Morrison Nathan, Levy Joshua, Shoshany Talia, Dickinson Aaron, Whalen Michael
Internal Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, USA.
Internal Medicine, Lankenau Medical Center, Wynnewood, USA.
Cureus. 2020 Nov 29;12(11):e11774. doi: 10.7759/cureus.11774.
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.
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。