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Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study
Open accessAbstract
Background Concerns regarding potential neurological complications of COVID-19 are being increasingly reported, primarily in small series. Larger studies have been limited by both geography and specialty. Comprehensive characterisation of clinical syndromes is crucial to allow rational selection and evaluation of potential therapies. The aim of this study was to investigate the breadth of complications of COVID-19 across the UK that affected the brain.Methods During the exponential phase of the pandemic, we developed an online network of secure rapid-response case report notification portals across the spectrum of major UK neuroscience bodies, comprising the Association of British Neurologists (ABN), the British Association of Stroke Physicians (BASP), and the Royal College of Psychiatrists (RCPsych), and representing neurology, stroke, psychiatry, and intensive care. Broad clinical syndromes associated with COVID-19 were classified as a cerebrovascular event (defined as an acute ischaemic, haemorrhagic, or thrombotic vascular event involving the brain parenchyma or subarachnoid space), altered mental status (defined as an acute alteration in personality, behaviour, cognition, or consciousness), peripheral neurology (defined as involving nerve roots, peripheral nerves, neuromuscular junction, or muscle), or other (with free text boxes for those not meeting these syndromic presentations). Physicians were encouraged to report cases prospectively and we permitted recent cases to be notified retrospectively when assigned a confirmed date of admission or initial clinical assessment, allowing identification of cases that occurred before notification portals were available. Data collected were compared with the geographical, demographic, and temporal presentation of overall cases of COVID-19 as reported by UK Government public health bodies.Findings The ABN portal was launched on April 2, 2020, the BASP portal on April 3, 2020, and the RCPsych portal on April 21, 2020. Data lock for this report was on April 26, 2020. During this period, the platforms received notification of 153 unique cases that met the clinical case definitions by clinicians in the UK, with an exponential growth in reported cases that was similar to overall COVID-19 data from UK Government public health bodies. Median patient age was 71 years (range 23-94; IQR 58-79). Complete clinical datasets were available for 125 (82%) of 153 patients. 77 (62%) of 125 patients presented with a cerebrovascular event, of whom 57 (74%) had an ischaemic stroke, nine (12%) an intracerebral haemorrhage, and one (1%) CNS vasculitis. 39 (31%) of 125 patients presented with altered mental status, comprising nine (23%) patients with unspecified encephalopathy and seven (18%) patients with encephalitis. The remaining 23 (59%) patients with altered mental status fulfilled the clinical case definitions for psychiatric diagnoses as classified by the notifying psychiatrist or neuropsychiatrist, and 21 (92%) of these were new diagnoses. Ten (43%) of 23 patients with neuropsychiatric disorders had new-onset psychosis, six (26%) had a neurocognitive (dementia-like) syndrome, and four (17%) had an affective disorder. 18 (49%) of 37 patients with altered mental status were younger than 60 years and 19 (51%) were older than 60 years, whereas 13 (18%) of 74 patients with cerebrovascular events were younger than 60 years versus 61 (82%) patients older than 60 years.Interpretation To our knowledge, this is the first nationwide, cross-specialty surveillance study of acute neurological and psychiatric complications of COVID-19. Altered mental status was the second most common presentation, comprising encephalopathy or encephalitis and primary psychiatric diagnoses, often occurring in younger patients. This study provides valuable and timely data that are urgently needed by clinicians, researchers, and funders to inform immediate steps in COVID-19 neuroscience research and health policy.Funding None.
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“77 (62%) of 125 patients presented with a cerebrovascular event”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 125- Asserted: passes — The authors put it forward as true.
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“one (1%) CNS vasculitis”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainSingle case- Asserted: passes — The authors put it forward as true.
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In the paper
“of whom 57 (74%) had an ischaemic stroke”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 77- Asserted: passes — The authors put it forward as true.
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In the paper
“Ten (43%) of 23 patients with neuropsychiatric disorders had new-onset psychosis”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 23- Asserted: passes — The authors put it forward as true.
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“The remaining 23 (59%) patients with altered mental status fulfilled the clinical case definitions for psychiatric diagnoses as classified by the notifying psychiatrist or neuropsychiatrist”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 39- Asserted: passes — The authors put it forward as true.
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“All seven patients with encephalitis met the criteria for confirmed SARS-CoV-2 infection.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 7- Asserted: passes — The authors put it forward as true.
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“During this period, the platforms received notification of 153 unique cases that met the clinical case definitions by clinicians in the UK”
- Also stated in: § Results · plain
“In the first 3 weeks of the submission portals accepting notifications (April 2–26, 2020), the CoroNerve study platforms received notification of 153 unique cases that met the clinical case definitions by clinicians in the UK.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 153- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Results · plain
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In the paper
“39 (31%) of 125 patients presented with altered mental status”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 125- Asserted: passes — The authors put it forward as true.
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In the paper
“and 21 (92%) of these were new diagnoses”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 23- Asserted: passes — The authors put it forward as true.
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In the paper
“and four (17%) had an affective disorder”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 23- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 6
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“Overall, the median age of 71 years (range 23–94; IQR 58–79) was similar to national data collected through UK Government public health bodies over the same time period, although for some centiles an older population could be overrepresented within the study cohort”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
hedged- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: The UK Government public health data used for comparison accurately reflect the overall COVID-19 case distribution.
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In the paper
“13 (18%) of 74 patients with cerebrovascular events were younger than 60 years versus 61 (82%) patients older than 60 years”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 74- Asserted: passes — The authors put it forward as true.
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In the paper
“114 (92%) of 125 patients with complete notification data met the criteria for confirmed SARS-CoV-2 infection, five (4%) met the criteria for probable SARS-CoV-2 infection, and five (4%) met the criteria for possible SARS-CoV-2 infection.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 125- Asserted: passes — The authors put it forward as true.
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In the paper
“Median patient age was 71 years (range 23–94; IQR 58–79).”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plain- Asserted: passes — The authors put it forward as true.
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“Dates of admission or initial clinical assessment were available for 112 (90%) of 125 patients and correlated with the national case identification data of all laboratory-confirmed patients with COVID-19 reported by government public health bodies over the same time period, reflecting the exponential phase of infection”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plaincorrelationaln = 125- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Rests on an assumption: The UK Government public health data used for comparison accurately reflect the overall COVID-19 case distribution.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and seven (30%) had an other psychiatric disorder, including one case of catatonia and one case of mania.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 23- Asserted: passes — The authors put it forward as true.
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In the paper
“the RCPsych web portal was launched 18 days later than the other neurological, stroke, and intensive care unit or more general portals, yet we observed a large number of psychiatric or neuropsychiatric notifications.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Overall, 75 (49%) of 153 cases were notified through the BASP portal, 53 (35%) through ABN or CoroNerve.com, and 25 (16%) through the RCPsych portal.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 153- Asserted: passes — The authors put it forward as true.
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In the paper
“Data on reporting physician specialty were available for 150 patients: 61 (41%) were stroke physicians, 39 (26%) were neurologists, 26 (17%) were psychiatrists or neuropsychiatrists, 23 (15%) were acute medicine or other physicians, and one (1%) was a general practitioner.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 150- Asserted: passes — The authors put it forward as true.
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“18 (49%) of 37 patients with altered mental status were younger than 60 years and 19 (51%) were older than 60 years”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Findings
plainn = 37- Asserted: passes — The authors put it forward as true.
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In the paper
“Patients were geographically dispersed across the UK, as were overall laboratory-confirmed cases of patients with COVID-19 reported by government public health bodies during the same time period”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“26 (17%) of 152 patients were from tertiary care hospitals, 125 (82%) were from secondary care hospitals, and one (1%) was from primary care.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 152- Asserted: passes — The authors put it forward as true.
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In the paper
“Cases were reported retrospectively for 24 (16%) of 153 patients and the remainder were reported prospectively.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Results
plainn = 153- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our approach to case ascertainment has the potential for reporting bias and requires validation through detailed prospective clinicoepidemiological data collection.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
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In the paper
“comprising encephalopathy or encephalitis and primary psychiatric diagnoses”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Abstract > Interpretation
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Cerebrovascular events in patients with COVID-19, which have been well described elsewhere,1, 9 were also identified as a major group within our cohort.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Discussion
boosted- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“However, these studies have largely been limited to two or three hospitals and are restricted by both geography and specialty, therefore not assessing the neurological and neuropsychiatric complications of COVID-19 across the clinical spectrum of neurology, stroke or acute medicine, psychiatry, and intensive care.”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Introduction
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“the present study included a priori considerations to determine the strength of the evidence for SARS-CoV-2 infection, and data collection was informed by clear clinical case definitions”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Discussion
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“there is a potential biological rationale for a vasculopathy, with a report of SARS-CoV-2 endothelitis in organs outside the cerebral vasculature22 and cerebrovascular events,23 in addition to coagulopathy, along with conventional stroke risk during sepsis.9, 24, 25”
§ Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study > Discussion
What the sources say
- Not checked yetcites [22]
- Not checked yetcites [23]
- Not checked yetcites [9] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
The paper relies on this without support.
The UK Government public health data used for comparison accurately reflect the overall COVID-19 case distribution.
“Data collected were compared with the geographical, demographic, and temporal presentation of overall cases of COVID-19 as reported by UK Government public health bodies.”
Claims other papers make about this one
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In the citing paper
“However, follow-up studies of post-covid syndrome cohorts have so far, with few exceptions, included symptom descriptions rather than diagnostic constructs (11)”
From Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (CBT-ACT) vs. Standard Care After Critical Illness Due to COVID-19: Protocol for a Pilot Randomized Controlled Trial (2022) · cites this paper as [11]
Experimental — accuracy not yet measuredIn the citing paper
“Recent reports highlighting the risk for neuropsychiatric impairments secondary to COVID-19 showed that SARS-CoV-2 infection is associated with non-negligible incidence of neurological and psychiatric manifestations”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [136]
In the citing paper
“provided evidence that neuropsychiatric and cognitive symptoms may arise as a direct CNS infection by the virus also [17, 136].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [136]
In the citing paper
“A recent population-based study showed that 26% of all those with neuropsychiatric disorders due to COVID-19 had a dementia-like syndrome, with a median patient age of 71 years [136].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [136]
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BackgroundShort‐term neuropsychiatric outcomes and quality of life in COVID‐19 survivors
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“INTRODUCTION The explosive spread of coronavirus disease 2019 (COVID-19) across the world has once again brought infectious disease epidemics into public attention [1].”
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BackgroundPsychotic symptoms in COVID-19 patients. A retrospective descriptive study
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“Similarly, neuropsychiatric disorders including neurocognitive impairment, anxiety, and depressed mood become increasingly important in the long term, even in patients with mild disease [15,16].”
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“For example, up to a third of persons who develop COVID-19 exhibit neuropsychiatric manifestations directly due to the infection itself (4) and significant numbers of patients are”
BackgroundCOVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: a narrative review
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“Together with the previous knowledge about increased risk of thrombosis in COVID-19, our findings suggest a potential causality [3,7,8,47,48].”
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“neuroepithelium, as it expresses the ACE-2 receptor and thereby causing inflammatory changes in bilateral olfactory clefts [5, 9, 41].”
BackgroundInfluentialTropism of SARS-CoV-2 for human cortical astrocytes
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“An altered mental status, defined as unspecified encephalopathy, encephalitis, or psychiatric diagnosis, was observed in 31% of patients [16].”
BackgroundNeuropathobiology of COVID-19: The Role for Glia
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“Cerebrovascular disorders associated with SARS-CoV-2 are well described, as are postinfectious encephalopathies, transverse myelitis, and acute disseminated encephalomyelitis.(12) Peripheral neurological manifestations, typically GBS and its variants, have also been described, but causality is debated.”
BackgroundNeuropsychiatric Complications of COVID-19
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“However, more serious neurological complications such as impaired consciousness, cerebrovascular events, encephalopathy/encephalitis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, seizures, delirium, dementia-like syndrome, and psychiatric disorders including psychosis, catatonia and mania have been r…”
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COVID-19 and Alzheimer’s disease: how one crisis worsens the other
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BackgroundPersistent COVID-19-associated neurocognitive symptoms in non-hospitalized patients
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Returning to physical activity after covid-19
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The extended autonomic system, dyshomeostasis, and COVID-19
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Invited Review: The spectrum of neuropathology in COVID‐19
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Mental health in the post‐COVID‐19 era: challenges and the way forward
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Neuropsychiatric and Cognitive Sequelae of COVID-19
Kumar, S., Veldhuis, A., & Malhotra, T. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.577529 · Cited by 143
Delirium and Adverse Outcomes in Hospitalized Patients with COVID ‐19
Garcez, F. B., Aliberti, M. J. R., Poço, P. C. E., Hiratsuka, M., Takahashi, S. D. F., Coelho, V. A., Salotto, D. B., Moreira, M. L. V., Filho, W. J., & Avelino‐Silva, T. J. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16803 · Cited by 139
“Most of these studies have either focused on impaired consciousness(7,21) or did not provide a clear construct of delirium as their main exposure.(16) In a cohort study of 214 adult patients, Mao et al(7) (2020) reported that central nervous system (CNS) symptoms were present in 25% of the cases, the most common being…”
BackgroundMethodResultChen, S., Jones, P. B., Underwood, B. R., Moore, A., Bullmore, E. T., Banerjee, S., Osimo, E. F., Deakin, J. B., Hatfield, C. F., Thompson, F. J., et al. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.09.020 · Cited by 127
Long COVID‐19: Objectifying most self‐reported neurological symptoms
Bungenberg, J., Humkamp, K., Hohenfeld, C., Rust, M. I., Ermis, U., Dreher, M., Hartmann, N. K., Marx, G., Binkofski, F., Finke, C., et al. (2022) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51496 · Cited by 137
“This clearly underlines the fact that there is a shift from mainly respiratory disease during acute COVID-19 to also neurological manifestations in the long-term the proportion of which was found to be rather small during acute infection primarily including inflammatory and cerebrovascular events.(36,37) Thus, a compr…”
BackgroundSARS-CoV-2 Infection of Microglia Elicits Proinflammatory Activation and Apoptotic Cell Death
Jeong, G. U., Lyu, J., Kim, K., Chung, Y. C., Yoon, G. Y., Lee, S., Hwang, I., Shin, W.-H., Ko, J., Lee, J., et al. (2022) · Microbiology Spectrum · doi:10.1128/spectrum.01091-22 · Cited by 126
Günster, C., Busse, R., Spoden, M., Rombey, T., Schillinger, G., Hoffmann, W. U., Weber‐Carstens, S., Schuppert, A., & Karagiannidis, C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255427 · Cited by 116
Late Complications of COVID-19; a Systematic Review of Current Evidence.
SeyedAlinaghi, S., Afsahi, A. M., MohsseniPour, M., Behnezhad, F., Salehi, M. A., Barzegary, A., Mirzapour, P., Mehraeen, E., & Dadras, O. (2021) · Archives of Academic Emergency Medicine · doi:10.22037/aaem.v9i1.1058 · Cited by 121
Rogers, J. P., Watson, C. J., Badenoch, J., Cross, B., Butler, M., Song, J., Hafeez, D., Morrin, H., Rengasamy, E. R., Thomas, L., et al. (2021) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2021-326405 · Cited by 133
Self-citationZhou, Y., Drăghici, A., Abbas, J., Mubeen, R., Boatcă, M. E., & Salam, M. A. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.626134 · Cited by 151
Rapid vigilance and episodic memory decrements in COVID-19 survivors
Zhao, S., Shibata, K., Hellyer, P. J., Trender, W. R., Manohar, S., Hampshire, A., & Husain, M. (2021) · Brain Communications · doi:10.1093/braincomms/fcab295 · Cited by 127
“These include acute cerebrovascular events such as ischaemic stroke and intracerebral haemorrhage.(4) In addition to severe neurological conditions, there can also be more chronic, longer-term consequences such as fatigue, low motivation, disturbed mood and poor sleep—all commonly reported symptoms amongst survivors,…”
BackgroundThye, A. Y.-K., Law, J. W., Tan, L. T., Pusparajah, P., Ser, H., Thurairajasingam, S., Letchumanan, V., & Lee, L. (2022) · Biology · doi:10.3390/biology11010061 · Cited by 122
Intracerebral endotheliitis and microbleeds are neuropathological features of COVID‐19
Kirschenbaum, D. S., Imbach, L., Rushing, E. J., Frauenknecht, K. B. M., Gascho, D., Ineichen, B. V., Keller, E., Köhler, S., Lichtblau, M., Reimann, R., et al. (2020) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12677 · Cited by 112
Siow, I., Lee, K. S., Zhang, J. J. Y., Saffari, S. E., Ng, A., & Young, B. (2021) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.105549 · Cited by 116
Neurobiochemical Cross-talk Between COVID-19 and Alzheimer’s Disease
Rahman, M. A., Islam, K., Rahman, S., & Alamin, M. (2020) · Molecular Neurobiology · doi:10.1007/s12035-020-02177-w · Cited by 121
“Inflammatorymediators have been implicated in CNSmanifestations, and immunological processes in peripheral nervous system (PNS) abnormalities, while skeletal muscle injury has been considered the direct effect of SARS-CoV-2 [10, 16, 17].”
BackgroundPilotto, A., Masciocchi, S., Volonghi, I., Crabbio, M., Magni, E., Giuli, V. D., Caprioli, F., Rifino, N., Sessa, M., Gennuso, M., et al. (2020) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaa609 · Cited by 144
Li, X., Raventós, B., Roel, E., Pistillo, A., Martinez-Hernandez, E., Delmestri, A., Reyes, C., Strauss, V., Prieto-Alhambra, D., Burn, E., et al. (2022) · BMJ · doi:10.1136/bmj-2021-068373 · Cited by 118
Mood Responses Associated With COVID-19 Restrictions
Terry, P. C., Parsons-Smith, R. L., & Terry, V. R. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.589598 · Cited by 107
Metadata
- Authors
- Varatharaj, A., Thomas, N., Ellul, M. A., Davies, N. W. S., Pollak, T. A., Tenorio, E. L., Sultan, M., Easton, A., Breen, G., Zandi, M., Coles, J. P., Manji, H., Al-Shahi Salman, R., Menon, D. K., Nicholson, T. R., Benjamin, L. A., Carson, A., Smith, C., Turner, M. R., Solomon, T., Kneen, R., Pett, S. L., Galea, I., Thomas, R. H., Michael, B. D., Allen, C., Archibald, N., Arkell, J., Arthur-Farraj, P., Baker, M., Ball, H., Bradley-Barker, V., Brown, Z., Bruno, S., Carey, L., Carswell, C., Chakrabarti, A., Choulerton, J., Daher, M., Davies, R., Di Marco Barros, R., Dima, S., Dunley, R., Dutta, D., Ellis, R., Everitt, A., Fady, J., Fearon, P., Fisniku, L., Gbinigie, I., Gemski, A., Gillies, E., Gkrania-Klotsas, E., Grigg, J., Hamdalla, H., Hubbett, J., Hunter, N., Huys, A.-C., Ihmoda, I., Ispoglou, S., Jha, A., Joussi, R., Kalladka, D., Khalifeh, H., Kooij, S., Kumar, G., Kyaw, S., Li, L., Littleton, E., Macleod, M., Macleod, M. J., Madigan, B., Mahadasa, V., Manoharan, M., Marigold, R., Marks, I., Matthews, P., Mccormick, M., Mcinnes, C., Metastasio, A., Milburn-McNulty, P., Mitchell, C., Mitchell, D., Morgans, C., Morris, H., Morrow, J., Mubarak Mohamed, A., Mulvenna, P., Murphy, L., Namushi, R., Newman, E., Phillips, W., Pinto, A., Price, D. A., Proschel, H., Quinn, T., Ramsey, D., Roffe, C., Ross Russell, A., Samarasekera, N., Sawcer, S., Sayed, W., Sekaran, L., Serra-Mestres, J., Snowdon, V., Strike, G., Sun, J., Tang, C., Vrana, M., Wade, R., Wharton, C., Wiblin, L., Boubriak, I., Herman, K., & Plant, G.
- Affiliations
- University Hospital Southampton NHS Foundation Trust (GB)
- Wellcome Centre for Mitochondrial Research (GB)
- University of Liverpool (GB)
- Chelsea and Westminster Hospital NHS Foundation Trust (GB)
- King's College London (GB)
- University of Utah (US)
- Newcastle University (GB)
- UCL Queen Square Institute of Neurology (GB)
- University of Cambridge (GB)
- University of Edinburgh (GB)
- Manchester Academic Health Science Centre (GB)
- University of Oxford (GB)
- MRC Clinical Trials Unit at UCL (GB)
- Royal Victoria Infirmary (GB)
- Corresponding author
- Michael, Benedict D
- ORCID
- Varatharaj, Aravinthan
- Thomas, Naomi
- Ellul, Mark A
- Davies, Nicholas W S
- Pollak, Thomas A
- Sultan, Mustafa
- Easton, Ava
- Breen, Gerome
- Zandi, Michael
- Coles, Jonathan P
- Manji, Hadi
- Menon, David K
- Nicholson, Timothy R
- Benjamin, Laura A
- Carson, Alan
- Smith, Craig
- Turner, Martin R
- Solomon, Tom
- Kneen, Rachel
- Pett, Sarah L
- Galea, Ian
- Thomas, Rhys H
- Michael, Benedict D
- Baker, Mark
- Ball, Harriet
- Carswell, Christopher
- Dutta, Dipankar
- Ellis, Richard
- Fisniku, Leonora
- Gillies, Emma
- Huys, Anne-Catherine
- Jha, Ashwani
- Kalladka, Dheeraj
- Khalifeh, Hind
- Li, Lucia
- Macleod, Malcolm
- Macleod, Mary Joan
- Marigold, Richard
- Matthews, Paul
- Metastasio, Antonio
- Mitchell, Duncan
- Morgans, Clare
- Morris, Huw
- Morrow, Jasper
- Mulvenna, Paula
- Newman, Edward
- Pinto, Ashwin
- Price, David Ashley
- Roffe, Christine
- Samarasekera, Neshika
- Sawcer, Stephen
- Sekaran, Lakshmanan
- Sun, James
- Wade, Ryckie
- Plant, Gordon
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 7
- Issue
- 10
- Pages
- 875-882
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC7316461
- OpenAlex
- W3037535840
- Cited by
- 1,246
- References
- 24
- Citations by year
- 2026: 17 · 2025: 51 · 2024: 89 · 2023: 141 · 2022: 287 · 2021: 466 · 2020: 195
- FWCI
- 117.99
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-10-01)
- Open access
- bronze
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo
- Funders
- GlaxoSmithKline
- Intensive Care Society
- National Institute for Health Research
- Association of British Paediatric Nurses
- Fondation Leducq
- Stroke Association
- Royal College of Psychiatrists
- UCLH Biomedical Research Centre
- Motor Neurone Disease Association
- Wellcome Trust
- European Society of Intensive Care Medicine
- Academy of Medical Sciences
- European Commission (734584)
- Medical Research Council
- Association for Cardiothoracic Anaesthesia and Critical Care
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- COVID-19 pandemic, neurological complications, neuropsychiatric complications, cerebrovascular events, stroke, altered mental status, peripheral neuropathy, case surveillance, clinical syndromes
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Age Factors, Aged, Aged, 80 and over, Mental Disorders, Cerebrovascular Disorders, Female, United Kingdom, Humans, Male, Middle Aged, Pneumonia, Viral, Retrospective Studies, Sex Factors, Coronavirus Infections, Young Adult, Pandemics
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