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Neurological complications of COVID-19

Dai et al., QJM: An International Journal of Medicine, doi:10.1093/qjmed/hcac272
Dec 2022  
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Review of the neurological complications of COVID-19 and their possible pathways and mechanisms. The main pathways of SARS-CoV-2 neuroinvasion include the olfactory nerve, gut-brain axis, vagus nerve, and hematogenous dissemination through disrupting the blood-brain barrier. Mechanisms of neurological damage include direct viral damage, cytokine storm, hypoxemia, and coagulation abnormalities. Authors discuss serious complications including ischemic and hemorrhagic stroke, encephalopathy, encephalitis, neurodegenerative diseases like Alzheimer's, and neuropsychiatric disorders. Authors also review potential methods for preventing neurological complications.
Dai et al., 9 Dec 2022, peer-reviewed, 8 authors. Contact: hmchyczsl@126.com.
This PaperMiscellaneousAll
Neurological complications of COVID-19
X Dai, X Cao, Q Jiang, B Wu, T Lou, Y Shao, Y Hu, Q Lan
QJM: An International Journal of Medicine, doi:10.1093/qjmed/hcac272
Corona Virus Disease 2019 (COVID-19) has caused several pandemic peaks worldwide due to its high variability and infectiousness, and COVID-19 has become a long-standing global public health problem. There is growing evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) frequently causes multi-organ injuries and more severe neurological manifestations. Therefore, increased awareness of possible neurological complications is beneficial in preventing and mitigating the impact of long-term sequelae and improving the prognostic outcome of critically ill patients with COVID-19. Here, we review the main pathways of SARS-CoV-2 neuroinvasion and the potential mechanisms causing neurological damage. We also discuss in detail neurological complications, aiming to provide cutting-edge basis for subsequent related basic research and clinical studies of diagnosis and treatment.
Author contributions Xingliang Dai (Conceptualization, Funding acquisition [
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There is growing evidence that severe acute ' 'respiratory syndrome coronavirus-2 (SARS-CoV-2) frequently causes multi-organ injuries and ' 'more severe neurological manifestations. Therefore, increased awareness of possible ' 'neurological complications is beneficial in preventing and mitigating the impact of long-term ' 'sequelae and improving the prognostic outcome of critically ill patients with COVID-19. Here, ' 'we review the main pathways of SARS-CoV-2 neuroinvasion and the potential mechanisms causing ' 'neurological damage. We also discuss in detail neurological complications, aiming to provide ' 'cutting-edge basis for subsequent related basic research and clinical studies of diagnosis ' 'and treatment.</jats:p>', 'DOI': '10.1093/qjmed/hcac272', 'type': 'journal-article', 'created': {'date-parts': [[2022, 12, 9]], 'date-time': '2022-12-09T14:33:56Z', 'timestamp': 1670596436000}, 'page': '161-180', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Neurological complications of COVID-19', 'prefix': '10.1093', 'volume': '116', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-0685-4766', 'authenticated-orcid': False, 'given': 'X', 'family': 'Dai', 'sequence': 'first', 'affiliation': [ { 'name': 'From the Department of Neurosurgery, The First Affiliated ' 'Hospital of Anhui Medical University , Hefei 230022, P. R. ' 'China'}]}, { 'given': 'X', 'family': 'Cao', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Clinical Medicine, The First Clinical College of ' 'Anhui Medical University , Hefei 230032, P. R. China'}]}, { 'given': 'Q', 'family': 'Jiang', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Clinical Medicine, The First Clinical College of ' 'Anhui Medical University , Hefei 230032, P. R. China'}]}, { 'given': 'B', 'family': 'Wu', 'sequence': 'additional', 'affiliation': [ { 'name': 'From the Department of Neurosurgery, The First Affiliated ' 'Hospital of Anhui Medical University , Hefei 230022, P. R. ' 'China'}]}, { 'given': 'T', 'family': 'Lou', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Clinical Medicine, The First Clinical College of ' 'Anhui Medical University , Hefei 230032, P. R. 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'year': '2021', 'journal-title': 'Clin Immunol'}, { 'key': '2023032720364652300_', 'first-page': '134', 'article-title': 'Cathepsin L plays a key role in SARS-CoV-2 infection in humans and ' 'humanized mice and is a promising target for new drug development', 'volume': '6', 'author': 'Zhao', 'year': '2021', 'journal-title': 'Signal Transduct Target Ther'}, { 'key': '2023032720364652300_', 'first-page': '202', 'article-title': 'Comparing COVID-19 vaccines for their characteristics, efficacy and ' 'effectiveness against SARS-CoV-2 and variants of concern: a narrative ' 'review', 'volume': '28', 'author': 'Fiolet', 'year': '2022', 'journal-title': 'Clin Microbiol Infect'}, { 'key': '2023032720364652300_', 'first-page': '1', 'article-title': 'COVID-19 vaccines: the status and perspectives in delivery points of ' 'view', 'volume': '170', 'author': 'Chung', 'year': '2021', 'journal-title': 'Adv Drug Deliv Rev'}, { 'key': '2023032720364652300_', 'first-page': '7020', 'article-title': 'The 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{ 'key': '2023032720364652300_', 'first-page': '1044', 'article-title': 'Hyperactivation of P2X7 receptors as a culprit of COVID-19 ' 'neuropathology', 'volume': '26', 'author': 'Ribeiro', 'year': '2021', 'journal-title': 'Mol Psychiatry'}, { 'key': '2023032720364652300_', 'first-page': '1344', 'article-title': 'Montelukast drug may improve COVID-19 prognosis: a review of evidence', 'volume': '11', 'author': 'Barre', 'year': '2020', 'journal-title': 'Front Pharmacol'}, { 'key': '2023032720364652300_', 'first-page': '173629', 'article-title': 'Can selective serotonin reuptake inhibitors have a neuroprotective ' 'effect during COVID-19?', 'volume': '889', 'author': 'Costa', 'year': '2020', 'journal-title': 'Eur J Pharmacol'}, { 'key': '2023032720364652300_', 'first-page': '194', 'article-title': 'Pathological sequelae of long-haul COVID', 'volume': '23', 'author': 'Mehandru', 'year': '2022', 'journal-title': 'Nat Immunol'}, {'key': '2023032720364652300_', 'author': 'World Health Organization (WHO)'}, {'key': '2023032720364652300_', 'author': 'World Health Organization (WHO)'}, { 'key': '2023032720364652300_', 'first-page': 'e2313', 'article-title': 'Covid-19 vaccines and variants of concern: a review', 'volume': '32', 'author': 'Hadj', 'year': '2022', 'journal-title': 'Rev Med Virol'}], 'container-title': 'QJM: An International Journal of Medicine', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://academic.oup.com/qjmed/advance-article-pdf/doi/10.1093/qjmed/hcac272/48479022/hcac272.pdf', 'content-type': 'application/pdf', 'content-version': 'am', 'intended-application': 'syndication'}, { 'URL': 'https://academic.oup.com/qjmed/article-pdf/116/3/161/49652026/hcac272.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'syndication'}, { 'URL': 'https://academic.oup.com/qjmed/article-pdf/116/3/161/49652026/hcac272.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 3, 27]], 'date-time': '2023-03-27T20:37:16Z', 'timestamp': 1679949436000}, 'score': 1, 'resource': {'primary': {'URL': 'https://academic.oup.com/qjmed/article/116/3/161/6885454'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 12, 9]]}, 'references-count': 262, 'journal-issue': { 'issue': '3', 'published-online': {'date-parts': [[2022, 12, 9]]}, 'published-print': {'date-parts': [[2023, 3, 27]]}}, 'URL': 'http://dx.doi.org/10.1093/qjmed/hcac272', 'relation': {}, 'ISSN': ['1460-2725', '1460-2393'], 'subject': ['General Medicine'], 'published-other': {'date-parts': [[2023, 3, 1]]}, 'published': {'date-parts': [[2022, 12, 9]]}}
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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