Neurology Unit, University Hospital of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Multiple Sclerosis Clinical and Research Unit, University Hospital of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
J Neurol. 2021 Apr;268(4):1171-1178. doi: 10.1007/s00415-020-10131-y. Epub 2020 Aug 27.
SARS-CoV2 infection is responsible for a complex clinical syndrome, named Coronavirus Disease 2019 (COVID-19), whose main consequences are severe pneumonia and acute respiratory distress syndrome. Occurrence of acute and subacute neurological manifestations (encephalitis, stroke, headache, seizures, Guillain-Barrè syndrome) is increasingly reported in patients with COVID-19. Moreover, SARS-CoV2 immunopathology and tissue colonization in the gut and the central nervous system, and the systemic inflammatory response during COVID-19 may potentially trigger chronic autoimmune and neurodegenerative disorders. Specifically, Parkinson's disease, multiple sclerosis and narcolepsy present several pathogenic mechanisms that can be hypothetically initiated by SARS-CoV2 infection in susceptible individuals. In this short narrative review, we summarize the clinical evidence supporting the rationale for investigating SARS-CoV2 infection as risk factor for these neurological disorders, and suggest the opportunity to perform in the future SARS-CoV2 serology when diagnosing these disorders.
SARS-CoV2 感染可引起一种复杂的临床综合征，即 2019 年冠状病毒病（COVID-19），其主要后果为严重肺炎和急性呼吸窘迫综合征。越来越多的 COVID-19 患者出现急性和亚急性神经系统表现（脑炎、中风、头痛、癫痫发作、吉兰-巴雷综合征）。此外，SARS-CoV2 在肠道和中枢神经系统中的免疫病理和组织定植，以及 COVID-19 期间的全身炎症反应，可能会引发慢性自身免疫和神经退行性疾病。具体而言，帕金森病、多发性硬化症和发作性睡病都存在一些可能由易感个体的 SARS-CoV2 感染引发的发病机制。在这个简短的叙述性综述中，我们总结了支持将 SARS-CoV2 感染作为这些神经系统疾病的危险因素进行研究的临床证据，并建议在未来诊断这些疾病时进行 SARS-CoV2 血清学检测。
