Search

Background: Despite the expanding literature that discusses insights into the clinical picture and mechanisms by which the SARS‐CoV‐2 virus invades the nervous system, data on the neuropathologic findings of patients who died following SARS-CoV-2 infection is limited. Methods: A broad literature search was done for published articles that reported on histopathological findings of the brain in patients with COVID-19 in PUBMED by Medline, EMBASE, and CENTRAL by the Cochrane Library, and SCOPUS from December 31, 2019 to October 31, 2020. Results: The systematic literature search strategy used resulted in a total of 1608 articles of which 14 were included in the analysis (PROSPERO registration number: CRD42020221022). There were ten case series, two case reports, one retrospective cohort, and one prospective cohort. The age of the subjects ranged between 38-90 years old, most of them older than 65-years-old (n=66, 45.2%) and males (n=79, 54.1%). Most tested negative in SARS-CoV-2 immunohistochemistry (n=70, 47.9%). The striking pathologic changes included diffuse edema (n=25, 17.1%), gliosis with diffuse activation of microglia and astrocytes (n=52, 35.6%), infarctions involving cortical and subcortical areas of the brain (n=4, 2.7%), intracranial bleed (subarachnoid hemorrhage and punctate hemorrhages) (n=18, 12.4%), arteriosclerosis (n=43, 29.5%), hypoxic-ischemic injury (n=41, 28.1%), and signs of inflammation (n=52, 35.6%). The cause of death was mainly attributed to the cardiorespiratory system (n=66, 45.2%). Conclusions: The neuropathologic changes observed likely represent direct cytopathic effects and indirect effects secondary to host-specific inflammatory response induced by the viral infection. Further studies however are required to better elucidate the pathologic mechanism. Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. Declaration of Interests: None.

Background The internet has made significant contributions towards health education. Analyzing the pattern of online behavior regarding meningitis and vaccinations may be worthwhile. It is hypothesized that the online search patterns in meningitis are correlated with its number of cases and the search patterns of its related vaccines. Methods This was an infodemiological study that determined the relationship among online search interest in meningitis, its worldwide number of cases and its associated vaccines. Using Google Trends™ Search Volume Indices (SVIs), we evaluated the search queries “meningitis,” “pneumococcal vaccine,” “BCG vaccine,” “meningococcal vaccine” and “influenza vaccine” in January 2021, covering January 2008 to December 2020. Spearman rank correlation was used to determine correlations between these queries. Results The worldwide search interest in meningitis from 2008 to 2020 showed an average SVI of 46 ± 8.8. The most searched topics were symptoms, vaccines, and infectious agents with SVIs of 100, 52, and 39, respectively. The top three countries with the highest search interest were Ghana, Kazakhstan, and Kenya. There were weak, but statistically significant correlations between meningitis and the BCG (ρ = 0.369, p ρ = 0.183, p Conclusion The relationships among the Google SVIs for meningitis and its related vaccines and number of cases data were inconsistent and remained unclear. Future infodemiological studies may expand their scopes to social media, semantics, and big data for more robust conclusions.

Our study aimed to determine the profile of Guillain���Barr�� syndrome (GBS) in the Philippines, compare the outcomes who received intravenous immunoglobulin (IVIg) and therapeutic plasma exchange (TPE), and determine the factors related to hospital stay and late motor recovery. We conducted a retrospective cohort study of adult GBS patients admitted to the Philippine General Hospital from 2009 to 2019. We included 105 patients with confirmed GBS diagnoses. The median age was 43 years (interquartile range 32 to 56); the female-to-male ratio was 1.62:1; the predominant variant was acute inflammatory demyelinating polyneuropathy (n = 40, 38.1%). The difference in outcomes of patients in the IVIg (n = 44) and TPE (n = 24) groups (walking with aid/GBS-disability scores/ventilator dependency at 1 month, duration dependent on the ventilator, intensive care unit stay, and hospital stay) were not statistically significant, except for mild disability at 1 month (p = 0.009). Pneumonia, urinary tract infection, and dysautonomia were significantly related to a prolonged hospital stay. No predetermined variables were associated with late motor recovery. After adjusting for age and sex, the cumulative hazard risk for late motor recovery was 0.69 (95% CI 0.27���1.74). Our study presented the first comprehensive information regarding the features and outcomes of GBS patients in the Philippines. AIDP ��� Acute inflammatory demyelinating polyneuropathy; AMAN ��� Acute motor axonal neuropathy; AMSAN ��� Acute motor and sensory axonal neuropathy; GBS ��� Guillain���Barr�� syndrome; GBS-DS ��� Guillain���Barr�� syndrome disability scale; ICU ��� Intensive care unit; IVIg ��� Intravenous immunoglobulin; MFS ��� Miller���Fisher syndrome; PGH ��� Philippine General Hospital; TPE ��� Therapeutic plasma exchange.