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[新型冠状病毒肺炎的神经肌肉并发症 - 第2部分:肌肉疾病]

[Neuromuscular complications of SARS-CoV-2 infection-Part 2: muscle disorders].

作者信息

Lehmann Helmar C, Schoser Benedikt, Wunderlich Gilbert, Berlit Peter, Fink Gereon R

机构信息

Klinik und Poliklinik für Neurologie, Universitätsklinikum Köln, Kerpener Straße 62, 50937, Köln, Deutschland.

LMU Klinikum, Friedrich-Baur-Institut, Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Deutschland.

出版信息

Nervenarzt. 2021 Jun;92(6):548-555. doi: 10.1007/s00115-021-01093-1. Epub 2021 Mar 29.

Abstract

Apart from disorders and diseases of the peripheral nerves, symptoms and disorders of the musculature and the neuromuscular transmission have also been described in association with coronavirus disease 2019 (COVID-19). In the second part of our review we provide an overview about frequently reported symptoms, such as myalgia as well as defined disorders, such as rhabdomyolysis, myositis, myasthenia and intensive care unit (ICU)-acquired weakness, which have been described during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections or COVID-19.Furthermore, the criteria for a causality, such as association strength, plausibility, time course, and experimental evidence for a causal association that should be applied for the COVID-19-asssociated neuromuscular conditions described in the two parts of the review are discussed. At present, in addition to anosmia, which is also known in the lay press, myalgia in particular as a nonspecific symptom are frequent sequelae of a symptomatic SARS-CoV‑2 infection. Other neuromuscular complications seem to be principally plausible (considering the pathogenesis) but apparently rare consequences of a SARS-CoV‑2 infection. Prospective or cohort studies are necessary to confirm a causality and assess the risk.

摘要

除了周围神经疾病外,与2019冠状病毒病(COVID-19)相关的肌肉组织症状和神经肌肉传递障碍也有报道。在本综述的第二部分,我们概述了一些常见症状,如肌痛,以及一些明确的疾病,如横纹肌溶解症、肌炎、肌无力和重症监护病房(ICU)获得性肌无力,这些症状和疾病在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染或COVID-19期间已有描述。此外,还讨论了因果关系的标准,如关联强度、合理性、时间进程,以及本综述两部分中描述的与COVID-19相关的神经肌肉疾病因果关联的实验证据。目前,除了在大众媒体中也广为人知的嗅觉丧失外,肌痛尤其是作为一种非特异性症状,是有症状的SARS-CoV-2感染常见的后遗症。其他神经肌肉并发症从发病机制来看似乎主要是合理的,但显然是SARS-CoV-2感染罕见的后果。需要进行前瞻性研究或队列研究来证实因果关系并评估风险。

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本文引用的文献

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Clin Neurophysiol. 2020 Dec;131(12):2809-2816. doi: 10.1016/j.clinph.2020.09.017. Epub 2020 Oct 15.
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