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Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study

BACKGROUND: The post-COVID syndrome is the various physical and neuropsychiatric symptoms after the acute phase of COVID-19. The understanding of pathophysiology of this syndrome and its treatment need to further studies. This study aimed to present three cases of neuropsychiatric symptoms after COV...

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Autores principales: Shafiee, Gita, Arastou, Tohid, Heshmat, Ramin, Jamshidi, Ahmad Reza, Larijani, Bagher, Arzaghi, Seyed Masoud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569165/
https://www.ncbi.nlm.nih.gov/pubmed/36267491
http://dx.doi.org/10.1007/s40200-022-01138-5
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author Shafiee, Gita
Arastou, Tohid
Heshmat, Ramin
Jamshidi, Ahmad Reza
Larijani, Bagher
Arzaghi, Seyed Masoud
author_facet Shafiee, Gita
Arastou, Tohid
Heshmat, Ramin
Jamshidi, Ahmad Reza
Larijani, Bagher
Arzaghi, Seyed Masoud
author_sort Shafiee, Gita
collection PubMed
description BACKGROUND: The post-COVID syndrome is the various physical and neuropsychiatric symptoms after the acute phase of COVID-19. The understanding of pathophysiology of this syndrome and its treatment need to further studies. This study aimed to present three cases of neuropsychiatric symptoms after COVID-19 and effective treatments in these patients. CASE PRESENTATION: Three patients with new or progressively neuropsychiatric symptoms such as seizures, attention difficulties, insomnia, confusion and etc., were referred to our clinic about 8 months after severe COVID-19 infection. The patients were assessed with extensive workup includes a neurological exam, brain MRI, LORETA scan, and biochemical and levels of inflammatory serum markers. All patients had elevated levels of TNF-α, poor neurological exam, and abnormal reports of MRI or LORETA scan. Diagnosis of post- COVID neuropsychiatric complications was made for the patients.TNF inhibition with Adalimumab (40 mg/weekly for a month) was initiated for the patients and led to a dramatic improvement of all symptoms. CONCLUSIONS: To our knowledge, this report is the first case series study that suggests TNF inhibitors in the treatment of post-COVID-19 syndrome, especially neuropsychological complications. However, future studies should evaluate the best therapeutic options for this syndrome.
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spelling pubmed-95691652022-10-16 Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study Shafiee, Gita Arastou, Tohid Heshmat, Ramin Jamshidi, Ahmad Reza Larijani, Bagher Arzaghi, Seyed Masoud J Diabetes Metab Disord Case Report BACKGROUND: The post-COVID syndrome is the various physical and neuropsychiatric symptoms after the acute phase of COVID-19. The understanding of pathophysiology of this syndrome and its treatment need to further studies. This study aimed to present three cases of neuropsychiatric symptoms after COVID-19 and effective treatments in these patients. CASE PRESENTATION: Three patients with new or progressively neuropsychiatric symptoms such as seizures, attention difficulties, insomnia, confusion and etc., were referred to our clinic about 8 months after severe COVID-19 infection. The patients were assessed with extensive workup includes a neurological exam, brain MRI, LORETA scan, and biochemical and levels of inflammatory serum markers. All patients had elevated levels of TNF-α, poor neurological exam, and abnormal reports of MRI or LORETA scan. Diagnosis of post- COVID neuropsychiatric complications was made for the patients.TNF inhibition with Adalimumab (40 mg/weekly for a month) was initiated for the patients and led to a dramatic improvement of all symptoms. CONCLUSIONS: To our knowledge, this report is the first case series study that suggests TNF inhibitors in the treatment of post-COVID-19 syndrome, especially neuropsychological complications. However, future studies should evaluate the best therapeutic options for this syndrome. Springer International Publishing 2022-10-15 /pmc/articles/PMC9569165/ /pubmed/36267491 http://dx.doi.org/10.1007/s40200-022-01138-5 Text en © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
spellingShingle Case Report
Shafiee, Gita
Arastou, Tohid
Heshmat, Ramin
Jamshidi, Ahmad Reza
Larijani, Bagher
Arzaghi, Seyed Masoud
Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study
title Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study
title_full Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study
title_fullStr Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study
title_full_unstemmed Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study
title_short Post COVID-19 neuropsychiatric complications and therapeutic role for TNF-α inhibitors: a case series study
title_sort post covid-19 neuropsychiatric complications and therapeutic role for tnf-α inhibitors: a case series study
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9569165/
https://www.ncbi.nlm.nih.gov/pubmed/36267491
http://dx.doi.org/10.1007/s40200-022-01138-5
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