Ranganathan Chakrapani, Fusinski Shelley D, Obeid Imad M, Ismail Khaled M, Ferguson Derrick T, Raminick Mindy F, Dawes Sean M
Ascension Macomb-Oakland Hospital, Neurology, USA.
Ascension Macomb-Oakland Hospital, Pulmonary/Critical Care Medicine, USA.
eNeurologicalSci. 2021 Mar;22:100327. doi: 10.1016/j.ensci.2021.100327. Epub 2021 Feb 7.
Patients infected with COVID-19 virus, show a highly variable symptomatology which can include central nervous system (CNS) dysfunction. One of the most disabling CNS manifestations is persistent severe encephalopathy seen for weeks after the resolution of the acute viral pneumonia and associated acute systemic illnesses. The precise pathophysiology of this persistent Post COVID Encephalopathy is unknown but may involve direct viral invasion of microvascular endothelium, microvascular thrombosis, toxic neuronal effects of inflammatory products, vasoactive pathology at arteriolar level or leptomeningeal inflammation. Currently, there are no established specific treatments for Post COVID -19 encephalopathy. We present a case series of three patients that underwent Therapeutic Plasma Exchange (TPE) with salinized albumin that suggests a positive therapeutic effect. We believe that the results warrant further evaluation for the role of TPE with a prospective randomized trial in persistent Post COVID -19 encephalopathy syndrome.
感染新冠病毒的患者表现出高度可变的症状，其中可能包括中枢神经系统（CNS）功能障碍。最致残的中枢神经系统表现之一是在急性病毒性肺炎及相关急性全身性疾病消退数周后出现的持续性严重脑病。这种持续性新冠后脑病的确切病理生理学尚不清楚，但可能涉及病毒对微血管内皮的直接侵袭、微血管血栓形成、炎症产物的毒性神经元效应、小动脉水平的血管活性病理变化或软脑膜炎症。目前，对于新冠后脑病尚无既定的特异性治疗方法。我们报告了一组三例接受了用盐化白蛋白进行治疗性血浆置换（TPE）的患者病例系列，提示了积极的治疗效果。我们认为这些结果值得通过前瞻性随机试验进一步评估TPE在持续性新冠后脑病综合征中的作用。
