Orsucci Daniele, Ienco Elena Caldarazzo, Nocita Gianpaolo, Napolitano Alessandro, Vista Marco
Unit of Neurology, San Luca Hospital, Lucca, Italy.
Drugs Context. 2020 Jun 11;9. doi: 10.7573/dic.2020-5-1. eCollection 2020.
Severe acute respiratory syndrome-correlated new coronavirus (SARS-Cov-2) infection may result in neurological signs and symptoms through different mechanisms. Although direct infection of the central nervous system is uncertain or very rare and the para-infectious complications (e.g. inflammatory neuropathies) are rare, delirium and septic encephalopathy are common in severely ill patients. Smell dysfunction and headache are very common in mild cases, especially in younger people and females. Muscle pain is common in both mild and severe cases, and in the most compromised patients, it is accompanied by increased creatine kinase levels and by a likely true myopathic damage. Ischemic stroke has been reported as a possible complication of the hypercoagulability associated with severe SARS-Cov-2 infection, but further studies are needed. Most of the neurological manifestations may occur early in the illness. Therefore, during the pandemic period, neurologists need to be involved, alert, and prepared. Neurological practice will not be the same until a vaccine is available.
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染可能通过不同机制导致神经体征和症状。虽然中枢神经系统的直接感染尚不确定或非常罕见,且感染后并发症(如炎性神经病)也很少见,但谵妄和脓毒症性脑病在重症患者中很常见。嗅觉功能障碍和头痛在轻症病例中非常常见,尤其是在年轻人和女性中。肌肉疼痛在轻症和重症病例中都很常见,在病情最严重的患者中,还伴有肌酸激酶水平升高以及可能存在的真正的肌病损伤。缺血性中风已被报道为与严重SARS-CoV-2感染相关的高凝状态的一种可能并发症,但仍需进一步研究。大多数神经表现可能在疾病早期出现。因此,在疫情期间,神经科医生需要参与其中,保持警惕并做好准备。在有疫苗可用之前,神经科的诊疗工作将有所不同。