MERS symptoms were typically severe with 70% of those hospitalized in this study requiring intensive care and 60% of this cohort died [34].
T87 6829-7006 Sentence denotes The literature reports a fatal case of a 34-year-old woman with diabetes hospitalized for MERS, who two weeks after diagnosis developed a headache with nausea and vomiting [15].
T88 7007-7249 Sentence denotes An urgent computed tomography scan showed right frontal lobe intracerebral hemorrhage with massive brain edema; laboratory findings showed disseminated intravascular coagulation, including thrombocytopenia and a prolonged coagulation profile.
T89 7250-7432 Sentence denotes In another case, a 28-year-old man was hospitalized in the intensive care unit for MERS complicated by bacterial pneumonia and had to be put on a ventilator for respiratory distress.
T90 7433-7561 Sentence denotes Unfortunately, after initial improvement, he reported weakness and tingling in his legs that made it impossible for him to walk.
T91 7562-7729 Sentence denotes Using neuroimaging scans, cerebrospinal fluid analysis, nerve conduction velocity studies, and spinal imaging, a diagnosis was made of critical-illness polyneuropathy.
T92 7730-7901 Sentence denotes He was treated with intravenous (IV) immunoglobulin 400 mg/kg daily for five days and was discharged in 40 days; gradual improvement was noted over the next 6 months [15].
T93 7903-7936 Sentence denotes Severe acute respiratory syndrome
T94 7937-8010 Sentence denotes SARS broke out in Hong Kong, Taiwan, Canada, and other locations in 2003.
T95 8011-8109 Sentence denotes It has been reported to be associated with encephalitis, ischemic stroke, and polyneuropathy [35].
T96 8110-8194 Sentence denotes Seizures have been mentioned as the first symptom of SARS-related encephalitis [36].
T97 8195-8334 Sentence denotes In a necropsy study of eight patients who died of SARS, there was evidence of SARS-CoV infection in the brain cortex and hypothalamus [37].
T98 8335-8472 Sentence denotes Particles from the SARS-CoV virus have been found in the brains of patients infected with SARS, most frequently in brain neurons [37–39].
T99 8473-8618 Sentence denotes Murine studies found that intranasal injections of both MERS-CoV and SARS-CoV could enter the brain, presumably via the olfactory nerves [40,41].
T100 8619-8758 Sentence denotes Among the areas of the brain infected, the brain stem was a primary, but not exclusive, target for both MERS-CoV [41] and SARS-CoV [40,42].
T101 8759-8826 Sentence denotes Neurological sequelae of SARS have been only sporadically reported.
T102 8827-9067 Sentence denotes Acute olfactory neuropathy has been reported in a case study of a 27-year-old female SARS patient who was diagnosed with SARS in 2003, hospitalized, and recovered with combination therapy of antiviral therapy (ribivarin plus steroids) [43].
T103 9068-9129 Sentence denotes Fever persisted for about three weeks from onset of symptoms.
T104 9130-9256 Sentence denotes She was discharged from the hospital at around the same time she reported the paroxysmal bilateral loss of her sense of smell.
T105 9257-9441 Sentence denotes An otolaryngologic examination, biochemistry tests, and subsequent magnetic resonance imaging scans showed nothing unusual with no lesions that might account for her loss of olfaction.
T106 9442-9535 Sentence denotes Now 2 years after her recovery from SARS, she still has not regained her sense of smell [43].
T107 9536-9747 Sentence denotes The common causes of anosmia include structural defects in the nasal cavity or sinuses, head injury, brain trauma, brain lesions, or drug-induced loss of olfaction, and in her case, these could all be ruled out.
T108 9748-9843 Sentence denotes It was postulated that her anosmia was a coronavirus-induced form of olfactory neuropathy [43].
T109 9844-9912 Sentence denotes Neuromuscular symptoms associated with SARS have also been reported.
T110 9913-10012 Sentence denotes A 51-year-old woman in Taiwan developed probable SARS shortly after her husband was diagnosed [44].
T111 10013-10191 Sentence denotes She was hospitalized and intubated and had no evidence of respiratory syncytial virus; however, a bone-marrow biopsy showed evidence of infection-related hemophagocytic syndrome.
T112 10192-10318 Sentence denotes Her condition gradually improved and she was extubated, but she complained of weakness, numbness, and paresthesia in her legs.
T113 10319-10509 Sentence denotes Ten days after extubation, a neurological examination showed good mental clarity with intact cranial nerves, but symmetric loss of muscle strength in her legs and mild weakness in the hands.
T114 10510-10687 Sentence denotes These conditions improved slowly and two months later, a neurological examination reported only mild loss of leg strength and slight numbness in the toes of her right foot [44].
T115 10688-10862 Sentence denotes A case report from Hong Kong describes a 59-year-old woman with severe SARS who developed status epilepticus; evidence of the virus was found in her cerebrospinal fluid [45].
T116 10863-11020 Sentence denotes Another case report describes a pregnant patient with SARS who experienced a generalized convulsion with suspected nervous system invasion by the virus [46].
T117 11021-11203 Sentence denotes The neurological manifestations observed in SARS include peripheral axonal neuropathy and elevated muscle enzymes, which might be caused by extensive virus-driven vasculitis [38,47].
T118 11204-11312 Sentence denotes These were considered to be polyneuropathic and/or myopathic symptoms associated with critical illness [47].
T119 11314-11322 Sentence denotes COVID-19
T120 11323-11441 Sentence denotes Neurological symptoms have been sporadically reported in COVID-19 patients but have not yet been well studied [48,49].
T121 11442-11566 Sentence denotes The current body of evidence suggests that the SARS-CoV-2 can affect the nervous system in previously unsuspected ways [50].
T122 11567-11660 Sentence denotes The neuroinvasive capabilities of the SARS-CoV-2 doubtless exist but remain to be elucidated.
T123 11661-11788 Sentence denotes Observed neurological symptoms of COVID-19 include febrile seizures, convulsions, mental status changes, and encephalitis [51].
T124 11789-11946 Sentence denotes Among the most commonly reported possibly neurological symptoms of COVID-19 are nonspecific symptoms, such as headache, myalgia, dizziness, and fatigue [21].
T125 11947-12100 Sentence denotes In a study at a single center in China (n = 214), 36.4% (n = 78) of hospitalized COVID-19 patients had what were identified as neurological symptoms[52].
T126 12101-12275 Sentence denotes In a multicenter retrospective study from Europe of 417 patients who recovered from mild to moderate COVID-19, 86% reported olfactory dysfunction and 88% problems with taste.
T127 12276-12375 Sentence denotes In fact, in 12% of patients, the loss of the sense of smell was the first symptom of COVID-19 [53].
T128 12376-12668 Sentence denotes The loss of smell has emerged as being more prevalent among patients infected with COVID-19 than patients infected with other viruses or with other types of respiratory conditions [54] and has been recommended as a symptom that may help guide earlier diagnosis and treatment of COVID-19 [55].
T129 12669-12797 Sentence denotes In a meta-analysis (n = 1,627 patients, 10 studies), a loss of the sense of smell was reported in 53% of COVID-19 patients [55].
T130 12798-12898 Sentence denotes It appears that the frequency of neurological symptoms is associated with COVID-19 disease severity.
T131 12899-13157 Sentence denotes In the aforementioned study of 214 hospitalized patients with COVID-19 infection (41% severe and 59% non-severe disease), severe patients were more likely than non-severe patients to have neurologically related manifestations (45.5% vs. 30.2%, respectively).
T132 13158-13421 Sentence denotes In this study, the most frequently reported neurological manifestations for severe and non-severe patients, respectively, were acute cerebrovascular disease (5.7% vs. 0.8%), impaired consciousness (14.8% vs. 2.4%) and skeletal muscle injury (19.3% vs. 4.8%) [52].
T133 13422-13544 Sentence denotes This does not take into account more diffuse symptoms, such as confusion or headache, which may also be neurological [51].
T134 13545-13633 Sentence denotes Most COVID-19 patients seem to exhibit pulmonary symptoms before neurological ones [49].
T135 13634-13860 Sentence denotes About a third of diagnosed COVID-19 patients have some form of symptomology of suspected neurological origin, which might include headache, dizziness, impaired consciousness, ataxia, epilepsy, and cerebrovascular disease [49].
T136 13861-14004 Sentence denotes Besides an impaired or absent sense of smell or taste, vision disturbances, neuralgia, and skeletal muscle damage have also been reported [49].
T137 14005-14208 Sentence denotes Nucleic acid from the SARS-CoV-2 virus has been detected in the cerebrospinal fluid of patients, and the virus itself has been identified in brain tissue on autopsy of patients who died of COVID-19 [49].
T138 14209-14288 Sentence denotes Such findings are rare but confirm that the SARS-CoV-2 virus can enter the CNS.
T139 14289-14518 Sentence denotes A 24-year-old Japanese man with COVID-19 presented with generalized epileptic seizures and decreased consciousness; RNA from the SARS-CoV-2 was not detectable in his nasopharynx but was identified in the cerebrospinal fluid [56].
T140 14519-14697 Sentence denotes Using a polymerase chain reaction (PCR) assay, the SARS-CoV-2 was likewise detected in the cerebrospinal fluid of an obese 40-year-old female COVID-19 patient with diabetes [57].