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Pathophysiology, diagnosis, and management of neuroinflammation in covid-19

Brown, Rachel L; Benjamin, Laura; Lunn, Michael P; Bharucha, Tehmina; Zandi, Michael S; Hoskote, Chandrashekar; McNamara, Patricia; (2023) Pathophysiology, diagnosis, and management of neuroinflammation in covid-19. BMJ , 382 , Article e073923. 10.1136/bmj-2022-073923. Green open access

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Abstract

Although neurological complications of SARS-CoV-2 infection are relatively rare, their potential long term morbidity and mortality have a significant impact, given the large numbers of infected patients. Covid-19 is now in the differential diagnosis of a number of common neurological syndromes including encephalopathy, encephalitis, acute demyelinating encephalomyelitis, stroke, and Guillain-Barré syndrome. Physicians should be aware of the pathophysiology underlying these presentations to diagnose and treat patients rapidly and appropriately. Although good evidence has been found for neurovirulence, the neuroinvasive and neurotropic potential of SARS-CoV-2 is limited. The pathophysiology of most complications is immune mediated and vascular, or both. A significant proportion of patients have developed long covid, which can include neuropsychiatric presentations. The mechanisms of long covid remain unclear. The longer term consequences of infection with covid-19 on the brain, particularly in terms of neurodegeneration, will only become apparent with time and long term follow-up.

Type: Article
Title: Pathophysiology, diagnosis, and management of neuroinflammation in covid-19
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmj-2022-073923
Publisher version: https://doi.org/10.1136/bmj-2022-073923
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, GUILLAIN-BARRE-SYNDROME, ACUTE ISCHEMIC-STROKE, NEUROLOGICAL MANIFESTATIONS, SARS-COV-2 INFECTION, CYTOTOXIC LESIONS, CORPUS-CALLOSUM, ENCEPHALITIS, NEUROPATHOLOGY, MULTICENTER, CHILDREN
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neuroinflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Lab for Molecular Cell Bio MRC-UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10180784
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