[Skip to Content]

Claim CME

Infectious Diseases

The Spectrum of Neurologic Disease in the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic InfectionNeurologists Move to the Frontlines

Educational Objective
To understand the types of neurological complications that can arise in patients with moderate to severe COVID-19 exposure

1 Credit CME

JAMA Neurology

Published Online: April 10, 2020

Editorial

Article Information and Disclosures

Samuel J. Pleasure, MD, PhD^1,2;

Ari J. Green, MD^1,2;

S. Andrew Josephson, MD^1,3

Author Affiliations

¹Deparment of Neurology and Weill Institute for Neuroscience, University of California, San Francisco
²Associate Editor, JAMA Neurology
³Editor, JAMA Neurology

Read article on JAMA Network

Read Article Claim CME

The global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has emerged as an unprecedented worldwide crisis in the early months of 2020, overwhelming health systems and challenging societies as we seek to contain its spread. In the tremendous flood of viral pneumonia cases and resultant life-threatening respiratory complications, the extent of potential neurologic manifestations of coronavirus disease 2019 (COVID-19) has remained unclear. In this issue of JAMA Neurology, a retrospective consecutive case series¹ of 214 patients from Wuhan, China, with either moderate or severe COVID-19 reports an early view of the incidence and types of neurologic complications and sets the stage for future longitudinal work in the area.

Claim CME

Sign in to take quiz and track your certificates

Buy This Activity

Article Information

Corresponding Author: S. Andrew Josephson, MD, University of California, San Francisco, Neurology, 505 Parnassus Ave, Box 0114, San Francisco, California 94143 (andrew.josephson@ucsf.edu).

Published Online: April 10, 2020. doi:10.1001/jamaneurol.2020.1065

Correction: This article was corrected on June 8, 2020, to add an additional reference.

Conflict of Interest Disclosures: Dr Pleasure received grants from National Institute of Mental Health, the Weill Institute for Neuroscience, the Brain Research Foundation, and the George and Judy Marcus Fund for Innovation. Dr Green reported personal fees from Viela Bio, Mylan, Bionure, and Neurona; other support from Pipeline Therapeutics; and grants and other support from Inception Sciences outside the submitted work. Dr Josephson reported personal fees from JAMA Neurology and personal fees from Continuum Audio outside the submitted work. No other disclosures were reported.

References

Mao L , Jin H , Wang M , et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020. Published online April 10, 2020. doi:10.1001/jamaneurol.2020.1127 PubMed Google Scholar

Peiris JSM , Yuen KY , Osterhaus ADME , Stöhr K . The severe acute respiratory syndrome. N Engl J Med. 2003;349(25):2431-2441. doi:10.1056/NEJMra032498 PubMed Google Scholar Crossref

Wang D , Hu B , Hu C , et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069. doi:10.1001/jama.2020.1585 PubMed Google Scholar Crossref

Tsai L-K , Hsieh S-T , Chao C-C , et al. Neuromuscular disorders in severe acute respiratory syndrome. Arch Neurol. 2004;61(11):1669-1673. doi:10.1001/archneur.61.11.1669 PubMed Google Scholar Crossref

Zochodne DW . SARS, SIRS, and neurological disease. Arch Neurol. 2004;61(11):1647-1648. doi:10.1001/archneur.61.11.1647 PubMed Google Scholar Crossref

Ding Y , Wang H , Shen H , et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol. 2003;200(3):282-289. doi:10.1002/path.1440 PubMed Google Scholar Crossref

Hwang CS . Olfactory neuropathy in severe acute respiratory syndrome: report of a case. Acta Neurol Taiwan. 2006;15(1):26-28.PubMed Google Scholar

Umapathi T , Kor AC , Venketasubramanian N , et al. Large artery ischaemic stroke in severe acute respiratory syndrome (SARS). J Neurol. 2004;251(10):1227-1231. doi:10.1007/s00415-004-0519-8 PubMed Google Scholar Crossref

Li Y-C , Bai W-Z , Hashikawa T . The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020. doi:10.1002/jmv.25824 PubMed Google Scholar

Guan WJ , Ni ZY , Hu Y , et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020. doi:10.1056/NEJMoa2002032 PubMed Google Scholar

ENT UK. Loss of sense of smell as marker of COVID-19 infection. Accessed March 30, 2020. https://www.entuk.org/sites/default/files/files/Loss%20of%20sense%20of%20smell%20as%20marker%20of%20COVID.pdf.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.