Determination of COVID-19 Related Virus in Central Nervous System

COVID-19 Testing Clinical Trial

Official title:

Determination of SARS-Cov-2 Virus in Central Nervous System

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04775784
• Other study ID #: NCH08-2020
• Status: Recruiting
• Start date: December 17, 2020
• Est. completion date: December 31, 2023

Study information

• Verified date: April 2023
• Source: IRCCS San Raffaele
• Contact: Laura Sincinelli
• Phone: 00390226435568
• Email: sincinelli.laura[@]hsr.it
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Coronavirus disease 2019 (COVID-19) is a highly infectious pandemic disease caused by SARS-CoV-2 virus. Central Nervous System (CNS) complications associated with COVID-19 might be secondary sequelae due to exuberant systemic innate-mediated hyper-inflammation, which may impair neurovascular endothelial function, disrupt blood brain barrier (BBB), activates CNS innate immune signaling pathways, and induces parainfectious autoimmunity, potentially contributing to the CNS manifestations. Although the predominant clinical manifestation of SARS-CoV-2 is characterized by dyspnea, unremitting fever and hypoxemic respiratory failure, neurologic manifestations do occur in most hospitalized SARS-CoV-2 patients and include non-specific encephalopathy, psychosis, meningitis/encephalitis, myelitis, cerebrovascular events, Guillain-Barre' syndrome, and cranial or peripheral neuropathies, such as anosmia and ageusia. To date, data about primary CNS involvement due to neurotropism and direct neuroinvasion are still lacking.

Description:

Determination of SARS-CoV-2 presence in central nervous system

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 300
• Est. completion date: December 31, 2023
• Est. primary completion date: June 1, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Adult patients
• Patients candidate for CNS surgery
• Patients who have been tested for nasopharyngeal swab for SARS-CoV-2
• Patients who have been tested for serology test for anti SARS-CoV-2 immunoglobulinG (IgG) and immunoglobulinM (IgM) antibodies
• Patients able to sign informed consent

Exclusion Criteria:

• Patients not meeting inclusion criteria

Related Conditions & MeSH terms

• Central Nervous System Diseases
• Central Nervous System Infections
• CNS Disease
• CNS Infection
• COVID-19
• COVID-19 Testing

Intervention

Diagnostic Test:
• Determination of SARS-CoV2 presence in CNS
Brain tissue sampling

Locations

Country	Name	City	State
Italy	IRCCS San Raffaele Scientific Institute	Milan

Sponsors (1)

Lead Sponsor	Collaborator
IRCCS San Raffaele

Country where clinical trial is conducted

Italy, 

References & Publications (15)

Berger JR. COVID-19 and the nervous system. J Neurovirol. 2020 Apr;26(2):143-148. doi: 10.1007/s13365-020-00840-5. Epub 2020 May 23. — View Citation

Bernard-Valnet R, Pizzarotti B, Anichini A, Demars Y, Russo E, Schmidhauser M, Cerutti-Sola J, Rossetti AO, Du Pasquier R. Two patients with acute meningoencephalitis concomitant with SARS-CoV-2 infection. Eur J Neurol. 2020 Sep;27(9):e43-e44. doi: 10.1111/ene.14298. Epub 2020 May 30. No abstract available. — View Citation

Espindola OM, Brandao CO, Gomes YCP, Siqueira M, Soares CN, Lima MASD, Leite ACCB, Torezani G, Araujo AQC, Silva MTT. Cerebrospinal fluid findings in neurological diseases associated with COVID-19 and insights into mechanisms of disease development. Int J Infect Dis. 2021 Jan;102:155-162. doi: 10.1016/j.ijid.2020.10.044. Epub 2020 Oct 28. — View Citation

Kumar A, Pareek V, Prasoon P, Faiq MA, Kumar P, Kumari C, Narayan RK. Possible routes of SARS-CoV-2 invasion in brain: In context of neurological symptoms in COVID-19 patients. J Neurosci Res. 2020 Dec;98(12):2376-2383. doi: 10.1002/jnr.24717. Epub 2020 Aug 31. — View Citation

Liotta EM, Batra A, Clark JR, Shlobin NA, Hoffman SC, Orban ZS, Koralnik IJ. Frequent neurologic manifestations and encephalopathy-associated morbidity in Covid-19 patients. Ann Clin Transl Neurol. 2020 Nov;7(11):2221-2230. doi: 10.1002/acn3.51210. Epub 2020 Oct 5. — View Citation

Liu J, Xie W, Wang Y, Xiong Y, Chen S, Han J, Wu Q. A comparative overview of COVID-19, MERS and SARS: Review article. Int J Surg. 2020 Sep;81:1-8. doi: 10.1016/j.ijsu.2020.07.032. Epub 2020 Jul 26. — View Citation

Montalvan V, Lee J, Bueso T, De Toledo J, Rivas K. Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review. Clin Neurol Neurosurg. 2020 Jul;194:105921. doi: 10.1016/j.clineuro.2020.105921. Epub 2020 May 15. — View Citation

Najjar S, Najjar A, Chong DJ, Pramanik BK, Kirsch C, Kuzniecky RI, Pacia SV, Azhar S. Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020 Aug 6;17(1):231. doi: 10.1186/s12974-020-01896-0. — View Citation

Noorwali AA, Turkistani AM, Asiri SI, Trabulsi FA, Alwafi OM, Alzahrani SH, Rashid MM, Hegazy SA, Alzaydi MD, Bawakid KO. Descriptive epidemiology and characteristics of confirmed cases of Middle East respiratory syndrome coronavirus infection in the Makkah Region of Saudi Arabia, March to June 2014. Ann Saudi Med. 2015 May-Jun;35(3):203-9. doi: 10.5144/0256-4947.2015.203. — View Citation

Paniz-Mondolfi A, Bryce C, Grimes Z, Gordon RE, Reidy J, Lednicky J, Sordillo EM, Fowkes M. Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). J Med Virol. 2020 Jul;92(7):699-702. doi: 10.1002/jmv.25915. — View Citation

Pereira A. Long-Term Neurological Threats of COVID-19: A Call to Update the Thinking About the Outcomes of the Coronavirus Pandemic. Front Neurol. 2020 Apr 17;11:308. doi: 10.3389/fneur.2020.00308. eCollection 2020. No abstract available. — View Citation

Solomon IH, Normandin E, Bhattacharyya S, Mukerji SS, Keller K, Ali AS, Adams G, Hornick JL, Padera RF Jr, Sabeti P. Neuropathological Features of Covid-19. N Engl J Med. 2020 Sep 3;383(10):989-992. doi: 10.1056/NEJMc2019373. Epub 2020 Jun 12. No abstract available. — View Citation

Song E, Zhang C, Israelow B, Lu-Culligan A, Prado AV, Skriabine S, Lu P, Weizman OE, Liu F, Dai Y, Szigeti-Buck K, Yasumoto Y, Wang G, Castaldi C, Heltke J, Ng E, Wheeler J, Alfajaro MM, Levavasseur E, Fontes B, Ravindra NG, Van Dijk D, Mane S, Gunel M, Ring A, Kazmi SAJ, Zhang K, Wilen CB, Horvath TL, Plu I, Haik S, Thomas JL, Louvi A, Farhadian SF, Huttner A, Seilhean D, Renier N, Bilguvar K, Iwasaki A. Neuroinvasion of SARS-CoV-2 in human and mouse brain. bioRxiv. 2020 Sep 8:2020.06.25.169946. doi: 10.1101/2020.06.25.169946. Preprint. — View Citation

Virhammar J, Kumlien E, Fallmar D, Frithiof R, Jackmann S, Skold MK, Kadir M, Frick J, Lindeberg J, Olivero-Reinius H, Ryttlefors M, Cunningham JL, Wikstrom J, Grabowska A, Bondeson K, Bergquist J, Zetterberg H, Rostami E. Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid. Neurology. 2020 Sep 8;95(10):445-449. doi: 10.1212/WNL.0000000000010250. Epub 2020 Jun 25. — View Citation

Yachou Y, El Idrissi A, Belapasov V, Ait Benali S. Neuroinvasion, neurotropic, and neuroinflammatory events of SARS-CoV-2: understanding the neurological manifestations in COVID-19 patients. Neurol Sci. 2020 Oct;41(10):2657-2669. doi: 10.1007/s10072-020-04575-3. Epub 2020 Jul 28. — View Citation

* Note: There are 15 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Determination of SARS-CoV-2 presence in the CNS	Brain tissue sampling analysis	Surgery