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新型冠状病毒肺炎的神经症状:系统评价的系统综述、与其他神经疾病的比较及对医疗服务的影响

The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services.

作者信息

Wildwing Tamar, Holt Nicole

机构信息

Faculty of Health and Wellbeing, Canterbury Christ Church University Ringgold Standard Institution, North Holmes Road, Canterbury, UK.

Faculty of Health and Wellbeing, Canterbury Christ Church University Ringgold Standard Institution, Canterbury, Kent, UK.

出版信息

Ther Adv Chronic Dis. 2021 Jan 28;12:2040622320976979. doi: 10.1177/2040622320976979. eCollection 2021.

Abstract

AIMS

In response to the rapid spread of COVID-19, this paper provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called 'Long Covid' on neurological services and primary care and similarities with other neurological disorders are discussed.

METHODS

Firstly, a systematic overview of current reviews of neurological symptoms of COVID-19 was conducted. Secondly, the implications of these findings are discussed in relation to the potential effect on neurological services and the similarities in the experience of patients with COVID-19 and those with other neurological disorders. A total of 45 systematic reviews were identified within seven databases, published between 11 April 2020 and 15 October 2020, following a search in June 2020, updated on 20 October 2020.

RESULTS

The results indicated that COVID-19 exhibits two types of neurological symptoms; life-threatening symptoms such as Guillain-Barre Syndrome (GBS) and encephalitis, and less devastating symptoms such as fatigue and myalgia. Many of these so-called lesser symptoms appear to be emerging as longer-term for some sufferers and have been recently labelled Long Covid. When compared, these less devastating symptoms are very similar to other neurological conditions such as chronic fatigue syndrome (CFS) and functional neurological disorder (FND).

CONCLUSION

Implications for neurological healthcare services in the United Kingdom (UK) may include longer waiting times and a need for more resources (including more qualified health professionals). There is also a possible change-effect on health professionals' perceptions of other neurological conditions such as CFS and FND. Future research is recommended to explore changes in health professionals' perceptions of neurological symptoms because of COVID-19.

摘要

目的

为应对新冠病毒病(COVID-19)的迅速传播,本文为卫生专业人员提供更易获取的现有证据,总结对COVID-19患者出现的神经症状进行系统评价的系统综述结果。讨论了所谓“长新冠”对神经科服务和初级保健的影响以及与其他神经疾病的相似之处。

方法

首先,对当前关于COVID-19神经症状的综述进行系统综述。其次,讨论这些发现对神经科服务的潜在影响以及COVID-19患者与其他神经疾病患者经历的相似之处。在2020年6月搜索并于2020年10月20日更新后,在七个数据库中识别出共45篇2020年4月11日至2020年10月15日发表的系统综述。

结果

结果表明,COVID-19表现出两种类型的神经症状;危及生命的症状,如吉兰-巴雷综合征(GBS)和脑炎,以及破坏性较小的症状,如疲劳和肌痛。其中许多所谓的较轻症状对一些患者来说似乎正在演变为长期症状,最近被称为“长新冠”。相比之下,这些破坏性较小的症状与其他神经疾病,如慢性疲劳综合征(CFS)和功能性神经障碍(FND)非常相似。

结论

对英国神经医疗服务的影响可能包括更长的等待时间和对更多资源(包括更合格的卫生专业人员)的需求。对卫生专业人员对其他神经疾病,如CFS和FND的认知也可能产生变化。建议未来开展研究,探索由于COVID-19导致卫生专业人员对神经症状认知的变化。

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