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      Global Consortium Study of Neurological Dysfunction in COVID-19 (GCS-NeuroCOVID): Study Design and Rationale

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          Abstract

          Background

          As the COVID-19 pandemic developed, reports of neurological dysfunctions spanning the central and peripheral nervous systems have emerged. The spectrum of acute neurological dysfunctions may implicate direct viral invasion, para-infectious complications, neurological manifestations of systemic diseases, or co-incident neurological dysfunction in the context of high SARS-CoV-2 prevalence. A rapid and pragmatic approach to understanding the prevalence, phenotypes, pathophysiology and prognostic implications of COVID-19 neurological syndromes is urgently needed.

          Methods

          The Global Consortium to Study Neurological dysfunction in COVID-19 (GCS-NeuroCOVID), endorsed by the Neurocritical Care Society (NCS), was rapidly established to address this need in a tiered approach. Tier-1 consists of focused, pragmatic, low-cost, observational common data element (CDE) collection, which can be launched immediately at many sites in the first phase of this pandemic and is designed for expedited ethical board review with waiver-of-consent. Tier 2 consists of prospective functional and cognitive outcomes assessments with more detailed clinical, laboratory and radiographic data collection that would require informed consent. Tier 3 overlays Tiers 1 and 2 with experimental molecular, electrophysiology, pathology and imaging studies with longitudinal outcomes assessment and would require centers with specific resources. A multicenter pediatrics core has developed and launched a parallel study focusing on patients ages <18 years.

          Study sites are eligible for participation if they provide clinical care to COVID-19 patients and are able to conduct patient-oriented research under approval of an internal or global ethics committee. Hospitalized pediatric and adult patients with SARS-CoV-2 and with acute neurological signs or symptoms are eligible to participate. The primary study outcome is the overall prevalence of neurological complications among hospitalized COVID-19 patients, which will be calculated by pooled estimates of each neurological finding divided by the average census of COVID-19 positive patients over the study period. Secondary outcomes include: in-hospital, 30 and 90-day morality, discharge modified Rankin score, ventilator-free survival, ventilator days, discharge disposition, and hospital length of stay.

          Results

          In a one-month period (3/27/20–4/27/20) the GCS-NeuroCOVID consortium was able to recruit 71 adult study sites, representing 17 countries and 5 continents and 34 pediatrics study sites.

          Conclusions

          This is one of the first large-scale global research collaboratives urgently assembled to evaluate acute neurological events in the context of a pandemic. The innovative and pragmatic tiered study approach has allowed for rapid recruitment and activation of numerous sites across the world—an approach essential to capture real-time critical neurological data to inform treatment strategies in this pandemic crisis.

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          Most cited references25

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          SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor

          Summary The recent emergence of the novel, pathogenic SARS-coronavirus 2 (SARS-CoV-2) in China and its rapid national and international spread pose a global health emergency. Cell entry of coronaviruses depends on binding of the viral spike (S) proteins to cellular receptors and on S protein priming by host cell proteases. Unravelling which cellular factors are used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal therapeutic targets. Here, we demonstrate that SARS-CoV-2 uses the SARS-CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option. Finally, we show that the sera from convalescent SARS patients cross-neutralized SARS-2-S-driven entry. Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.
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            A first case of meningitis/encephalitis associated with SARS-Coronavirus-2

            Highlights • Novel coronavirus (SARS-Coronavirus-2:SARS-CoV-2) which emerged in Wuhan, China, has spread to multiple countries rapidly. • This is the first case of meningitis associated with SARS-CoV-2 who was brought in by ambulance. • The specific SARS-CoV-2 RNA was not detected in the nasopharyngeal swab but was detected in a CSF. • This case warns the physicians of patients who have CNS symptoms.
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              • Abstract: found
              • Article: not found

              Severe Acute Respiratory Syndrome Coronavirus Infection Causes Neuronal Death in the Absence of Encephalitis in Mice Transgenic for Human ACE2

              Journal of Virology, 82(15), 7264-7275
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                Author and article information

                Contributors
                mcnett.21@osu.edu
                Journal
                Neurocrit Care
                Neurocrit Care
                Neurocritical Care
                Springer US (New York )
                1541-6933
                1556-0961
                22 May 2020
                : 1-10
                Affiliations
                [1 ]GRID grid.137628.9, ISNI 0000 0004 1936 8753, Department of Neurology, , NYU School of Medicine, ; New York, NY USA
                [2 ]GRID grid.261331.4, ISNI 0000 0001 2285 7943, Division of Stroke and Neurocritical Care, Department of Neurology, , The Ohio State University, ; Columbus, OH USA
                [3 ]GRID grid.239553.b, ISNI 0000 0000 9753 0008, Division of Pediatric Critical Care Medicine, , UPMC Children’s Hospital of Pittsburgh, ; Pittsburgh, PA USA
                [4 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Departments of Anesthesiology and Critical Care Medicine, and Pediatrics, Johns Hopkins Children’s Center, , The Johns Hopkins University SOM, ; Baltimore, MD USA
                [5 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, Primary Children’s Hospital, , University of Utah School of Medicine, ; Salt Lake City, UT USA
                [6 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, , The Johns Hopkins University School of Medicine, ; Baltimore, MD USA
                [7 ]GRID grid.5335.0, ISNI 0000000121885934, Division of Anaesthesia, Addenbrooke’s Hospital, , University of Cambridge, ; Cambridge, UK
                [8 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Departments of Anesthesiology, Pediatrics, Bioengineering, and Clinical and Translational Science, Safar Center for Resuscitation Research, , University of Pittsburgh, ; Pittsburgh, PA USA
                [9 ]GRID grid.5361.1, ISNI 0000 0000 8853 2677, Neurocritical Care Unit, Department of Neurology, , Medical University of Innsbruck, ; Innsbruck, Austria
                [10 ]GRID grid.261331.4, ISNI 0000 0001 2285 7943, College of Nursing, , The Ohio State University, ; 760 Kinnear Rd, Columbus, OH 43212 USA
                [11 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Departments of Critical Care Medicine, Neurology, and Neurosurgery, Safar Center for Resuscitation Research, , University of Pittsburgh School of Medicine, ; Pittsburgh, PA USA
                Article
                995
                10.1007/s12028-020-00995-3
                7243953
                32445105
                db28a967-c536-409d-9a5c-d1a8161fc6f5
                © Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2020

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Categories
                Take a Closer Look at Trials

                Emergency medicine & Trauma
                covid-19,sars-cov-2,neurological manifestations,neurological symptoms,coronavirus

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