Post-infectious neurological complications of COVID-19 – A tertiary care center experience

Background: The neurological manifestations of acute SARS-CoV-2 infection are well established, but limited understanding of the post-infectious neurological complications of COVID-19 (PINCC) contributes to significant morbidity and mortality. Hence in this study, we aimed to describe the clinical,...

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Main Authors: S.M. Krishna Mohan M, Asish Vijayaraghavan, Soumya Sundaram, Sruthi S. Nair, Sajith Sukumaran
Format: Article
Language:English
Published: Elsevier 2023-11-01
Series:Journal of Clinical Virology Plus
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667038023000327
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author S.M. Krishna Mohan M
Asish Vijayaraghavan
Soumya Sundaram
Sruthi S. Nair
Sajith Sukumaran
author_facet S.M. Krishna Mohan M
Asish Vijayaraghavan
Soumya Sundaram
Sruthi S. Nair
Sajith Sukumaran
author_sort S.M. Krishna Mohan M
collection DOAJ
description Background: The neurological manifestations of acute SARS-CoV-2 infection are well established, but limited understanding of the post-infectious neurological complications of COVID-19 (PINCC) contributes to significant morbidity and mortality. Hence in this study, we aimed to describe the clinical, radiological, and electrophysiological spectrum and outcome of PINCC from a tertiary referral center. Methods: We identified 18 cases with diverse neurological manifestations following recovery from an acute SARS-CoV-2 infection. The neurological manifestations, magnetic resonance imaging findings of the brain and spinal cord, nerve conduction studies, and the treatment and outcome data were collected from electronic medical records. Results: The mean age of presentation was 47± 18.5 years, and 11 patients (61 %) were male. For 11 (61 %) patients, prior COVID-19 symptoms were minimal or absent. The mean time to onset of neurological manifestations was 3 weeks after COVID-19 infection (range 1–8 weeks). 14 patients (77.8 %) had central nervous system (CNS) manifestations, and 4 (22.2 %) had peripheral nervous system (PNS) manifestations. The CNS manifestations included cerebrovascular events in 7, demyelination in 4, and aseptic meningitis, amnestic mild cognitive impairment, and disseminated tuberculosis in one case each. PNS manifestations were Guillain-Barré syndrome, mononeuritis multiplex, asymmetric polyradiculoneuropathy, and isolated diaphragm palsy in one patient each. Conclusion: Post-infectious neurological complications of COVID-19 can involve both central and peripheral nervous system and is independent of the severity of acute infection.
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spelling doaj.art-47367949e496425f9a023b98488c445c2023-11-17T05:28:35ZengElsevierJournal of Clinical Virology Plus2667-03802023-11-0134100165Post-infectious neurological complications of COVID-19 – A tertiary care center experienceS.M. Krishna Mohan M0Asish Vijayaraghavan1Soumya Sundaram2Sruthi S. Nair3Sajith Sukumaran4Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, IndiaComprehensive Neurointensive Care Program, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, IndiaComprehensive Neurointensive Care Program, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India; Corresponding author at: Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, Kerala, India.Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, IndiaComprehensive Neurointensive Care Program, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, IndiaBackground: The neurological manifestations of acute SARS-CoV-2 infection are well established, but limited understanding of the post-infectious neurological complications of COVID-19 (PINCC) contributes to significant morbidity and mortality. Hence in this study, we aimed to describe the clinical, radiological, and electrophysiological spectrum and outcome of PINCC from a tertiary referral center. Methods: We identified 18 cases with diverse neurological manifestations following recovery from an acute SARS-CoV-2 infection. The neurological manifestations, magnetic resonance imaging findings of the brain and spinal cord, nerve conduction studies, and the treatment and outcome data were collected from electronic medical records. Results: The mean age of presentation was 47± 18.5 years, and 11 patients (61 %) were male. For 11 (61 %) patients, prior COVID-19 symptoms were minimal or absent. The mean time to onset of neurological manifestations was 3 weeks after COVID-19 infection (range 1–8 weeks). 14 patients (77.8 %) had central nervous system (CNS) manifestations, and 4 (22.2 %) had peripheral nervous system (PNS) manifestations. The CNS manifestations included cerebrovascular events in 7, demyelination in 4, and aseptic meningitis, amnestic mild cognitive impairment, and disseminated tuberculosis in one case each. PNS manifestations were Guillain-Barré syndrome, mononeuritis multiplex, asymmetric polyradiculoneuropathy, and isolated diaphragm palsy in one patient each. Conclusion: Post-infectious neurological complications of COVID-19 can involve both central and peripheral nervous system and is independent of the severity of acute infection.http://www.sciencedirect.com/science/article/pii/S2667038023000327Post infectious COVID-19 complicationsNeurological manifestationsSARS-CoV-2 infectionCOVID-19Stroke
spellingShingle S.M. Krishna Mohan M
Asish Vijayaraghavan
Soumya Sundaram
Sruthi S. Nair
Sajith Sukumaran
Post-infectious neurological complications of COVID-19 – A tertiary care center experience
Journal of Clinical Virology Plus
Post infectious COVID-19 complications
Neurological manifestations
SARS-CoV-2 infection
COVID-19
Stroke
title Post-infectious neurological complications of COVID-19 – A tertiary care center experience
title_full Post-infectious neurological complications of COVID-19 – A tertiary care center experience
title_fullStr Post-infectious neurological complications of COVID-19 – A tertiary care center experience
title_full_unstemmed Post-infectious neurological complications of COVID-19 – A tertiary care center experience
title_short Post-infectious neurological complications of COVID-19 – A tertiary care center experience
title_sort post infectious neurological complications of covid 19 a tertiary care center experience
topic Post infectious COVID-19 complications
Neurological manifestations
SARS-CoV-2 infection
COVID-19
Stroke
url http://www.sciencedirect.com/science/article/pii/S2667038023000327
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