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Najdaghi S, Narimani Davani D, Hashemian M, Ebrahimi N. Cerebellitis following COVID-19 infection: A case-based systematic review and pooled analysis. Heliyon 2024; 10:e34497. [PMID: 39113976 PMCID: PMC11305223 DOI: 10.1016/j.heliyon.2024.e34497] [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: 03/26/2024] [Revised: 07/04/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Background The COVID-19 pandemic has been linked to neurological complications, including Cerebellitis. This study aims to investigate the clinical features, and consequences of Cerebellitis following COVID-19 infection, informing medical management strategies. Methods A systematic search was conducted through PubMed, Web of Science, Embase, ProQuest, and Cochrane databases from January 2018 to September 12, 2023, on cases post-COVID-19. Demographics, clinical characteristics, and diagnostic techniques were analyzed using descriptive statistics. Chi-Square tests assessed associations between diagnoses and treatments, with visualizations including heatmaps and scatter plots. Results After the final Screening, the analysis of 18 cases revealed Cerebellitis post-COVID-19 spanned 9 countries, predominantly from the USA (27.8 %), with a mean patient age of 40.1 years (±24.6). Males comprised 94.4 % of cases. Common underlying conditions included hypertension (22.2 %) and diabetes (11.1 %). Neurological symptoms presented on average 15.15 ± 12.7 days post-COVID-19 infection. A moderate negative correlation (r = -0.358) was observed between age and symptom onset. Blood and CSF biomarkers showed weak correlations with symptom onset intervals. Treatment efficacy varied, with most cases achieving symptom-free outcomes. The Chi-Square test for diagnosis-treatment associations yielded a p-value of 0.089, and for follow-up outcomes, a p-value of 0.283, indicating no significant statistical associations. Conclusion This systematic review highlights increased reports of Cerebellitis in males in their fourth decade of life, with the highest comorbidities being vascular diseases. Marker assessments show a decrease in CSF protein in half of patients, along with complete recovery following combination treatment with antivirals and steroids in acute Cerebellitis.
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Affiliation(s)
- Soroush Najdaghi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Delaram Narimani Davani
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Hashemian
- Department of Medical Librarianship and Information Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Ebrahimi
- Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Immunology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Burzyńska M, Uryga A, Kasprowicz M, Czosnyka M, Goździk W, Robba C. Cerebral Autoregulation, Cerebral Hemodynamics, and Injury Biomarkers, in Patients with COVID-19 Treated with Veno-Venous Extracorporeal Membrane Oxygenation. Neurocrit Care 2023; 39:425-435. [PMID: 36949359 PMCID: PMC10033181 DOI: 10.1007/s12028-023-01700-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/14/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND This study aimed to describe the cerebrovascular dynamics, in particular cerebral autoregulation (CA), and cerebral biomarkers as neuron-specific enolase (NSE) in patients with a diagnosis of coronavirus disease 2019 and acute respiratory distress syndrome as well as undergoing veno-venous extracorporeal membrane treatment. METHODS This was a single center, observational study conducted in the intensive care unit of the University Hospital in Wroclaw from October 2020 to February 2022. Transcranial Doppler recordings of the middle cerebral artery conducted for at least 20 min were performed. Cerebral autoregulation (CA) was estimated by using the mean velocity index (Mxa), calculated as the moving correlation coefficient between slow-wave oscillations in cerebral blood flow velocity and arterial blood pressure. Altered CA was defined as a positive Mxa. Blood samples for the measurement of NSE were obtained at the same time as transcranial Doppler measurements. RESULTS A total of 16 patients fulfilled the inclusion criteria and were enrolled in the study. The median age was 39 (34-56) years. Altered CA was found in 12 patients, and six out of seven patients who died had altered CA. A positive Mxa was a significant predictor of mortality, with a sensitivity of 85.7%. We found that three out of five patients with pathological changes in brain computed tomography and six out of ten patients with neurological complications had altered CA. NSE was a significant predictor of mortality (cutoff value: 28.9 µg/L); area under the curve = 0.83, p = 0.006), with a strong relationship between increased level of NSE and altered CA, χ2 = 6.24; p = 0.035; φ = 0.69. CONCLUSIONS Patients with coronavirus disease 2019-related acute respiratory distress syndrome, requiring veno-venous extracorporeal membrane treatment, are likely to have elevated NSE levels and altered CA. The CA was associated with NSE values in this group. This preliminary analysis suggests that advanced neuromonitoring and evaluation of biomarkers should be considered in this population.
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Affiliation(s)
- Małgorzata Burzyńska
- Department of Anaesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Uryga
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370, Wroclaw, Poland.
| | - Magdalena Kasprowicz
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370, Wroclaw, Poland
| | - Marek Czosnyka
- Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Institute of Electronic Systems, Faculty of Electronics and Information Technology, Warsaw University of Technology, Warsaw, Poland
| | - Waldemar Goździk
- Department of Anaesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland
| | - Chiara Robba
- IRCCS, Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV 16, Genoa, Italy
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Silva RC, da Rosa MM, Leão HI, Silva EDL, Ferreira NT, Albuquerque APB, Duarte GS, Siqueira AM, Pereira MC, Rêgo MJBM, Pitta MGR. Brain damage serum biomarkers induced by COVID-19 in patients from northeast Brazil. J Neurovirol 2023; 29:180-186. [PMID: 36719594 PMCID: PMC9888322 DOI: 10.1007/s13365-023-01119-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/15/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023]
Abstract
Neurological symptoms have been often reported in COVID-19 disease. In the present study, we evaluated brain damage associated with the increase of serum levels of neurological biomarkers S100B and neuron-specific enolase (NSE) induced by SARS-CoV-2 infection, in a population from Northeastern Brazil. Thirty-six healthy control (G1) individuals and 141 patients with confirmed COVID-19 were enrolled in this study. Positive-COVID-19 patients were divided into two groups according to the severity of illness by the National Institute of Health (NIH) criteria, 76 patients with mild symptoms for COVID-19 and (G2) and 65 with acute respiratory conditions requiring supplemental oxygenation via intensive care unit (ICU) admission (G3). A follow-up study was conducted with 23 patients from G2 14 (D14) and 21 (D21) days after the onset of symptoms. Serum levels of NSE and S100B were measured using the enzyme-linked immunoassay method (ELISA). Results revealed a significant positive association between G3 patients and S100B serum expression (p = 0.0403). The serum levels of NSE were also significantly enhanced in the G3 group compared to the control (p < 0.0001) and G2 group (p < 0.0001). In addition, clinical features such as symptoms and oxygenation status were not correlated with NSE or S100B serum expression. The follow-up study demonstrated a decrease over time (21 days) in NSE serum expression (p < 0.0001). These results suggest that brain damage is followed by acute virus exposure, with no long-term effects. Future work examining COVID-19 recovery will shed light on chronic neurological damage of SARS-CoV-2 infection.
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Affiliation(s)
- Ryan C Silva
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Michelle M da Rosa
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
- Biochemistry Department, Federal University of Pernambuco (UFPE), Recife, PE, Brazil.
| | - Heloísa I Leão
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Eduardo D L Silva
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Nathália T Ferreira
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Amanda P B Albuquerque
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Gisele S Duarte
- Instituto Nacional de Infectologia Evandro Chagas: INI - Fiocruz, Rio de Janeiro, Brazil
| | - André M Siqueira
- Instituto Nacional de Infectologia Evandro Chagas: INI - Fiocruz, Rio de Janeiro, Brazil
| | - Michelly C Pereira
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
- Physiology and Pharmacology Department, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Moacyr J B M Rêgo
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
- Biochemistry Department, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | - Maira G R Pitta
- Laboratory of Immunomodulation and New Therapeutic Approaches (LINAT), Research Center in Immunomodulation and New Therapeutic Approaches Suely Galdino (Nupit SG), Federal University of Pernambuco (UFPE), Recife, PE, Brazil
- Biochemistry Department, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
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Rentería I, García-Suárez PC, Moncada-Jiménez J, Machado-Parra JP, Antunes BM, Lira FS, Jiménez-Maldonado A. Unhealthy Dieting During the COVID-19 Pandemic: An Opinion Regarding the Harmful Effects on Brain Health. Front Nutr 2022; 9:876112. [PMID: 35571935 PMCID: PMC9097874 DOI: 10.3389/fnut.2022.876112] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Since 2020, the world has been suffering from a pandemic that has affected thousands of people regardless of socio-economic conditions, forcing the population to adopt different strategies to prevent and control the advance of the disease, one of which is social distancing. Even though social distancing is a safe strategy to reduce the spread of COVID-19, it is also the cause of a rising sedentary behavior. This behavior develops an excess of fat tissue that leads to metabolic and inflammatory disruption related to chronic diseases and mental health disorders, such as anxiety, depression, and sleep issues. Furthermore, the adoption of dietary patterns involving the consumption of ultra-processed foods, higher in fats and sugars, and the reduction of fresh and healthy foods may play a role in the progress of the disease. In this perspective, we will discuss how an unhealthy diet can affect brain function and, consequently, be a risk factor for mental health diseases.
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Affiliation(s)
- Iván Rentería
- Facultad de Deportes, Universidad Autónoma de Baja California, Ensenada, Mexico
| | - Patricia Concepción García-Suárez
- Facultad de Deportes, Universidad Autónoma de Baja California, Ensenada, Mexico
- Department of Health, Sports and Exercise Sciences, University of Kansas, Lawrence, KS, United States
| | - José Moncada-Jiménez
- Human Movement Sciences Research Center (CIMOHU), University of Costa Rica, San José, Costa Rica
| | | | | | - Fabio Santos Lira
- Exercise and Immunometabolism Research Group, Department of Physical Education, Paulista State University, UNESP, Presidente Prudente, São Paulo, Brazil
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Cione E, Siniscalchi A, Gangemi P, Cosco L, Colosimo M, Longhini F, Luciani F, De Sarro G, Berrino L, D’Agostino B, Gallelli L. Neuron-specific enolase serum levels in COVID-19 are related to the severity of lung injury. PLoS One 2021; 16:e0251819. [PMID: 34010310 PMCID: PMC8133450 DOI: 10.1371/journal.pone.0251819] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/03/2021] [Indexed: 12/29/2022] Open
Abstract
The multifunctional role of neuron-specific enolase (NSE) in lung diseases is well established. As the lungs are greatly affected in COVID-19, we evaluated serum NSE levels in COVID-19 patients with and without dyspnea. In this study, we evaluated both SARS-CoV-2-infected and uninfected patients aged >18 years who were referred to hospitals in Catanzaro, Italy from March 30 to July 30, 2020. Epidemiological, clinical, and radiological characteristics, treatment, and outcome data were recorded and reviewed by a trained team of physicians. In total, 323 patients (178 men, 55.1% and 145 women, 44.9%) were enrolled; of these, 128 were COVID-19 patients (39.6%) and 195 were control patients (60.4%). Westergren’s method was used to determine erythroid sedimentation rate. A chemiluminescence assay was used for measurement of interleukin-6, procalcitonin, C-reactive protein, and NSE. We detected significantly higher NSE values (P<0.05) in COVID-19 patients than in controls. Interestingly, within the COVID-19 group, we also observed a further significant increase in dyspnea (Dyspnea Scale and Exercise score: 8.2 ± 0.8; scores ranging from 0 to 10, with higher numbers indicating very severe shortness of breath). These data provide the background for further investigations into the potential role of NSE as a clinical marker of COVID-19 progression.
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Affiliation(s)
- Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences-Department of Excellence 2018-2020, University of Calabria, Rende, Cosenza, Italy
| | | | - Pietro Gangemi
- Operative Unit of Clinical Chemistry Laboratory, Pugliese Ciaccio Hospital, Catanzaro, Italy
| | - Lucio Cosco
- Department of Infectious Disease, Pugliese Ciaccio Hospital, Catanzaro, Italy
| | - Manuela Colosimo
- Department of Microbiology and Virology, Pugliese Ciaccio Hospital, Catanzaro, Italy
| | - Federico Longhini
- Department of Medical and Surgical Science, Operative Unit of Anesthesiology and Reanimation, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | - Filippo Luciani
- Department of Infectious Disease, Annunziata Hospital, Cosenza, Italy
| | - Giovambattista De Sarro
- Department of Health Science, School of Medicine, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, University of Catanzaro, Catanzaro, Italy
- Department of Health Science, School of Medicine, Research Center FA@UNICZ, University of Catanzaro, Catanzaro, Italy
| | | | - Liberato Berrino
- Department of Experimental Medicine L. Donatelli, Section of Pharmacology, School of Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Bruno D’Agostino
- Department of Experimental Medicine L. Donatelli, Section of Pharmacology, School of Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- * E-mail:
| | - Luca Gallelli
- Department of Health Science, School of Medicine, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, University of Catanzaro, Catanzaro, Italy
- Department of Health Science, School of Medicine, Research Center FA@UNICZ, University of Catanzaro, Catanzaro, Italy
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