Author: Edén, Arvid; Simrén, Joel; Price, Richard W.; Zetterberg, Henrik; Gisslén, Magnus
Title: Neurochemical biomarkers to study CNS effects of COVIDâ€19: A narrative review and synthesis Cord-id: 3r3tustl Document date: 2021_8_20
ID: 3r3tustl
Snippet: Neurological symptoms are frequently reported in patients suffering from COVIDâ€19. Common CNSâ€related symptoms include anosmia, caused by viral interaction with either neurons or supporting cells in nasal olfactory tissues. Diffuse encephalopathy is the most common sign of CNS dysfunction, which likely results from the CNS consequences of the systemic inflammatory syndrome associated with severe COVIDâ€19. Additionally, microvascular injuries and thromboembolic events likely contribute to t
Document: Neurological symptoms are frequently reported in patients suffering from COVIDâ€19. Common CNSâ€related symptoms include anosmia, caused by viral interaction with either neurons or supporting cells in nasal olfactory tissues. Diffuse encephalopathy is the most common sign of CNS dysfunction, which likely results from the CNS consequences of the systemic inflammatory syndrome associated with severe COVIDâ€19. Additionally, microvascular injuries and thromboembolic events likely contribute to the neurologic impact of acute COVIDâ€19. These observations are supported by evidence of CNS immune activation in cerebrospinal fluid (CSF) and in autopsy tissue, along with the detection of microvascular injuries in both pathological and neuroimaging studies. The frequent occurrence of thromboembolic events in patients with COVIDâ€19 has generated different hypotheses, among which viral interaction with perivascular cells is particularly attractive, yet unproven. A distinguishing feature of CSF findings in SARSâ€CoVâ€2 infection is that clinical signs characteristic of neurotropic viral infections (CSF pleocytosis and blood–brain barrier injury) are mild or absent. Moreover, virus detection in CSF is rare and often of uncertain significance. In this review, we provide an overview of the neurological impact that occurs in the acute phase of COVIDâ€19, and the role of CSF biomarkers in the clinical management and research to better treat and understand the disease. In addition to aiding as diagnostic and prognostic tools during acute infection, the use of comprehensive and wellâ€characterized CSF and blood biomarkers will be vital in understanding the potential impact on the CNS in the rapidly increasing number of individuals recovering from COVIDâ€19.
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