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以年轻患者血管炎相关性卒中为首发表现的新型冠状病毒病(COVID19)病例报告。

Vasculitis-related stroke in young as a presenting feature of novel coronavirus disease (COVID19) - Case report.

机构信息

Neurology Service of Specialized Health Department, Center of Biological and Health Sciences, Universidade do Estado do Pará, Belém, Brazil; Neurology Unit of Pará (UNINEURO), Belém, Brazil.

Neurology Unit of Pará (UNINEURO), Belém, Brazil; Centro Universitário Metropolitano da Amazônia, UNIFAMAZ, Brazil.

出版信息

J Clin Neurosci. 2020 Sep;79:169-171. doi: 10.1016/j.jocn.2020.07.034. Epub 2020 Jul 17.

Abstract

COVID-19 is the disease caused by Novel Coronavirus (SARS-CoV-2) infection and world current main public health problem, due to its easy transmissibility and multiple clinical presentations. The main symptoms reported worldwide are dry cough, dyspnea, and fever, as well as anosmia and ageusia. COVID-19 diagnosis is made with RT-PCR, but many other complementary exams may be used to guide clinical practice, such as Chest Computerized Tomography (CT), showing ground glass opacities; increase in inflammatory markers, as C-Reactive Protein and Erythrocyte Sedimentation Rate; hemogram might show hypoalbuminemia, thrombocytopenia. Severe cases may evolve to thromboembolic and atheroembolic events, leading to stroke, myocardial infarction, pulmonary thromboembolism. Male, 28 years old, went for neurological appointment after presenting episode of intense headache, dysarthria, deviation of lip rhyme on appointment's eve. Previously healthy, no comorbidities or risk factors. Underwent brain MRI and serum serological analysis. SARS-CoV-2 capacity of affecting brain homeostasis by breaking blood-brain barrier, makes it easier to develop ischemic or inflammatory damage, and invading central nervous system. Neurological symptoms and syndromes are the main consequences of COVID-19 pandemic and must be prevented through adequate clinical management.

摘要

新型冠状病毒(SARS-CoV-2)感染引起的 COVID-19 是目前全球主要的公共卫生问题,因为其具有很强的传染性和多种临床表现。全球报告的主要症状为干咳、呼吸困难和发热,以及嗅觉和味觉丧失。COVID-19 的诊断采用 RT-PCR,但可能会使用许多其他补充检查来指导临床实践,例如胸部计算机断层扫描(CT),显示磨玻璃样混浊;炎症标志物增加,如 C 反应蛋白和红细胞沉降率;血象可能显示低白蛋白血症、血小板减少症。严重病例可能会发展为血栓栓塞和动脉粥样栓塞事件,导致中风、心肌梗死、肺血栓栓塞症。男性,28 岁,在出现剧烈头痛、构音障碍、唇音偏斜后预约神经科就诊。既往健康,无合并症或危险因素。行脑 MRI 和血清血清学分析。新型冠状病毒通过破坏血脑屏障影响脑内稳态的能力,使其更容易发生缺血性或炎症性损伤,并侵犯中枢神经系统。神经系统症状和综合征是 COVID-19 大流行的主要后果,必须通过适当的临床管理加以预防。

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