SARS-CoV 2
Conditions
Keywords
COVID-19, Brainstem, Electrophysiology
Brief summary
Although direct evidence is currently lacking, the high identity between SARS-CoV-1 and SARS-CoV-2 suggests, that the latter viral strain could also infect the Central Nervous System (CNS). Indeed, some cases of SARS-COV2 encephalitis begin to be described and CNS damages are increasingly highlighted in the literature, but still not objectified by imaging and do not allow to explain the entire clinical patterns. We hypothesise that these CNS damages are not always objectified by Magnetic Resonance Imaging (MRI) but could be indirectly observed by a physiological dysfunction of neural conduction in the brainstem. We will explore brainstem disruption through an electrophysiological approach.
Detailed description
Clinical and preclinical data from studies with other coronaviruses suggest an evident neurotropism, which may result in more complex clinical scenarios. Can the SARS-CoV-2 enter the Central Nervous System (CNS) and infect neural cells ? And if yes, how the CNS damage contributes to pathophysiology of the COVID-19, to its signs, symptoms and progression as well as to its sequelae. It has been demonstrated that coronaviruses such as SARS-CoV and MERS-CoV do not limit their presence to the respiratory tract and frequently invade the CNS. The intranasal administration of SARS-CoV-1 or MERS-COV resulted in the rapid invasion of viral particles into the brain of mice, possibly through the olfactory bulb via trans-synaptic route. The brainstem, which hosts the respiratory neuronal circuit in the medulla, was severely infected with both types of viruses, which may contribute to degradation and failure of respiratory centres.
Interventions
PROCEDUREAuditory Evoked Potentials (AEP)
Record of electrophysiological responses (Auditory Evoked Potentials or AEP) during auditory stimulations with an electroencephalogram (EEG).
PROCEDUREBlink and Masseter Inhibitory Reflex
Electrophysiological exploration while stimulating trigeminal nerve to record 1) motor response induced (muscle contraction delay (Blink)) of the facial nerve, or 2) the contraction inhibition of masseters (Masseter Inhibitory Reflex (MIR)).
Sponsors
University Hospital, Bordeaux
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
: * Age ≥ 18 years. * Hospitalized patient suffering from a positive COVID 19 diagnosed by Reverse transcription polymerase chain reaction (RT-PCR) or chest computed tomography scan (CTscan) with specific lesions
Exclusion criteria
: * History of neurological damage interfering with auditory evoked potentials (PEA) and Electromyography (EMG) reflexes of the brainstem (stroke of the brainstem, acoustic neuroma, amyotrophic lateral sclerosis, facial diplegia, damage to nerves V or VII, etc.) * Impaired alertness * Sedative treatments or treatments that disturb nerve conduction. * Pregnancy or breastfeeding * Individuals under legal protection or unable to express personally their consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Latency of electrophysiological response | Inclusion (T0) | Latencies of electrophysiological responses with Auditory Evoked Potentials |
| Delay of Muscle contraction | Inclusion (T0) | Delay of Muscle contraction (Blink reflex) |
| Delay of silent period | Inclusion (T0) | Delay of silent period while the patient is asked to tighten the jaws (Masseter Inhibitory Reflex) |
| Duration of silent period | Inclusion (T0) | Duration of silent period while the patient is asked to tighten the jaws (Masseter Inhibitory Reflex) |
| Inhibition rate | Inclusion (T0) | Inhibition rate while the patient is asked to tighten the jaws (Masseter Inhibitory Reflex) |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORBertrand Glize
bertrand.glize@chu-bordeaux.fr
Outcome results
None listed