Acute and Long-Lasting Neurological Symptoms in SARS CoV-2 Infected Patients

There have been reported a large number of neurological symptoms in CoV-2 infected patients after the COVID-19 outbreak was declared in January 2020. Cases reports as well as series of COVID-19 patients have shown a wide variety of neurological symptoms such as stroke, encephalomyelitis, polyradiculoneuropathy and other neurological conditions. Despite the fact, a high incidence of neurological symptoms have been reported during the COVID-19 pandemic, the proportion of them in acute and in a more chronic phase has not been exactly described in most of the papers published until now. We described in this article the neurological symptoms in a series of COVID-19 patients during the acute phase of infection while they were admitted into the hospital and subsequently the persisting neurological symptoms showed in the following 6 months in the outpatients’ evaluation once they were discharged from the hospital in the province of Catalonia-Spain from January to June of 2020.

Extraskeletal symptoms and comorbidities of diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis(DISH) is a noninflammatory disease characterized by calcification and ossification of soft tissues, mainly enthesis and spinal ligaments. The clinical presentation primarily includes spinal involvement-induced pain and range of motion. Although rare, life-threatening gastrointestinal, respiratory or neurological events or severe morbidity due to bone compression on the adjacent structures may develop. There is a limited amount of data on DISHrelated events in the literature. In recent years, comorbid metabolic disorders are of great interest in patients with DISH. The early diagnosis of these conditions as well as rare entities allows an effective multidisciplinary approach for the treatment of DISH. In this article, we review extraskeletal symptoms and associated comorbidities in patients with DISH.

Alzheimer’s disease risk after COVID-19:a view from the perspective of the infectious hypothesis of neurodegeneration

In light of the rising evidence of the association between viral and bacterial infections and neurodegeneration,we aimed at revisiting the infectious hypothesis of Alzheimer’s disease and analyzing the possible implications of COVID-19 neurological sequelae in long-term neurodegeneration.We wondered how SARS-CoV-2 could be related to the amyloid-βcascade and how it could lead to the pathological hallmarks of the disease.We also predict a paradigm change in clinical medicine,which now has a great opportunity to conduct prospective surveillance of cognitive sequelae and progression to dementia in people who suffered severe infections together with other risk factors for Alzheimer’s disease.

Frequency and risk factors of psychological distress among individuals with epilepsy before and during the outbreak of the SARS-CoV-2 Omicron variant in China:an online questionnaire survey

Background The COVID-19 pandemic substantially increases the risk of severe psychological distress among people with epilepsy(PWE),especially those with monthly household income<5000 RMB or with uncontrolled seizures.Patients with Kessler scores>12 should consult a psychiatrist,especially during major disasters.This study was aimed to compare the frequency of psychological distress among Chinese PWE before and during the outbreak of the SARS-CoV-2 Omicron variant,and to identify risk factors for such distress.Methods In this prospective study,we collected sociodemographic data of PWE aged>14 years,who were treated at our center during December 1 to 15,2022.All participants completed the 6-item Kessler Psychological Distress Scale before the outbreak and again during the outbreak.Health visitors who were unrelated to those patients during the outbreak were included as a control.Multivariate logistic regression analysis was performed to identify risk factors of severe psychological distress and its exacerbation.Results Of the 223 PWE,127 were tested positive for SARS-CoV-2,while 174 of 218 controls were positive for SARS-CoV-2.The neurological symptoms were similar between PWE and controls with SARS-CoV-2.The average Kessler score of PWE was significantly higher during the outbreak than before it(9.93±3.98 vs.8.52±0.23,P<0.001).The average score of controls during the outbreak(5.146±0.35,P<0.001)was significantly lower than that of the PWE.We identified three independent predictors for severe psychological distress in PWE during the outbreak,i.e.,monthly household income<5000 RMB(OR=0.252,95%CI 0.064–0.998,P=0.048),severe psychological distress before the outbreak(OR=0.067,95%CI 0.026–0.174,P<0.001),and seizure onset within 30 days before the assessment during the outbreak(OR=0.356,95%CI 0.157–0.805,P=0.013).Of the three predictors,the last one was also an independent predictor for exacerbation of psychological distress during the outbreak(OR=0.302,95%CI 0.123–0.741,P=0.009).Conclusions Our analysis suggests that the COVID-19 pandemic has substantially increased psychological distress of individuals with epilepsy,regardless of the viral infection or not.Various neurological symptoms similar to those of“long COVID”appeared for the first time among these individuals during the Omicron outbreak,highlighting the need for clinicians to screen carefully for this condition.Management of epilepsy during the pandemic or a similar major disaster should focus on the control of seizures and maintenance of mental health,especially among those with monthly household incomes below 5000 RMB,suffering uncontrolled seizures and having a history of severe psychological distress.