Olfactory dysfunctions and neurological complications in patients with COVID-19

Authors

DOI:

https://doi.org/10.34024/rnc.2024.v32.15140

Keywords:

COVID-19, anosmia, olfactory, diseases of the nervous system

Abstract

Introduction. Cases of pneumonia of unknown etiology, but with characteristics similar to a viral condition, were identified in China in late 2019. Subsequently, researchers found severe acute respiratory syndrome coronavirus 2 to be the cause of this infection, which was named COVID-19. The COVID-19 may be associated with brain injury. Two mechanisms are proposed for the virus to reach the brain: the hematogenous route and retrograde neuronal dissemination, the latter involving the olfactory system. Thus, olfactory disturbances may indicate the occurrence of brain injury and may be associated with neurological complications. Objective. To analyze the association between olfactory dysfunctions and neurological complications in patients with COVID-19. Method. A retrospective observational study. Results. In total, the medical records of 989 hospitalized patients were evaluated. The most prevalent symptoms among patients were headache (22.3%), asthenia (15.5%), anosmia (8.3%), ageusia (5.0%). Among patients with headache, anosmia, and aging symptoms, 14%, 10.2%, and 10.2% died, respectively. The occurrence of lowered consciousness level (LCL), mental confusion, and stroke were related to 54.5%, 70%, and 60% of deaths, respectively. Conclusion. The occurrence of LCL, mental confusion, and stroke during hospitalization were considered predictors of death. On the other hand, the neurological manifestations of anosmia, ageusia, and headache were related to favorable outcomes.

References

Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol 2020;92:401–2. https://doi.org/10.1002/jmv.25678

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study. JAMA Neurol 2020;77:683-90. https://doi.org/10.1001/jamaneurol.2020.1127

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. https://doi.org/10.1016/S0140-6736(20)30183-5

Hess DC, Eldahshan W, Rutkowski E. COVID-19-Related Stroke. Translat Stroke Res 2020;11:322-5. https://doi.org/10.1007/s12975-020-00818-9

Ahmed MU, Hanif M, Ali MJ, Haider MA, Kherani D, Memon GM, et al. Neurological Manifestations of COVID-19 (SARS-CoV-2): A Review. Front Neurol 2020;11:518. https://doi.org/10.3389/fneur.2020.00518

Turner AJ, Hiscox JA, Hooper NM. ACE2: From vasopeptidase to SARS virus receptor. Trends Pharmacol Sci 2004;25:291-4. https://doi.org/10.1016/j.tips.2004.04.001

Politi LS, Salsano E, Grimaldi M. Magnetic Resonance Imaging Alteration of the Brain in a Patient With Coronavirus Disease 2019 (COVID-19) and Anosmia. JAMA Neurol 2020;77:1028-9. https://doi.org/10.1001/jamaneurol.2020.2125

Jose RJ, Manuel A. COVID-19 cytokine storm: the interplay between inflammation and coagulation. Lancet Respir Med 2020;8:e46-7. https://doi.org/10.1016/S2213-2600(20)30216-2

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol 2020;77:683-90. https://doi.org/10.1001/jamaneurol.2020.1127

Li S-R, Tang Z-J, Li Z-H, Liu X. Searching therapeutic strategy of new coronavirus pneumonia from angiotensin-converting enzyme 2: the target of COVID-19 and SARS-CoV. Eur J Clin Microbiol Infec Dis 2020;39:1021. https://doi.org/10.1007/s10096-020-03883-y

Bergmann CC, Lane TE, Stohlman SA. Coronavirus infection of the central nervous system: host-virus stand-off. Nat Rev Microbiol 2006;4:121-32. https://doi.org/10.1038/nrmicro1343

Wang K, Chen W, Zhou YS, Lian JQ, Zhang Z, Du P, et al. SARS-CoV-2 invades host cells via a novel route: CD147-spike protein. BioRxiv 2020;2020:1-10. https://doi.org/10.1101/2020.03.14.988345

Cantuti-Castelvetri L, Ojha R, Pedro LD, Djannatian M, Franz J, Kuivanen S, et al. Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science 2020;370:856-60. https://doi.org/10.1126/science.abd2985

Shang J, Wan Y, Luo C, Ye G, Geng Q, Auerbach A, et al. Cell entry mechanisms of SARS-CoV-2. Proc Natl Acad Sci USA 2020;117:11727. https://doi.org/10.1073/pnas.2003138117

Iadecola C, Anrather J, Kamel H. Effects of COVID-19 on the Nervous System. Cell 2020;183:16-27. https://doi.org/10.1016/j.cell.2020.08.028

Zhou Z, Kang H, Li S, Zhao X. Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms. J Neurol 2020;267:2179-84. https://doi.org/10.1007/s00415-020-09929-7

Sarin H. Physiologic upper limits of pore size of different blood capillary types and another perspective on the dual pore theory of microvascular permeability. J Angiogenes Res 2010;2:14. https://doi.org/10.1186/2040-2384-2-14

Nampoothiri S, Sauve F, Ternier G, Fernandois D, Coelho C, Imbernon M, et al. The hypothalamus as a hub for SARS-CoV-2 brain infection and pathogenesis. BioRxiv 2020;2020:1-46. https://doi.org/10.1101/2020.06.08.139329

Erickson MA, Banks WA. Neuroimmune Axes of the Blood-Brain Barriers and Blood-Brain Interfaces: Bases for Physiological Regulation, Disease States, and Pharmacological Interventions. Pharmacol Rev 2018;70:278-314. https://doi.org/10.1124/pr.117.014647

Diao B, Wang C, Tan Y, Chen X, Liu Y, Ning L, et al. Reduction and Functional Exhaustion of T Cells in Patients With Coronavirus Disease 2019 (COVID-19). Front Immunol 2020;11:827. https://doi.org/10.3389/fimmu.2020.00827

Bryce C, Grimes Z, Pujadas E, Ahuja S, Beasley MB, Albrecht R, et al. Pathophysiology of SARS-CoV-2: targeting of endothelial cells renders a complex disease with thrombotic microangiopathy and aberrant immune response. The Mount Sinai COVID-19 autopsy experience. MedRxiv 2020;2020:1-24. https://doi.org/10.1101/2020.05.18.20099960

Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, et al. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. N Engl J Med 2020;382:e60. https://doi.org/10.1056/NEJMc2009787

Lodigiani C, Iapichino G, Carenzo L, Cecconi M, Ferrazzi P, Sebastian T, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res 2020;191:9-14. https://doi.org/10.1016/j.thromres.2020.04.024

Downloads

Published

2024-01-12

How to Cite

Rossa, I. C. M. ., Stocco, R. B. ., Pereira, M. R. C. ., Pinto, M. F. B. V., Trintinalha, M. de O., & Twardowschy, C. A. (2024). Olfactory dysfunctions and neurological complications in patients with COVID-19. Revista Neurociências, 32, 1–17. https://doi.org/10.34024/rnc.2024.v32.15140

Issue

Vol. 32 (2024)

Section

Artigos Originais

License

Copyright (c) 2024 Isabella Cristina Mendes Rossa, Rebecca Benicio Stocco, Marcos Roberto Curcio Pereira, Maria Fernanda Braga Vilacio Pinto, Mariana de Oliveira Trintinalha, Carlos Alexandre Twardowschy

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.