Mainali Shraddha, Darsie Marin E
Department of Neurology, The Ohio State University, Columbus, OH, United States.
Department of Emergency Medicine, University of Wisconsin Hospitals and Clinics, Madison, WI, United States.
Front Aging Neurosci. 2021 Mar 23;13:648662. doi: 10.3389/fnagi.2021.648662. eCollection 2021.
The COVID-19 pandemic continues to prevail as a catastrophic wave infecting over 111 million people globally, claiming 2. 4 million lives to date. Aged individuals are particularly vulnerable to this disease due to their fraility, immune dysfunction, and higher rates of medical comorbidities, among other causes. Apart from the primary respiratory illness, this virus is known to cause multi-organ dysfunction including renal, cardiac, and neurologic injuries, particularly in the critically-ill cohorts. Elderly patients 65 years of age or older are known to have more severe systemic disease and higher rates of neurologic complications. Morbidity and mortality is very high in the elderly population with 6-930 times higher likelihood of death compared to younger cohorts, with the highest risk in elderly patients ≥85 years and especially those with medical comorbidities such as hypertension, diabetes, heart disease, and underlying respiratory illness. Commonly reported neurologic dysfunctions of COVID-19 include headache, fatigue, dizziness, and confusion. Elderly patients may manifest atypical presentations like fall or postural instability. Other important neurologic dysfunctions in the elderly include cerebrovascular diseases, cognitive impairment, and neuropsychiatric illnesses. Elderly patients with preexisting neurologic diseases are susceptibility to severe COVID-19 infection and higher rates of mortality. Treatment of neurologic dysfunction of COVID-19 is based on existing practice standards of specific neurologic condition in conjunction with systemic treatment of the viral illness. The physical, emotional, psychologic, and financial implications of COVID-19 pandemic have been severe. Long-term data are still needed to understand the lasting effects of this devastating pandemic.
新冠疫情仍在肆虐,这场灾难性的浪潮已在全球感染了超过1.11亿人,迄今已夺去240万人的生命。老年人由于身体虚弱、免疫功能障碍以及较高的合并症发病率等原因,尤其容易感染这种疾病。除了原发性呼吸道疾病外,已知这种病毒会导致多器官功能障碍,包括肾脏、心脏和神经损伤,特别是在重症患者中。已知65岁及以上的老年患者患有更严重的全身性疾病和更高的神经并发症发生率。老年人群的发病率和死亡率非常高,与年轻人群相比,死亡可能性高出6至930倍,85岁及以上的老年患者风险最高,尤其是那些患有高血压、糖尿病、心脏病和潜在呼吸道疾病等合并症的患者。新冠病毒常见的神经功能障碍包括头痛、疲劳、头晕和意识模糊。老年患者可能表现出跌倒或姿势不稳等非典型症状。老年人其他重要的神经功能障碍包括脑血管疾病、认知障碍和神经精神疾病。患有既往神经疾病的老年患者易感染重症新冠病毒,死亡率也更高。新冠病毒神经功能障碍的治疗基于特定神经疾病的现有实践标准,并结合对病毒疾病的全身治疗。新冠疫情对身体、情感、心理和经济方面的影响都很严重。仍需要长期数据来了解这场毁灭性疫情的持久影响。