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新型冠状病毒 2019 患者的磁共振成像(MRI)和神经表现。

Magnetic Resonance Imaging (MRI) and neurological manifestations in SARS-CoV-2 patients.

机构信息

Department of Physiology, Medicine-Neurology Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

Eur Rev Med Pharmacol Sci. 2021 Jan;25(2):1101-1108. doi: 10.26355/eurrev_202101_24681.

Abstract

OBJECTIVE

The "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" disease caused a challenging and threating pandemic (COVID-19) worldwide with a great loss to life and the global economy. SARS-CoV-2 mainly involves the respiratory system, however, with Magnetic Resonance Imaging (MRI), neurological and special senses clinical manifestations have been reported rarely. The present study aims to investigate the MRI findings, clinical manifestations of neurological and special senses involvement in SARS-CoV-2 patients.

MATERIALS AND METHODS

In this study, 284 articles from the databases "Pub-Med, Web of Science-Clarivate Analytics, Embase and Google Scholar" were identified. The keywords, coronavirus, SARS-CoV-2, COVID-19 pandemic, MRI, brain, special senses, neurological involvement were entered into the search engines and the concerned documents were selected and reviewed. The descriptive information was recorded from the particular studies; finally, we included 48 publications.

RESULTS

The common neurological manifestations in SARS-CoV-2 patients were headache, impaired consciousness, acute cerebrovascular disease, ataxia, tremors, meningitis, encephalitis, cerebral bleeding, subarachnoid hemorrhage, frontal lobe, temporal lobe and intracerebral hematoma, hemiparesis and seizures. However, common special senses manifestations in SARS-CoV-2 patients were olfactory, auditory and gustatory disorders including red eyes, painless monocular visual disturbance, anosmia, ageusia, dysgeusia, dysosmia and hypoacusis. Moreover, the MRI findings identified in SARS-CoV-2 patients were isolated oval-shaped lesion in the corpus callosum, bilateral basal ganglia hemorrhage, ischemic lesions involving the corpus callosum, basal ganglia, cerebellum and vasogenic edema extending to the cerebral peduncles, pons and ventricles.

CONCLUSIONS

The neurologic manifestations of SARS-CoV-2 patients are highly variable. The SARS-COV-2 exerts its damaging effects on the nervous system and special senses by developing determinant numerous neurological and special senses' clinical manifestations. Physicians with the help of MRI must rule out the neurological and special senses manifestations among SARS-CoV-2 patients.

摘要

目的

“严重急性呼吸系统综合症冠状病毒 2 型(SARS-CoV-2)”引起的疾病在全球范围内造成了极具挑战性和威胁性的大流行(COVID-19),给生命和全球经济带来了巨大损失。SARS-CoV-2 主要涉及呼吸系统,然而,磁共振成像(MRI)、神经系统和特殊感觉的临床表现很少有报道。本研究旨在探讨 SARS-CoV-2 患者的 MRI 表现、神经系统和特殊感觉受累的临床表现。

材料和方法

本研究从“Pub-Med、Web of Science-Clarivate Analytics、Embase 和 Google Scholar”数据库中确定了 284 篇文章。在搜索引擎中输入关键词“冠状病毒、SARS-CoV-2、COVID-19 大流行、MRI、脑、特殊感觉、神经受累”,并选择和回顾相关文献。从特定研究中记录描述性信息;最后,我们纳入了 48 篇文献。

结果

SARS-CoV-2 患者常见的神经系统表现为头痛、意识障碍、急性脑血管病、共济失调、震颤、脑膜炎、脑炎、脑出血、蛛网膜下腔出血、额叶、颞叶和脑内血肿、偏瘫和癫痫发作。然而,SARS-CoV-2 患者常见的特殊感觉表现为嗅觉、听觉和味觉障碍,包括眼红、无痛性单眼视觉障碍、嗅觉丧失、味觉丧失、味觉障碍、嗅觉障碍和听力下降。此外,SARS-CoV-2 患者的 MRI 表现为孤立的胼胝体椭圆形病变、双侧基底节出血、胼胝体、基底节、小脑和血管源性水肿延伸至大脑脚、脑桥和脑室的缺血性病变。

结论

SARS-CoV-2 患者的神经系统表现高度多样化。SARS-CoV-2 通过产生大量的神经系统和特殊感觉临床表现,对神经系统和特殊感觉造成损害。医生必须借助 MRI 排除 SARS-CoV-2 患者的神经系统和特殊感觉表现。

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