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Selected articles assessing relationship between Parkinson's disease and COVID-19 infection severity.
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Background
Pre-existing neurological diseases have been identified as risk factors for severe COVID-19 infection and death. There is a lack of comprehensive literature review assessing the relationship between pre-existing neurological conditions and COVID-19 outcomes. Identification of high risk groups is critical for optimal treatment and care....
Context in source publication
Context 1
... systematic reviews assessed the impact of PD on COVID-19 severity across 279,934 patients with PD (Table 5) [29][30][31][32][33]. Across several of these reviews it was found that the risk of severe COVID-19 in Table 4 Selected articles assessing relationship between epilepsy and COVID-19 infection severity. [29][30][31]. ...Similar publications
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Citations
... 4 Importantly, children with complex medical conditions, particularly those with pre-existing neurologic disease, may have a higher risk of neurologic complications 10 and more severe disease. 6,11,12 Definitions of SARS-CoV-2-related neurologic complications lack consensus, with a wide range of symptoms included in surveillance studies. 4,10,13 Neurologic manifestations range from nonspecific symptoms, 14 including headache, anosmia and fatigue, 15 accounting for more than 90% of patients with neurologic involvement, 1 to seizures, encephalitis and cerebral edema. ...
... Among nonfebrile seizure patients admitted to ICU, 57% had chronic underlying neurologic conditions, a known risk. 4,11,12,26 Additionally, children with underlying neurologic disorders had significantly greater odds of any neurologic complication, underscoring the added burden in this vulnerable group. This finding highlights the need for increased awareness and monitoring of children with pre-existing neurologic complications presenting with COVID-19. ...
Background
We aimed to describe the clinical spectrum and burden of COVID-19–associated neurologic disease in Australian children.
Methods
We extracted Australian national sentinel site surveillance data on COVID-19–associated neurologic disease in children hospitalized in the Paediatric Active Enhanced Disease Surveillance network, 2020–2023. Neurologic complications included encephalitis, encephalopathy, Guillain–Barre syndrome, seizures and cerebrovascular accident among others. We calculated the proportion of hospitalized pediatric COVID-19 cases associated with neurologic disease and described the spectrum of presentations including clinical features and severity. We calculated incidence rates of neurologic disease within COVID-19 variant eras among hospitalized patients.
Results
We identified 311 cases of SARS-CoV-2 infection with neurologic disease among 4616 hospitalized pediatric cases of COVID-19 reported through the surveillance network, representing 5.3 cases per 100 pediatric COVID-19 admissions. The most common COVID-19–associated neurologic presentations were seizures (n = 215), including febrile seizures. Nonspecific encephalopathy (n = 62), encephalitis, Guillain–Barre Syndrome, acute cerebellar syndromes, acute demyelinating encephalomyelitis and cerebrovascular accident were also reported. Almost 60% of children were ≤4 years, approximately 30% had pre-existing neurologic conditions and almost half had other medical comorbidities. COVID-19–associated neurologic complications infrequently led to death, although 25% (n = 2/8) of children with COVID-19 encephalitis died. The incidence rate of COVID-19-associated neurologic disease was lowest during the late Omicron era.
Conclusions
Neurologic complications among COVID-19 hospitalized children are relatively frequent. While most neurologic complications are transient, including seizures, encephalitis remains a cause of significant morbidity. Children with pre-existing neurologic disease and other comorbidities are at higher risk.
... Elderly individuals have been identified as a population with a high mortality rate of COVID-19, severe COVID-19 symptoms and complications, and the need for invasive mechanical ventilation [3]. In particular, elderly individuals with the diagnosis of a major neurocognitive disorder (MND) have increased COVID-19 severity and mortality rates [4][5][6][7][8][9][10][11]. A study found that large increases in mortality in individuals with MNDs such as Alzheimer's disease as an underlying or contributing cause of death occurred in the first year of the COVID-19 pandemic in the United States [12]. ...
Vaccination helps reduce the risk of coronavirus disease 2019 (COVID-19) infection in elderly individuals with major neurocognitive disorders (MNDs). However, some caregivers are hesitant to have their elderly family members with MNDs vaccinated against COVID-19. This study explored the factors influencing caregivers’ intentions to vaccinate elderly family members with MNDs against COVID-19. A total of 232 caregivers of elderly family members with MNDs participated in this study. In this survey, data regarding COVID-19 vaccination acceptance, fear, side effects, family members’ attitudes toward vaccination, mental health status, neuropsychiatric symptoms, and cognitive impairments were collected from the elderly participants with MNDs. The associations between these variables and the caregivers’ intention to vaccinate their elderly family members with MNDs against COVID-19 were examined using a multivariable linear regression analysis model. The results revealed that caregivers’ perceived familial support for vaccination, the perceived value of vaccination, and autonomy to vaccinate elder family members were positively correlated with caregivers’ intention to vaccinate elderly family members with MNDs, whereas elderly family members’ age was negatively correlated with caregiver intentions. This study demonstrated that caregiver factors (perceived familial support, value of vaccination, and autonomy) and elderly family members’ age were correlated with caregiver intention. These factors should be considered in developing interventions to enhance caregivers’ intentions to vaccinate their elderly family members with MNDs against COVID-19.
... Higher incidences of diabetes [70][71][72], hypertension [73], and kidney disorders [74,75], among others, have been reported in individuals post-COVID-19 compared to non-COVID matched controls. Worsening of disease progression of existing clinical disorders has been reported in patients with hypertension [76,77], kidney disease [78], multiple sclerosis [79][80][81][82][83][84], dementia [85][86][87], and other neurological conditions [86][87][88][89][90][91] post-COVID-19 compared to non-COVID matched controls. We expect that there will be accelerated aging of multiorgan systems in some individuals, especially those with experience of severe acute COVID-19 and/or with major pre-existing comorbidities. ...
... Higher incidences of diabetes [70][71][72], hypertension [73], and kidney disorders [74,75], among others, have been reported in individuals post-COVID-19 compared to non-COVID matched controls. Worsening of disease progression of existing clinical disorders has been reported in patients with hypertension [76,77], kidney disease [78], multiple sclerosis [79][80][81][82][83][84], dementia [85][86][87], and other neurological conditions [86][87][88][89][90][91] post-COVID-19 compared to non-COVID matched controls. We expect that there will be accelerated aging of multiorgan systems in some individuals, especially those with experience of severe acute COVID-19 and/or with major pre-existing comorbidities. ...
Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management; Conclusions: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Addressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.
... Higher incidences of diabetes [68][69][70], hypertension [71], kidney disorders [72,73] among others have been reported in individuals post COVID-19 compared to non-COVID matched controls. Worsening of disease progression of existing clinical disorders have been reported in patients with hypertension [74,75], kidney disease [76], multiple sclerosis [77][78][79][80][81][82], dementia [83][84][85] and other neurological conditions [84][85][86][87][88][89] post COVID-19 compared to non-COVID matched controls. We expect that there will be accelerated aging of multiorgan systems in some individuals, especially those experienced severe acute COVID-19 and/or with major pre-existing comorbidities. ...
... Higher incidences of diabetes [68][69][70], hypertension [71], kidney disorders [72,73] among others have been reported in individuals post COVID-19 compared to non-COVID matched controls. Worsening of disease progression of existing clinical disorders have been reported in patients with hypertension [74,75], kidney disease [76], multiple sclerosis [77][78][79][80][81][82], dementia [83][84][85] and other neurological conditions [84][85][86][87][88][89] post COVID-19 compared to non-COVID matched controls. We expect that there will be accelerated aging of multiorgan systems in some individuals, especially those experienced severe acute COVID-19 and/or with major pre-existing comorbidities. ...
Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a systematic literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management.; Conclusion: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Ad-dressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.
Alpha-synuclein (α-syn) is a 140-amino-acid, intrinsically disordered, soluble protein that is abundantly present in the brain. It plays a crucial role in maintaining cellular structures and organelle functions, particularly in supporting synaptic plasticity and regulating neurotransmitter turnover. However, for reasons not yet fully understood, α-syn can lose its physiological role and begin to aggregate. This altered α-syn disrupts dopaminergic transmission and causes both presynaptic and postsynaptic dysfunction, ultimately leading to cell death. A group of neurodegenerative diseases known as α-synucleinopathies is characterized by the intracellular accumulation of α-syn deposits in specific neuronal and glial cells within certain brain regions. In addition to Parkinson’s disease (PD), these conditions include dementia with Lewy bodies (DLBs), multiple system atrophy (MSA), pure autonomic failure (PAF), and REM sleep behavior disorder (RBD). Given that these disorders are associated with α-syn-related neuroinflammation—and considering that SARS-CoV-2 infection has been shown to affect the nervous system, with COVID-19 patients experiencing neurological symptoms—it has been proposed that COVID-19 may contribute to neurodegeneration in PD and other α-synucleinopathies by promoting α-syn misfolding and aggregation. In this review, we focus on whether SARS-CoV-2 could act as an environmental trigger that facilitates the onset or progression of α-synucleinopathies. Specifically, we present new evidence on the potential role of SARS-CoV-2 in modulating α-syn function and discuss the causal relationship between SARS-CoV-2 infection and the development of parkinsonism-like symptoms.
Objectives
This study investigated post COVID-19 outcomes of patients with pre-existing neurological conditions up to 3.5 years post-infection.
Methods
This retrospective study consisted of 1,664 patients with COVID-19 (of which 1,320 had been hospitalized for acute COVID-19) and 8,985 non-COVID patients from the Montefiore Health System in the Bronx (Jan-2016 to Jul-2023). Primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE) post-COVID-19. Secondary outcomes were depression, anxiety, fatigue, headache, sleep disturbances, altered mental status, and dyspnea post-COVID-19. Cox proportional hazards model was used to calculate adjusted hazard ratios for all-cause mortality and major adverse cardiovascular event (MACE). Cumulative incidence function and Fine-Gray sub-distribution hazards model analysis were performed for secondary outcomes.
Results
Patients with a neurological disease hospitalized for COVID-19 were more likely to die (adjusted HR = 1.92 [CI:1.60, 2.30], P < 0.005), whereas patients non-hospitalized for COVID-19 had mortality rate (aHR = 1.08 [CI:0.65, 1.81], P = 0.76), compared to non-COVID patients. Patients with a neurological disease (hospitalized for COVID-19 aHR = 1.76 [CI:1.53, 2.03], P < 0.005; not hospitalized for COVID-19: aHR = 1.50 [CI:1.09, 2.05], P = 0.01) were more likely to experience a MACE compared to non-COVID patients. Notably Blacks (aHR = 1.49) and Hispanics (aHR = 1.35) had a higher risk of post COVID-19 MACE. Both hospitalized and non-hospitalized COVID-19 patients were more likely to develop higher cumulative incidence of altered mental status, fatigue, sleep disturbance, dyspnea compared to non-COVID patients (p < 0.05).
Conclusions
Patients with pre-existing neurological conditions who contracted COVID-19 were more likely to have worse outcomes compared to controls. Identifying at-risk individuals could enable more diligent follow-up.
Introduction:
Diverse neurological conditions are reported associated with the SARS-CoV-2 virus; neurological symptoms are the most common conditions to persist after the resolution of acute infection, affecting 20% of patients 6 months after acute illness. The COVID-19 Neuro Databank (NeuroCOVID) was created to overcome the limitations of siloed small local cohorts to collect detailed, curated, and harmonized de-identified data from a large diverse cohort of adults with new or worsened neurological conditions associated with COVID-19 illness, as a scientific resource.
Methods:
A Steering Committee including US and international experts meets quarterly to provide guidance. Initial study sites were recruited to include a wide US geographic distribution; academic and non-academic sites; urban and non-urban locations; and patients of different ages, disease severity, and comorbidities seen by a variety of clinical specialists. The NeuroCOVID REDCap database was developed, incorporating input from professional guidelines, existing common data elements, and subject matter experts. A cohort of eligible adults is identified at each site; inclusion criteria are: a new or worsened neurological condition associated with a COVID-19 infection confirmed by testing. De-identified data are abstracted from patients' medical records, using standardized common data elements and five case report forms. The database was carefully enhanced in response to feedback from site investigators and evolving scientific interest in post-acute conditions and their timing. Additional US and international sites were added, focusing on diversity and populations not already described in published literature. By early 2024, NeuroCOVID included over 2,700 patient records, including data from 16 US and 5 international sites. Data are being shared with the scientific community in compliance with NIH requirements. The program has been invited to share case report forms with the National Library of Medicine as an ongoing resource for the scientific community.
Conclusion:
The NeuroCOVID database is a unique and valuable source of comprehensive de-identified data on a wide variety of neurological conditions associated with COVID-19 illness, including a diverse patient population. Initiated early in the pandemic, data collection has been responsive to evolving scientific interests. NeuroCOVID will continue to contribute to scientific efforts to characterize and treat this challenging illness and its consequences.
