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新型冠状病毒肺炎的神经复杂性与预后

The Neurological Complexities and Prognosis of COVID-19.

作者信息

Padda Inderbir, Khehra Nimrat, Jaferi Urooj, Parmar Mayur S

机构信息

University of Washington, Seattle, WA USA.

Caribbean Medical University School of Medicine, Willemstad, Curaçao.

出版信息

SN Compr Clin Med. 2020;2(11):2025-2036. doi: 10.1007/s42399-020-00527-2. Epub 2020 Sep 29.

DOI:10.1007/s42399-020-00527-2
PMID:33015552
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7522181/
Abstract

Several neurological manifestations and complications linked to SARS-CoV-2 have been reported along with well-known respiratory pathology. The global active transmission of SARS-CoV-2 and its unexplained characteristics has led to a pandemic. Since its rapid emergence from Wuhan, China, in December 2019, several studies have reported the impacts of COVID-19 on the CNS and PNS and its implications. This comprehensive review article comprises case reports, case series, metaanalysis, cohort studies, retrospective studies, and narrative reviews focusing on COVID-19-associated CNS and PNS complexities. The authors searched for over 200 articles and used 52 publications related to the neurological complexities of COVID-19 affecting the CNS and PNS as part of the literature review process. The predominant CNS symptoms noted in COVID-19 patients were headaches and dizziness, and the most common PNS symptoms were alterations in smell and taste. Case reports on headache/dizziness, intracerebral hemorrhage, acute hemorrhagic necrotizing encephalopathy, meningitis/encephalitis, encephalopathy, cerebrovascular events, chemosensory dysfunction, Guillain-Barre syndrome, and acute transverse myelitis/acute necrotizing myelitis in PCR-confirmed SARS-CoV-2 subjects are also reported. New-onset neurological symptoms were also observed in children with PCR-confirmed SARS-CoV-2 that developed pediatric multisystem inflammatory syndrome (PIMS). This comprehensive review article will assist the clinicians and researchers to gain information about the neurological manifestations and complications associated with COVID-19 and develop planning to treat these symptoms in concerned patients of all ages. However, it is unclear whether SARS-CoV2-associated neurological effects are due to primary infections or secondary response to the possible mechanisms discussed in this review.

摘要

除了众所周知的呼吸道病理外,还报告了几种与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)相关的神经学表现和并发症。SARS-CoV-2在全球的活跃传播及其不明原因的特征导致了一场大流行。自2019年12月在中国武汉迅速出现以来,多项研究报告了2019冠状病毒病(COVID-19)对中枢神经系统(CNS)和周围神经系统(PNS)的影响及其意义。这篇全面的综述文章包括病例报告、病例系列、荟萃分析、队列研究、回顾性研究以及针对COVID-19相关的中枢神经系统和周围神经系统复杂性的叙述性综述。作者检索了200多篇文章,并使用了52篇与影响中枢神经系统和周围神经系统的COVID-19神经学复杂性相关的出版物作为文献综述过程的一部分。COVID-19患者中主要的中枢神经系统症状是头痛和头晕,最常见的周围神经系统症状是嗅觉和味觉改变。还报告了PCR确诊的SARS-CoV-2受试者中关于头痛/头晕、脑出血、急性出血性坏死性脑病、脑膜炎/脑炎、脑病、脑血管事件、化学感觉功能障碍、吉兰-巴雷综合征以及急性横贯性脊髓炎/急性坏死性脊髓炎的病例报告。在PCR确诊的SARS-CoV-2且患有儿童多系统炎症综合征(PIMS)的儿童中也观察到了新发神经症状。这篇全面的综述文章将帮助临床医生和研究人员获取有关与COVID-19相关的神经学表现和并发症的信息,并制定计划来治疗各年龄段相关患者的这些症状。然而,尚不清楚SARS-CoV-2相关的神经学影响是由于原发性感染还是对本综述中讨论的可能机制的继发性反应。

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