Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, DC, USA.
Division of Neurogenetics and Developmental Pediatrics, Children's National Hospital, Washington, DC, USA.
J Neurol. 2021 Nov;268(11):3988-3991. doi: 10.1007/s00415-021-10538-1. Epub 2021 Apr 1.
There have been considerations since the beginning of the Coronavirus pandemic that COVID-19 infection, like any other viral illness, can trigger neurological and metabolic decompensation in patients with mitochondrial diseases. At the time of writing, there were no published reports reviewing experiences and guidelines about management of COVID-19 infection in this patient population. We present a challenging case of an adult patient with a known diagnosis of Mitochondrial Encephalomyopathy, Lactic Acidosis and Stroke-like Episodes (MELAS) complicated by COVID-19 infection. She initially presented with altered mental status and vomiting and went on to develop a stroke-like episode, pancreatitis, and pneumatosis intestinalis. We review salient features of her hospitalization, including initiation of thromboprophylaxis in relation to intravenous arginine therapy, caution regarding medications such as remdesivir, and the incidence of gastrointestinal complications.
自冠状病毒大流行开始以来，人们就一直在考虑，COVID-19 感染，像任何其他病毒性疾病一样，可能会导致线粒体疾病患者的神经和代谢失代偿。在撰写本文时，尚无关于审查该患者群体 COVID-19 感染管理经验和指南的已发表报告。我们提出了一个具有挑战性的病例，涉及一名患有已知线粒体脑肌病、乳酸酸中毒和卒中样发作（MELAS）的成年患者，该患者并发 COVID-19 感染。她最初表现为精神状态改变和呕吐，随后发展为卒中样发作、胰腺炎和肠气肿。我们回顾了她住院期间的显著特征，包括静脉内精氨酸治疗相关的血栓预防、雷迪西韦等药物的使用注意事项以及胃肠道并发症的发生率。
