Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Neurology, Medicine, and Immunology-Microbiology, University of Colorado School of Medicine, Aurora, CO, USA.
Ann Neurol. 2020 Jul;88(1):1-11. doi: 10.1002/ana.25807.
In less than 6 months, the severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) has spread worldwide infecting nearly 6 million people and killing over 350,000. Initially thought to be restricted to the respiratory system, we now understand that coronavirus disease 2019 (COVID-19) also involves multiple other organs, including the central and peripheral nervous system. The number of recognized neurologic manifestations of SARS-CoV-2 infection is rapidly accumulating. These may result from a variety of mechanisms, including virus-induced hyperinflammatory and hypercoagulable states, direct virus infection of the central nervous system (CNS), and postinfectious immune mediated processes. Example of COVID-19 CNS disease include encephalopathy, encephalitis, acute disseminated encephalomyelitis, meningitis, ischemic and hemorrhagic stroke, venous sinus thrombosis, and endothelialitis. In the peripheral nervous system, COVID-19 is associated with dysfunction of smell and taste, muscle injury, the Guillain-Barre syndrome, and its variants. Due to its worldwide distribution and multifactorial pathogenic mechanisms, COVID-19 poses a global threat to the entire nervous system. Although our understanding of SARS-CoV-2 neuropathogenesis is still incomplete and our knowledge is evolving rapidly, we hope that this review will provide a useful framework and help neurologists in understanding the many neurologic facets of COVID-19. ANN NEUROL 2020;88:1-11 ANN NEUROL 2020;88:1-11.
在不到 6 个月的时间里，严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）已在全球范围内传播，感染了近 600 万人，导致超过 35 万人死亡。最初认为它只局限于呼吸系统，但现在我们知道，2019 年冠状病毒病（COVID-19）还涉及多个其他器官，包括中枢和外周神经系统。SARS-CoV-2 感染的神经系统表现被识别的数量正在迅速增加。这些可能是由多种机制引起的，包括病毒引起的过度炎症和高凝状态、病毒对中枢神经系统（CNS）的直接感染以及感染后免疫介导的过程。COVID-19 中枢神经系统疾病的例子包括脑病、脑炎、急性播散性脑脊髓炎、脑膜炎、缺血性和出血性中风、静脉窦血栓形成和血管内皮炎。在外周神经系统，COVID-19 与嗅觉和味觉功能障碍、肌肉损伤、格林-巴利综合征及其变体有关。由于其在全球范围内的分布和多因素的发病机制，COVID-19 对整个神经系统构成了全球性威胁。尽管我们对 SARS-CoV-2 神经发病机制的理解仍不完整，而且我们的知识正在迅速发展，但我们希望这篇综述将提供一个有用的框架，并帮助神经科医生了解 COVID-19 的许多神经方面。ANN NEUROL 2020;88:1-11 ANN NEUROL 2020;88:1-11。
