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多发性微出血:危重症COVID-19患者的一种严重神经学表现

Multiple Microbleeds: A Serious Neurological Manifestation in a Critically Ill COVID-19 Patient.

作者信息

Haroon Khawaja Hassan, Patro Satya Narayana, Hussain Suhail, Zafar AbdulAziz, Muhammad Ahmad

机构信息

Neuroscience Institute, Hamad Medical Corporation, Doha, Qatar.

Weill Cornell Medicine-Qatar, Doha, Qatar.

出版信息

Case Rep Neurol. 2020 Nov 2;12(3):373-377. doi: 10.1159/000512322. eCollection 2020 Sep-Dec.

Abstract

Coronavirus disease 2019 (COVID-19) is a viral illness caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is worldwide emerging evidence of multisystem involvement including different neurological manifestations in COVID-19 patients. As a result, healthcare systems worldwide are not only experiencing diagnostic but also therapeutic and prognostic challenges with COVID-19-related complications. Cerebral microbleeds and leukoencephalopathy have been described in COVID-19 patients; although the mechanism remains unknown, possibilities include endotheliitis with thrombotic microangiopathy, excessive inflammation, prolonged respiratory failure, and hypoxemia. We describe here the clinical, radiological, and laboratory findings as well as the 90-day outcome of a 72-year-old gentleman who presented with severe SARS-CoV-2 infection, leading to diffuse cerebral microhemorrhages and ischemic infarct causing severe morbidity. He was tested positive for COVID-19 confirmed by reverse transcriptase polymerase chain reaction.

摘要

2019冠状病毒病(COVID-19)是一种由新型严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的病毒性疾病。全球有越来越多的证据表明,COVID-19患者存在多系统受累,包括不同的神经表现。因此,全球医疗系统不仅在COVID-19相关并发症的诊断方面,而且在治疗和预后方面都面临挑战。COVID-19患者中已发现脑微出血和白质脑病;尽管其机制尚不清楚,但可能原因包括伴有血栓性微血管病的血管内皮炎、过度炎症反应、长时间呼吸衰竭和低氧血症。我们在此描述一名72岁男性患者的临床、影像学和实验室检查结果以及90天的预后情况,该患者出现严重的SARS-CoV-2感染,导致弥漫性脑微出血和缺血性梗死,造成严重的发病情况。通过逆转录聚合酶链反应确诊其COVID-19检测呈阳性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b27/7670363/ed5a55b889c7/crn-0012-0373-g01.jpg

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