Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Rio de Janeiro, RJ, Brasil.
Rev Soc Bras Med Trop. 2020 Oct 5;53:e20200477. doi: 10.1590/0037-8682-0477-2020. eCollection 2020.
Recent reports indicate that besides respiratory and systemic symptoms among coronavirus disease (COVID-19) patients, the disease has a wide spectrum of neurological manifestations (encephalitis, meningitis, myelitis, acute disseminated encephalomyelitis, metabolic and acute hemorrhagic necrotizing encephalopathy, cerebrovascular diseases, Guillain-Barré syndrome, polyneuritis cranialis, dysautonomia, and myopathies). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can spread from the respiratory system to the central nervous system, using transneuronal and hematogenous mechanisms. Although not every COVID-19 patient will test positive for the virus in the cerebrospinal fluid exam, the appearance of neurological symptoms associated with SARS-CoV-2 infection reveals the importance of understanding the neurologic manifestations and capacity for neural invasion associated with the pathogen. These aspects are relevant for correct diagnosis and treatment, and for the potential development of vaccines. This review highlights the latest evidence of SARS-CoV-2 infection with a focus on neurological involvement and potential neuropathogenesis mechanisms.
最近的报告表明,除了冠状病毒病 (COVID-19) 患者的呼吸和全身症状外,该疾病还具有广泛的神经系统表现(脑炎、脑膜炎、脊髓炎、急性播散性脑脊髓炎、代谢性和急性出血坏死性脑病、脑血管疾病、吉兰-巴雷综合征、颅神经病、自主神经功能紊乱和肌病)。严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 可以通过神经元转移和血液传播机制从呼吸系统传播到中枢神经系统。尽管并非每个 COVID-19 患者的脑脊液检查都会检测到病毒呈阳性,但与 SARS-CoV-2 感染相关的神经系统症状的出现表明,了解与病原体相关的神经表现和神经入侵能力非常重要。这些方面对于正确的诊断和治疗以及潜在疫苗的开发都很重要。本综述重点介绍了 SARS-CoV-2 感染的最新证据,包括神经系统受累和潜在的神经发病机制。