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{
    "pk": 14215,
    "title": "Update on Neurological Manifestations of SARS-CoV-2",
    "subtitle": null,
    "abstract": "Severe acute respiratory syndrome coronavirus 2, the source of COVID-19, causes numerous clinical findings including respiratory and gastrointestinal findings. Evidence is now growing for increasing neurological symptoms. This is thought to be from direct in-situ effects in the olfactory bulb caused by the virus. Angiotensin-converting enzyme 2 receptors likely serve as a key receptor for cell entry for most coronaviridae as they are present in multiple organ tissues in the body, notably neurons, and in type 2 alveolar cells in the lung. Hematogenous spread to the nervous system has been described, with viral transmission along neuronal synapses in a retrograde fashion. The penetration of the virus to the central nervous system (CNS) allows for the resulting intracranial cytokine storm, which can result in a myriad of CNS complications. There have been reported cases of associated cerebrovascular accidents with large vessel occlusions, cerebral venous sinus thrombosis, posterior reversible encephalopathy syndrome, meningoencephalitis, acute necrotizing encephalopathy, epilepsy, and myasthenia gravis. Peripheral nervous system effects such as hyposmia, hypogeusia, ophthalmoparesis, Guillain-Barré syndrome, and motor peripheral neuropathy have also been reported. In this review, we update the clinical manifestations of COVID-19 concentrating on the neurological associations that have been described, including broad ranges in both central and peripheral nervous systems.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Viral infections"
        },
        {
            "word": "Neurology"
        },
        {
            "word": "COVID-19"
        },
        {
            "word": "coronavirus"
        }
    ],
    "section": "Endemic Infections",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/06b4d8fk",
    "frozenauthors": [
        {
            "first_name": "Hisham",
            "middle_name": "M.",
            "last_name": "Valiuddin",
            "name_suffix": "",
            "institution": "University of Pennsylvania, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Almir",
            "middle_name": "",
            "last_name": "Kalajdzic",
            "name_suffix": "",
            "institution": "St. Mary Mercy Hospital, Department of Emergency Medicine, Livonia, Michi",
            "department": "None"
        },
        {
            "first_name": "James",
            "middle_name": "",
            "last_name": "Rosati",
            "name_suffix": "",
            "institution": "St. Mary Mercy Hospital, Department of Emergency Medicine, Livonia, Michi",
            "department": "None"
        },
        {
            "first_name": "Kevin",
            "middle_name": "",
            "last_name": "Boehm",
            "name_suffix": "",
            "institution": "Broward Health Medical Center, Department of Emergency Medicine, Fort Lauderdale, Florida",
            "department": "None"
        },
        {
            "first_name": "Dominique",
            "middle_name": "",
            "last_name": "Hill",
            "name_suffix": "",
            "institution": "St. Mary Mercy Hospital, Department of Emergency Medicine, Livonia, Michi",
            "department": "None"
        }
    ],
    "date_submitted": "2020-06-22T13:26:07+10:00",
    "date_accepted": "2020-06-22T13:26:07+10:00",
    "date_published": "2020-11-04T19:00:00+11:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14215/galley/7336/download/"
        }
    ]
}