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Journal of Neurology
Erschienen in: Journal of Neurology 2/2022

12.08.2021 | COVID-19 | Review Zur Zeit gratis

Association of CNS demyelination and COVID-19 infection: an updated systematic review

verfasst von: Ismail Ibrahim Ismail, Sara Salama

Erschienen in: Journal of Neurology | Ausgabe 2/2022

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Abstract

Background

Since the declaration of COVID-19 pandemic, several case reports of demyelination of both peripheral and central nervous systems have been published. The association between CNS demyelination and viral infection has long been documented, and this link was recently reported following SARS-CoV-2 infection as well.

Objectives

In this systematic review, we aim to investigate the existing literature on CNS demyelination associated with SARS-CoV-2, and the proposed pathophysiological mechanisms.

Methods

We conducted a systematic review of articles in PubMed, SCOPUS, EMBASE, Cochrane, Google Scholar and Ovid databases, from 1 January 2020 until June 15, 2021. The following keywords were used: “COVID-19”, “SARS-CoV-2”, “demyelination”, “demyelinating disease”, “multiple sclerosis”, “neuromyelitis optica”, and “transverse myelitis”.

Results

A total of 60 articles were included in the final analysis of this systematic review and included 102 patients: 52 (51%) men and 50 (49%) women, with a median age of 46.5 years. The demyelination mimicked a variety of conditions with a picture of encephalitis/encephalomyelitis being the most common. At the same time other patterns were less frequently reported such as MS, NMOSD and even MOGAD. Longitudinally extensive transverse myelitis (LETM) was the most frequently reported pattern of spinal cord involvement.

Conclusion

A growing body of literature has shown an association between SARS‐CoV‐2 infection and the development of different types of CNS demyelination. Although causality cannot readily be inferred, this review may suggest a probable causal relationship, through a para-infectious or post-infectious immune-mediated etiology in COVID-19 patients. This relationship needs to be clarified in future research.
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Metadaten
Titel
Association of CNS demyelination and COVID-19 infection: an updated systematic review
verfasst von
Ismail Ibrahim Ismail
Sara Salama
Publikationsdatum
12.08.2021
Verlag
Springer Berlin Heidelberg
Schlagwort
COVID-19
Erschienen in
Journal of Neurology / Ausgabe 2/2022
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-021-10752-x

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