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新冠疫情:神经学视角

COVID-19 Pandemic: A Neurological Perspective.

作者信息

Lahiri Durjoy, Ardila Alfredo

机构信息

Neurology, Institute of Post Graduate Medical Education & Research, Kolkata, IND.

Neuropsychology, I.M. Sechenov First Moscow State Medical University, Moscow, RUS.

出版信息

Cureus. 2020 Apr 29;12(4):e7889. doi: 10.7759/cureus.7889.

Abstract

Even though severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed to principally affect the respiratory system, neurological involvements have already been reported in some published work. We have reviewed original articles, case reports, and existing open-source data-sets to delineate the spectrum of neurological disorders potentially observed in SARS-CoV-2 positive cases. Neurological involvement in coronavirus disease 2019 (COVID-19) corresponds to three situations: (a) neurological manifestations of viral infection, (b) post-infective neurological complications, and (c) infection in patients with neurological co-morbidity. Neurological manifestations can further be subdivided into the central nervous system (headache, dizziness, alteration of the sensorium, ataxia encephalitis, stroke, and seizures) and peripheral nervous system (skeletal muscle injury and peripheral nerve involvement including hyposmia and hypogeusia) symptomatology. Post-infective neurological complications include demyelinating conditions. Reduced mobility and dementia as co-morbidities may predispose a patient to have a viral infection. It is concluded that the pandemic of COVID-19 presents for a neurologist some unique challenges. We observe that SARS-CoV-2 may have various neurological manifestations and in many cases, neurological features may precede typical respiratory symptoms.

摘要

尽管已观察到严重急性呼吸综合征冠状病毒2(SARS-CoV-2)主要影响呼吸系统,但在一些已发表的研究中已有神经受累的报道。我们回顾了原始文章、病例报告和现有的开源数据集,以描述在SARS-CoV-2阳性病例中可能观察到的神经系统疾病谱。2019冠状病毒病(COVID-19)中的神经受累对应三种情况:(a)病毒感染的神经表现,(b)感染后神经并发症,以及(c)有神经合并症患者的感染。神经表现可进一步细分为中枢神经系统(头痛、头晕、意识改变、共济失调、脑炎、中风和癫痫发作)和周围神经系统(骨骼肌损伤和周围神经受累,包括嗅觉减退和味觉减退)症状。感染后神经并发症包括脱髓鞘疾病。行动不便和痴呆作为合并症可能使患者易患病毒感染。结论是,COVID-19大流行给神经科医生带来了一些独特的挑战。我们观察到SARS-CoV-2可能有各种神经表现,而且在许多情况下,神经特征可能先于典型的呼吸道症状出现。

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