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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series

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Brasil Matos, Aline de Moura [1] ; Dahy, Flavia Esper [2] ; Luisi de Moura, Joao Victor [2] ; Nascimento Marcusso, Rosa Maria [2] ; Ferreira Gomes, Andre Borges [3, 4] ; Maia Carvalho, Fernanda Martins [3, 4] ; Peres Fernandes, Gustavo Bruniera [5] ; Felix, Alvina Clara [1] ; Smid, Jerusa [2] ; Vidal, Jose Ernesto [2, 1] ; Ferreira Frota, Norberto Anizio [3, 4] ; Casseb, Jorge [1] ; Easton, Ava [6, 7] ; Solomon, Tom [8, 9] ; Witkin, Steven S. [10, 1] ; Romano, Camila Malta [1, 11] ; Penalva de Oliveira, Augusto Cesar [2] ; Grp, NeuroCovBR Study
Total Authors: 18
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[1] Univ Sao Paulo, Fac Med, Inst Med Trop, Sao Paulo - Brazil
[2] Inst Infectol Emilio Ribas, Sao Paulo - Brazil
[3] Hosp Geral Fortaleza, Serv Neurol, Fortaleza, Ceara - Brazil
[4] Univ Fortaleza, Programa Posgrad Ciencias Med, Fortaleza, Ceara - Brazil
[5] Hosp Israelita Albert Einstein, Sao Paulo - Brazil
[6] Encephalitis Soc, Malton - England
[7] Univ Liverpool, Dept Clin Infect Microbiol & Immunol, Liverpool, Merseyside - England
[8] Univ Liverpool, Inst Infect Vet & Ecol Sci, Natl Inst Hlth Res, Hlth Protect Unit Emerging & Zoonot Infect, Liverpool, Merseyside - England
[9] Walton Ctr Natl Hlth Serv Fdn Trust, Liverpool, Merseyside - England
[10] Weill Cornell Med, Dept Obstet & Gynecol, New York, NY - USA
[11] Univ Sao Paulo, Hosp Clin, Fac Med, Sao Paulo - Brazil
Total Affiliations: 11
Document type: Journal article
Source: FRONTIERS IN NEUROLOGY; v. 12, AUG 4 2021.
Web of Science Citations: 0

Background: Previous reported neurologic sequelae associated with SARS-CoV-2 infection have mainly been confined to hospital-based patients in which viral detection was restricted to nasal/throat swabs or to IgM/IgG peripheral blood serology. Here we describe seven cases from Brazil of outpatients with previous mild or moderate COVID-19 who developed subacute cognitive disturbances. Methods: From June 1 to August 15, 2020, seven individuals 18 to 60 years old, with confirmed mild/moderate COVID-19 and findings consistent with encephalopathy who were observed >7 days after respiratory symptom initiation, were screened for cognitive dysfunction. Paired sera and CSF were tested for SARS-CoV-2 (IgA, IgG ELISA, and RT-PCR). Serum and intrathecal antibody dynamics were evaluated with oligoclonal bands and IgG index. Cognitive dysfunction was assessed by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Clock Drawing Test (CDT). Results: All but one of our patients were female, and the mean age was 42.6 years. Neurologic symptoms were first reported a median of 16 days (IQR 15-33) after initial COVID-19 symptoms. All patients had headache and altered behavior. Cognitive dysfunction was observed mainly in phonemic verbal fluency (MoCA) with a median of six words/min (IQR 5.25-10.75) and altered visuospatial construction with a median of four points (IQR 4-9) (CDT). CSF pleocytosis was not detected, and only one patient was positive for SARS-Co Conclusions: A subacute cognitive syndrome suggestive of SARS-CoV-2-initiated damage to cortico-subcortical associative pathways that could not be attributed solely to inflammation and hypoxia was present in seven individuals with mild/moderate COVID-19. (AU)

FAPESP's process: 19/03859-9 - Clinical, serological and virological characteristics of Dengue virus serotype 2 (DENV-2) infection in a cohort previously exposed to serotype 1
Grantee:Camila Malta Romano
Support Opportunities: Regular Research Grants
FAPESP's process: 20/05984-2 - Acute neurological manifestations associated with SARS-CoV-2 virus
Grantee:Jorge Simão do Rosário Casseb
Support Opportunities: Regular Research Grants