RESUMO
BACKGROUND: A growing number of reports suggest that infection with SARS-CoV-2 often leads to neurological involvement; however, data on the incidence and severity are limited to mainly case reports and retrospective studies. METHODS: This prospective, cross-sectional study of 102 SARS-CoV-2 PCR positive patients investigated the frequency, type, severity and risk factors as well as underlying pathophysiological mechanisms of neurological involvement (NIV) in COVID-19 patients. RESULTS: Across the cohort, 59.8% of patients had NIV. Unspecific NIV was suffered by 24.5%, mainly general weakness and cognitive decline or delirium. Mild NIV was found in 9.8%; most commonly, impaired taste or smell. Severe NIV was present in 23.5%; half of these suffered cerebral ischaemia. Incidence of NIV increased with respiratory symptoms of COVID-19. Mortality was higher with increasing NIV severity. Notably, 83.3% with severe NIV had a pre-existing neurological co-morbidity. All cerebrospinal fluid (CSF) samples were negative for SARS-CoV-2 RNA, and SARS-CoV-2 antibody quotient did not suggest intrathecal antibody synthesis. Of the patients with severe NIV, 50% had blood-brain barrier (BBB) disruption and showed a trend of elevated interleukin levels in CSF. Antibodies against neuronal and glial epitopes were detected in 35% of the patients tested. CONCLUSION: Cerebrovascular events were the most frequent severe NIV and severe NIV was associated with high mortality. Incidence of NIV increased with respiratory symptoms and NIV and pre-existing neurological morbidities were independent risk factors for fatality. Inflammatory involvement due to BBB disruption and cytokine release drives NIV, rather than direct viral invasion. These findings might help physicians define a further patient group requiring particular attention during the pandemic.
RESUMO
Why do people listen to music? Over the past several decades, scholars have proposed numerous functions that listening to music might fulfill. However, different theoretical approaches, different methods, and different samples have left a heterogeneous picture regarding the number and nature of musical functions. Moreover, there remains no agreement about the underlying dimensions of these functions. Part one of the paper reviews the research contributions that have explicitly referred to musical functions. It is concluded that a comprehensive investigation addressing the basic dimensions underlying the plethora of functions of music listening is warranted. Part two of the paper presents an empirical investigation of hundreds of functions that could be extracted from the reviewed contributions. These functions were distilled to 129 non-redundant functions that were then rated by 834 respondents. Principal component analysis suggested three distinct underlying dimensions: People listen to music to regulate arousal and mood, to achieve self-awareness, and as an expression of social relatedness. The first and second dimensions were judged to be much more important than the third-a result that contrasts with the idea that music has evolved primarily as a means for social cohesion and communication. The implications of these results are discussed in light of theories on the origin and the functionality of music listening and also for the application of musical stimuli in all areas of psychology and for research in music cognition.