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一名新冠病毒疾病患者在急诊科出现口吃和找词困难的情况。

Stuttering and Word-Finding Difficulties in a Patient With COVID-19 Presenting to the Emergency Department.

作者信息

Morrison Nathan, Levy Joshua, Shoshany Talia, Dickinson Aaron, Whalen Michael

机构信息

Internal Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, USA.

Internal Medicine, Lankenau Medical Center, Wynnewood, USA.

出版信息

Cureus. 2020 Nov 29;12(11):e11774. doi: 10.7759/cureus.11774.

Abstract

Coronavirus disease 2019 (COVID-19) was designated as a global pandemic by the World Health Organization (WHO) on March 11, 2020. The Cochrane Database of Systematic Reviews documents that COVID-19 has a wide range of common symptoms, which have made it difficult to characterize the disease. To date, the neurological symptoms of stuttering and word-finding difficulties have not been reported in confirmed COVID-19 cases. This case report describes the clinical course of a 53-year-old female that presented to the emergency department (ED) twice with varying symptoms consistent with COVID-19. At the second ED visit, she complained of new-onset stuttering and word-finding difficulties and tested positive for COVID-19 using the polymerase chain reaction (PCR) nasopharynx test. When contacted, the patient stated that her speech issues persisted at least seven days after discharge from her second ED visit. As a result, the virus may cause symptoms of an acute neurological event and should be taken into diagnostic consideration. These neurological findings may be explained by the recent discovery of the COVID-19 spike protein's ability to destabilize the blood-brain barrier (BBB) and enter the central nervous system (CNS). Increased classification of unrecognized COVID-19 symptoms and complications may aid in the characterization, surveillance, and prevention of the disease.

摘要

2020年3月11日,世界卫生组织(WHO)将2019冠状病毒病(COVID-19)定为全球大流行病。考科蓝系统评价数据库记录显示,COVID-19有多种常见症状,这使得对该疾病进行特征描述变得困难。迄今为止,确诊的COVID-19病例中尚未报告口吃和找词困难等神经症状。本病例报告描述了一名53岁女性的临床病程,她两次因符合COVID-19的不同症状前往急诊科(ED)就诊。在第二次前往急诊科就诊时,她抱怨出现新发口吃和找词困难,并且通过聚合酶链反应(PCR)鼻咽检测确诊为COVID-19阳性。经联系,患者表示其言语问题在第二次急诊科就诊出院后至少持续了七天。因此,该病毒可能会引发急性神经事件的症状,应纳入诊断考量。最近发现COVID-19刺突蛋白能够破坏血脑屏障(BBB)并进入中枢神经系统(CNS),这或许可以解释这些神经学发现。对未被识别的COVID-19症状和并发症进行更多分类,可能有助于对该疾病进行特征描述、监测和预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8723/7779121/43c6599ce0e8/cureus-0012-00000011774-i01.jpg

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