A case of possible atypical demyelinating event of the central nervous system following COVID-19
•Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people.•Neurological presentation of COVID-19 infection categorized into two groups of symptoms of the central nervous system (CNS) and of the peripheral nervous system (PNS).•C...
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| Vydáno v: | Multiple sclerosis and related disorders Ročník 44; s. 102324 |
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Elsevier B.V
01.09.2020
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| Abstract | •Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people.•Neurological presentation of COVID-19 infection categorized into two groups of symptoms of the central nervous system (CNS) and of the peripheral nervous system (PNS).•Cytokine storm, a well-known immune reaction to this specific viral infection, can cause inflammation and central nervous system (CNS) tissue axonal or demyelinating damage.•Our patient had a central demyelinating brain injury following COVID-19 infection.
After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS. |
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| AbstractList | •Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people.•Neurological presentation of COVID-19 infection categorized into two groups of symptoms of the central nervous system (CNS) and of the peripheral nervous system (PNS).•Cytokine storm, a well-known immune reaction to this specific viral infection, can cause inflammation and central nervous system (CNS) tissue axonal or demyelinating damage.•Our patient had a central demyelinating brain injury following COVID-19 infection.
After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS. Highlights•Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people. •Neurological presentation of COVID-19 infection categorized into two groups of symptoms of the central nervous system (CNS) and of the peripheral nervous system (PNS). •Cytokine storm, a well-known immune reaction to this specific viral infection, can cause inflammation and central nervous system (CNS) tissue axonal or demyelinating damage. •Our patient had a central demyelinating brain injury following COVID-19 infection. After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS.After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS. After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS. • Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people. • Neurological presentation of COVID-19 infection categorized into two groups of symptoms of the central nervous system (CNS) and of the peripheral nervous system (PNS). • Cytokine storm, a well-known immune reaction to this specific viral infection, can cause inflammation and central nervous system (CNS) tissue axonal or demyelinating damage. • Our patient had a central demyelinating brain injury following COVID-19 infection. After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is now a major public health concern. Here we present a 21-year-old male with encephalomyelitis following intermittent vomiting and malaise for 4 days. He reported upper respiratory signs and symptoms 2 weeks before this presentation. Two cerebrospinal fluid (CSF) analyses were notable for mononuclear pleocytosis, elevated protein (more than 100 mg/dl), and hypoglycorrhachia. Brain Magnetic Resonance Imaging (MRI) showed bilateral posterior internal capsule lesions extending to the ventral portion of the pons and a marbled splenium hyperintensity pattern. Cervical and thoracic MRI showed longitudinally extensive transverse myelitis (LETM), none of which were enhanced with gadolinium. Both the AQP4 and MOG antibodies were negative. Spiral chest computed tomography (CT) scan confirmed to COVID-19 as did the high IgG level against coronavirus, but the oropharyngeal swabs were negative. Neurological manifestations of COVID-19 have not been adequately studied. Some COVID-19 patients, especially those suffering from a severe disease, are highly likely to have central nervous system (CNS) manifestations. Our case is a post-COVID-19 demyelinating event in the CNS. |
| ArticleNumber | 102324 |
| Author | Darazam, Ilad Alavi Ramezani, Mahtab Sahraian, Mohammad Ali Roozbeh, Mehrdad Zoghi, Anahita |
| Author_xml | – sequence: 1 givenname: Anahita surname: Zoghi fullname: Zoghi, Anahita organization: Assistant professor of Neurology, Skull Base research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 2 givenname: Mahtab orcidid: 0000-0002-1148-3998 surname: Ramezani fullname: Ramezani, Mahtab email: drramezani23@gmail.com organization: Assistant professor of Neurology, Skull Base research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 3 givenname: Mehrdad surname: Roozbeh fullname: Roozbeh, Mehrdad organization: Resident of Neurology, Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 4 givenname: Ilad Alavi surname: Darazam fullname: Darazam, Ilad Alavi organization: Assistant professor of Infectious disease, Infectious Diseases and Tropical Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran – sequence: 5 givenname: Mohammad Ali orcidid: 0000-0002-3224-8807 surname: Sahraian fullname: Sahraian, Mohammad Ali organization: Professor of Neurology, Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32615528$$D View this record in MEDLINE/PubMed |
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| License | Copyright © 2020 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
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| Snippet | •Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people.•Neurological presentation of... Highlights•Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people. •Neurological... After the novel coronavirus disease outbreak first began in Wuhan, China, in December 2019, the viral epidemic has quickly spread across the world, and it is... • Clinical awareness of physicians about neurological complications of COVID-19 decreases the mortality rate among infected people. • Neurological presentation... |
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| SubjectTerms | ADEM Adult Case Report COVID-19 COVID-19 - complications Demyelinating Diseases - diagnostic imaging Demyelinating Diseases - virology Demyelinating event Encephalomyelitis - diagnostic imaging Encephalomyelitis - virology Humans Lung - diagnostic imaging Male Neurology NMOSD Young Adult |
| Title | A case of possible atypical demyelinating event of the central nervous system following COVID-19 |
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