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Inoue K, Aoki H, Toru S, Hatano Y, Imase R, Takasaki H, Tanaka M, Adachi S, Yokote H, Akiyama H, Yamane M. Early-onset herpes simplex encephalitis type 1 triggered by COVID-19 disease: A case report. Radiol Case Rep 2024; 19:855-858. [PMID: 38188949 PMCID: PMC10770472 DOI: 10.1016/j.radcr.2023.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 01/09/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) causes a systemic inflammatory response and a temporary immunosuppression of hosts. Several reports have showed that reactivation of herpes simplex virus type 1 (HSV-1) is strongly associated with COVID-19. We present a case of a 66-year-old female, who developed HSV-1 encephalitis, showing impaired consciousness and typical MRI findings such as hyperintense lesions in the temporal lobe, insular cortices, bilateral medial frontal lobe on diffusion-weighted imaging, 7 days after the onset of COVID-19 symptoms. The number of cases of encephalitis in patients with COVID-19 is increasing. However, there has been limited reports of HSV-1 encephalitis following COVID-19, especially for cases with an interval of 7 days or less from the onset of COVID-19 symptoms to the onset of HSV-1 encephalitis. Our case highlights the importance of considering HSV-1 encephalitis in the differential when managing a patient with COVID-19-associated neurologic complications, even if it is in the early stages of COVID-19.
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Affiliation(s)
- Kai Inoue
- Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Hanako Aoki
- Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Shuta Toru
- Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Yu Hatano
- Department of Internal Medicine, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Reina Imase
- Department of Internal Medicine, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Hiroshi Takasaki
- Department of Internal Medicine, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Michiko Tanaka
- Department of Internal Medicine, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Saori Adachi
- Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Hiroaki Yokote
- Department of Neurology, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Hideki Akiyama
- Department of Internal Medicine, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
| | - Michio Yamane
- Department of Internal Medicine, Nitobe Memorial Nakano General Hospital, Nakano-ku, Tokyo, Japan
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Abdoli A, Taghipour A, Jahromi MAM, Eftekharian F, Sahraei R, Sanie MS. Latent viral infections as neglected risk factors for long COVID. Lancet Glob Health 2024; 12:e197. [PMID: 38245109 DOI: 10.1016/s2214-109x(24)00010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Affiliation(s)
- Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran; Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran; Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mirza Ali Mofazzal Jahromi
- Department of Immunology, Jahrom University of Medical Sciences, Jahrom, Iran; Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fatemeh Eftekharian
- Department of Internal Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Reza Sahraei
- Department of Anesthesia and Intensive Care, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Mohammad Sadegh Sanie
- Department of Anesthesia and Intensive Care, Jahrom University of Medical Sciences, Jahrom, Iran
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3
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Maezawa M, Ochi J, Kubota N, Kamoshida T, Fuji M, Tsukada Y. Herpes Simplex Virus Encephalitis after Recovery from Coronavirus Disease 2019: A Rare Case Report. Intern Med 2023; 62:3515-3518. [PMID: 37779075 PMCID: PMC10749812 DOI: 10.2169/internalmedicine.1790-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/30/2023] [Indexed: 10/03/2023] Open
Abstract
An 85-year-old woman was diagnosed with coronavirus disease 2019 (COVID-19). The patient was treated with dexamethasone, and the infection was cured. She later developed a low-grade fever and fell unconscious. Positivity for herpes simplex virus deoxyribonucleic acid polymerase chain reaction (HSV-DNA PCR) was detected in the cerebrospinal fluid, so she was diagnosed with HSV encephalitis. The patient was treated with antiviral drugs and recovered from the HSV encephalitis. This case suggests that, in patients with COVID-19 and disorders of consciousness, the possibility of HSV encephalitis should be considered along with COVID-19 encephalitis.
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Affiliation(s)
- Mari Maezawa
- Department of Pulmology, Soka Municipal Hospital, Japan
| | - Junichi Ochi
- Department of Pulmology, Soka Municipal Hospital, Japan
| | | | | | - Mayumi Fuji
- Department of Pulmology, Soka Municipal Hospital, Japan
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Zhang B, Tsai YW, Wu JY, Liu TH, Chuang MH, Hsu WH, Huang PY, Lai CC. Risk of cytomegalovirus diseases among coronavirus disease survivors: A retrospective cohort study. J Med Virol 2023; 95:e29096. [PMID: 37705228 DOI: 10.1002/jmv.29096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/16/2023] [Accepted: 09/01/2023] [Indexed: 09/15/2023]
Abstract
This study was aimed at investigating the risk of cytomegalovirus (CMV) disease among coronavirus disease 2019 (COVID-19) survivors. In this retrospective cohort study, we used the TriNetX research network to identify adults with and without COVID-19 between January 1, 2022 and December 31, 2022. Propensity score matching was used to match the patients with and without COVID-19. The primary outcome was the risk of CMV disease during the 90-day follow-up period. Two matched cohorts comprising 2 501 634 patients with balanced baseline characteristics were created using propensity score matching. During the follow-up period, patients with COVID-19 had a higher risk of CMV disease than those without COVID-19 (hazard ratio [HR], 2.55; 95% confidence interval: 2.01-3.23). The higher risk of CMV disease in the COVID-19 cohort compared with that of the non-COVID-19 cohort remained unchanged in the subgroup analyses by sex (men: HR, 1.85 [1.38-2.47]; women: HR, 2.31 [1.63-3.27]), age (18-64 years: HR, 2.21 [1.71-2.85]; ≥65 years: HR, 1.97 [1.20-3.25]), obesity (HR, 1.54 [1.04-2.30]), diabetes mellitus (HR, 1.50 [1.08-2.08]), cancer (HR, 3.10 [1.95-4.92]), glucocorticoid use (HR, 3.14 [2.45-4.02]), transplantation (HR, 1.38 [1.08-1.77]), and unvaccinated status (HR, 2.37 [1.82-3.08]). In conclusion, COVID-19 can increase the risk of CMV disease. Clinicians should be aware of the risk of CMV disease in patients with COVID-19.
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Affiliation(s)
- Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Ya-Wen Tsai
- Center for Integrative Medicine, Chi Mei Medical Center, Tainan City, Taiwan
- Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Min-Hsiang Chuang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Wan-Hsuan Hsu
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
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Cao S, Bao M, Wang R, Xia M. Secondary progressive COVID-19-associated extensive leukoencephalopathy. Acta Neurol Belg 2023:10.1007/s13760-023-02323-w. [PMID: 37402090 DOI: 10.1007/s13760-023-02323-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Shugang Cao
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, China
| | - Minqiang Bao
- Department of Neurology, Xuancheng People's Hospital, The Affiliated Xuancheng Hospital of Wannan Medical College, Xuancheng, 242000, China
| | - Rongfeng Wang
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, China
| | - Mingwu Xia
- Department of Neurology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, China.
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Haddad M, Sheybani F, Olfati N, Nahayati MA, Boostani R, Layegh P, Rashid-Nejad A. Central nervous system reactivation of herpesviridae family in patients with COVID-19. J Neurovirol 2023; 29:211-217. [PMID: 37097596 PMCID: PMC10127951 DOI: 10.1007/s13365-023-01132-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/05/2023] [Accepted: 03/28/2023] [Indexed: 04/26/2023]
Abstract
The objective of this study is to describe our COVID-19 patients with herpesviridae reactivation in the central nervous system (CNS). Four patients were described including two with acute encephalitis and two with acute encephalomyelitis. Three of four patients had abnormal findings on neuroimaging studies. One of four patients died, one survived with major neurological sequelae, and two others fully recovered. Herpesviridae reactivation in the CNS in patients with COVID-19 is a rare but serious coincidence. The optimal therapeutic management has not been investigated and until more information is available, it is prudent to treat these patients with appropriate antivirals with or without anti-inflammatory agents.
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Affiliation(s)
- Mahboubeh Haddad
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshte Sheybani
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Nahid Olfati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Ali Nahayati
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Boostani
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvaneh Layegh
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azra Rashid-Nejad
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Carneiro VCDS, Pereira JG, de Paula VS. Family Herpesviridae and neuroinfections: current status and research in progress. Mem Inst Oswaldo Cruz 2022; 117:e220200. [PMID: 36417627 PMCID: PMC9677594 DOI: 10.1590/0074-02760220200] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Abstract
This article addresses the relationship between human herpesviruses (HHVs) and neuroinfections. Alphaherpesviruses, betaherpesviruses and gammaherpesviruses are neurotropic viruses that establish latency and exhibit reactivation capacity. Encephalitis and meningitis are common in cases of HHV. The condition promoted by HHV infection is a purported trigger for certain neurodegenerative diseases. Ongoing studies have identified an association between HSV-1 and the occurrence of Alzheimer's disease, multiple sclerosis and infections by HHV-6 and Epstein-Barr virus. In this review, we highlight the importance of research investigating the role of herpesviruses in the pathogenesis of diseases that affect the nervous system and describe other studies in progress.
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Affiliation(s)
| | | | - Vanessa Salete de Paula
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Virologia Molecular, Rio de Janeiro, RJ, Brasil,+ Corresponding author:
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Abstract
Persistent neurological and neuropsychiatric symptoms affect a substantial fraction of people after COVID-19 and represent a major component of the post-acute COVID-19 syndrome, also known as long COVID. Here, we review what is understood about the pathobiology of post-acute COVID-19 impact on the CNS and discuss possible neurobiological underpinnings of the cognitive symptoms affecting COVID-19 survivors. We propose the chief mechanisms that may contribute to this emerging neurological health crisis.
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Affiliation(s)
- Michelle Monje
- Department of Neurology, Stanford University, Stanford, CA 94305, USA; Howard Hughes Medical Institute, Stanford University, USA.
| | - Akiko Iwasaki
- Department of Immunobiology, Yale University, New Haven, CT 06520, USA; Howard Hughes Medical Institute, Yale University, USA.
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Guedes BF. NeuroCOVID-19: a critical review. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:281-289. [PMID: 35976326 PMCID: PMC9491425 DOI: 10.1590/0004-282x-anp-2022-s136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has challenged neurologists since its early days. Neurology consultation services were then overloaded by emergency department and intensive-care patients with acute neurological syndromes. These complications are better explained today, but the growing number of patients with reported longstanding neurological symptoms constitute an emerging, complex, and still poorly understood phenomenon. OBJECTIVE This review summarizes data on relevant neurological manifestations of acute SARS-CoV-2 infection and lasting post-infectious disease, also known as Long COVID. The complex history of Long COVID is examined to illustrate the upsides and challenges imposed by the active participation of patient communities in the production of medical knowledge. METHODS Narrative review. RESULTS Infection with the severe acute respiratory syndrome coronavirus 2 is associated with encephalopathy/delirium, cerebrovascular disease, headache, and peripheral nervous system involvement. Long COVID is a living concept jointly defined by patient communities, physicians and scientists, including neurologists. CONCLUSION Co-production of Long COVID knowledge between scientists and patients has initiated an era of patient-led research and evidence-based activism that acts as a two-edged sword - putting patient's suffering in the spotlight, but with a tradeoff in methodological consistency.
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Affiliation(s)
- Bruno Fukelmann Guedes
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo, SP, Brazil
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