Evidence map›Paper›PMID 34290872›Full record

ArticleSAGE open medical case reports2021

Unprovoked serotonin syndrome-like presentation of SARS-CoV-2 infection: A small case series.

Philip Keith, Marc Saint-Jour, Frank Pusey, Jeremy Hodges, Farid Jalali, L Keith Scott

Open access · goldAbstract readCase Reports
In one paragraph

Article in SAGE open medical case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 13 citations in OpenAlex.

  1. Article
  2. Serotonin syndrome controversies: A need for consensus.World journal of critical care medicine · 2024
    Review
  3. Role of Cytochrome P450 2C9 in COVID-19 Treatment: Current Status and Future Directions.European journal of drug metabolism and pharmacokinetics · 2023
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Philip KeithCritical Care Medicine, Lexington Medical Center, West Columbia, SC, USA.ORCID https://orcid.org/0000-0002-9415-0549
Marc Saint-JourInternal Medicine, Lexington Medical Center, West Columbia, SC, USA.
Frank PuseyNeurology, Lexington Medical Center, West Columbia, SC, USA.
Jeremy HodgesCritical Care Clinical Pharmacy, Novant Health Forsyth Medical Center, Winston-Salem, NC, USA.
Farid JalaliDivision of Gastroenterology, Saddleback Medical Group, Laguna Hills, CA, USA.
L Keith ScottDivision of Trauma and Surgical Critical Care, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA.
Lexington Medical Center · USNovant Health Forsyth Medical Center · USSaddleback Memorial Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clinicians and researchers have reported an array of neurological abnormalities in coronavirus disease 2019 (COVID-19), and while serotonin excess has been observed we are unaware of reports of central nervous system serotonin toxicity in COVID-19. We present two cases that resemble serotonin syndrome in COVID-19, but without identifiable inciting medications. A 54-year-old with multiple sclerosis and diabetes mellitus presented with altered mental status. His altered sensorium was attributed to diabetic ketoacidosis, but his condition quickly deteriorated with fever to 105 degrees Fahrenheit, rigidity in all extremities, inducible clonus, and hyperreflexia. He was intubated and was treated for possible meningitis and seizure. Neurologic workup was negative for acute pathology. Despite acetaminophen, his core temperature remained elevated to 105 degrees Fahrenheit. He was treated with external cooling and cyproheptadine and within 48 h, his fever, rigidity, hyperreflexia, and clonus resolved. He was extubated and discharged home on day 14. A 72-year-old with hyperlipidemia was admitted with tremors, 4 days after testing positive for COVID-19. His symptoms rapidly worsened, and he was transferred to the Intensive Care Unit on day 3

Indexed as

Central nervous systemcoronaviruscyproheptadineserotoninserotonin syndrome

Identifiers

PMID34290872
PMCPMC8274092
OpenAlexW3179329819

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.