{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:33Z","timestamp":1772168913032,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.155250.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000}}],"reference-count":17,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Background Cogan\u2019s syndrome is a rare autoimmune disorder characterized by ocular inflammation, vestibulocochlear dysfunction, and systemic vasculitis. Case Presentation We report a 28-year-old female who experienced decreased visual acuity and ocular redness one month after a COVID-19 infection, with ophthalmological signs linked to keratitis, uveitis and retinal vasculitis. Two weeks later, she developed vertigo, tinnitus, and sudden hearing loss, leading to a diagnosis of Cogan\u2019s disease. The patient received corticosteroid therapy, resulting in regression of ophthalmological signs, but progressed to complete deafness. One month later, she presented with lymphocytic meningitis and high intracranial pressure, which improved under treatment. The patient later received cochlear implants. Objective This case report aims to highlight an atypical presentation of Cogan\u2019s syndrome with neurological involvement following a COVID-19 infection. This case contributes to the limited literature on such presentations. Conclusion Our case is one of only two reported instances of Cogan\u2019s syndrome presenting with neurological signs post-COVID-19 infection, underscoring the rarity and complexity of this condition.<\/ns4:p>","DOI":"10.12688\/f1000research.155250.2","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T07:55:07Z","timestamp":1734681307000},"page":"1104","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Atypical post-COVID Cogan's syndrome"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6889-4181","authenticated-orcid":false,"given":"Sameh","family":"Mezri","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2279-3038","authenticated-orcid":false,"given":"Chaima","family":"Zitouni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wafa","family":"Sleimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayssa","family":"Bouzidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayhi","family":"Sameh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"88-93","DOI":"10.5693\/djo.02.2023.07.001","article-title":"Cogan syndrome: a case report and review of the literature.","volume":"29","author":"N Kahuam-L\u00f3pez","year":"2023","journal-title":"Digit. J. Ophthalmol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"476527","DOI":"10.1155\/2013\/476527","article-title":"Atypical Cogan\u2019s Syndrome.","volume":"2013","author":"J Queir\u00f3s","year":"2013","journal-title":"Case Rep. Ophthalmol. Med."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2517-2518","DOI":"10.1007\/s10067-023-06642-4","article-title":"Cogan syndrome following SARS-COV-2 infection.","volume":"42","author":"L Chen","year":"2023","journal-title":"Clin. Rheumatol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"318-321","DOI":"10.1016\/j.reuma.2019.11.008","article-title":"Cogan syndrome: Descriptive analysis and clinical experience of 7 cases diagnosed and treated in two third level hospitals.","volume":"17","author":"T Almorza Hidalgo","year":"2021","journal-title":"Reumatol. Clin."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"55-63","DOI":"10.1097\/NRL.0b013e31823fa3a0","article-title":"Cogan syndrome: an analysis of reported neurological manifestations.","volume":"18","author":"N Antonios","year":"2012","journal-title":"Neurologist."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"103340","DOI":"10.1016\/j.autrev.2023.103340","article-title":"Insights into new-onset autoimmune diseases after COVID-19 vaccination.","volume":"22","author":"M Guo","year":"2023","journal-title":"Autoimmun. 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Head Neck Dis."},{"key":"ref15","first-page":"6-13","article-title":"COGAN\u2019S SYNDROME.","volume":"59","author":"D Iliescu","year":"2015","journal-title":"Rom. J. Ophthalmol."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"277-282","DOI":"10.5152\/iao.2023.22991","article-title":"Sensorineural Hearing Loss in Autoimmune Diseases: A Systematic Review and Meta-analysis.","volume":"19","author":"X Li","year":"2023","journal-title":"J. Int. Adv. Otol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"179-187","DOI":"10.7150\/ijms.97831","article-title":"Investigating the Process of Autoimmune Inner Ear Disease: Unveiling the Intricacies of Pathogenesis and Therapeutic Strategies.","volume":"22","author":"M Wang","year":"2025","journal-title":"Int. J. Med. Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1-11","DOI":"10.2147\/JMDH.S150940","article-title":"Optimal management of Cogan\u2019s syndrome: a multidisciplinary approach.","volume":"11","author":"V D\u2019Aguanno","year":"2017","journal-title":"J. Multidiscip. Healthc."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"469-487","DOI":"10.1002\/lio2.563","article-title":"Hearing loss in inner ear and systemic autoimmune disease: A systematic review of post-cochlear implantation outcomes.","volume":"6","author":"J Lee","year":"2021","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"32-34","DOI":"10.5693\/djo.02.2015.09.002","article-title":"Cogan syndrome with severe medium and large vessel vasculitis.","volume":"22","author":"D Sevgi","year":"2015","journal-title":"Digit. J. Ophthalmol."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T05:40:09Z","timestamp":1736142009000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,20]]},"references-count":17,"URL":"https:\/\/doi.org\/10.12688\/f1000research.155250.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.155250.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.175760.r351350","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.175760.r351350","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,20]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.170398.r330430, Debashis Maikap, Kalinga Institute of Industrial Technology (KIIT), Odisha, 06 Nov 2024, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/13-1104\/v1#referee-response-330430","order":0,"name":"referee-response-330430","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Chaima zitouni<\/b>; \n<i>Posted: 11 Dec 2024<\/i>; We sincerely thank Dr. Debashis Maikap for the thoughtful review and valuable comments, and here are our detailed responses to the comments provided:  Corrections were made for terms like &quot;retinal vasculitis&quot; rather than &quot;vascularitis&quot; to maintain accuracy in clinical descriptions  Response: We have corrected the typo from &quot;vascularitis&quot; to &quot;vasculitis&quot; as per your suggestion. &nbsp;  Although the case notes a possible autoimmune response triggered by COVID-19, adding context on the immune response patterns in COVID-19 and their role in post-infectious autoimmune diseases like CS would enhance the discussion. The link between viral triggers and autoimmune conditions via mechanisms such as molecular mimicry can deepen understanding of disease etiology.  Response: We have included in the discussion an analysis of the potential mechanisms linking autoimmune pathologies to COVID-19. &nbsp;  The use of high-dose corticosteroids presents infection risks, yet there was no mention of prophylactic measures, such as vaccinations or antibiotic prophylaxis, which are critical in managing immunosuppressed patients. Inclusion of these preventive strategies would provide a more comprehensive view of patient safety in long-term treatment.  Response: We have added a discussion of the prophylactic measures to prevent complications arising from immunosuppressive treatments. &nbsp;  Immunosuppressive agents such as cyclophosphamide, mycophenolate mofetil (MMF), or azathioprine, often utilized as steroid-sparing therapies, were not included in this case report as potential adjunctive treatments for achieving long-term systemic control. In atypical CS cases with progressive symptoms, early initiation of these therapies might have contributed to improved outcomes.  Response: In response to your suggestion, we have expanded the discussion to include steroid-sparing immunosuppressive agents such as methotrexate and azathioprine\u2026  &nbsp;  Complement levels and anti-double-stranded DNA (anti-dsDNA) antibodies, critical for ruling out lupus as an alternative diagnosis, were not mentioned.  Response: The anti-DNA antibody was tested (we have added this to the revised text), while the complement levels were not measured. &nbsp;  References Update: The following reference has been added to support the discussion on atypical presentations of Cogan\u2019s syndrome: Maikap D, Pradhan A, Padhan P. A rare case of atypical Cogan's syndrome presenting as encephalitis. Mod Rheumatol Case Rep. 2022 Jun 24;6(2):305-308. doi: 10.1093\/mrcr\/rxab055. PMID: 34957524 (ref-1).  Response: We have added the requested reference to the manuscript and integrated it into the relevant section of the discussion.","URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2#referee-comment-12940","order":1,"name":"referee-comment-12940","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.175760.r351350, Andrea Frosolin, University of Siena, Siena, 06 Jan 2025, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/13-1104\/v2#referee-response-351350","order":2,"name":"referee-response-351350","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}