IRCCS Fondazione Don Carlo Gnocchi Onlus, Milano, Italy.
Brain Inj. 2021 Nov 10;35(12-13):1647-1648. doi: 10.1080/02699052.2021.1972456. Epub 2021 Sep 6.
We recently published in this journal (Caronni and colleagues, Brain Injury, 2021-04-16) the first description of the spread of the SARS-CoV-2 infection in a cohort of brain injured patients with a disorder of consciousness (DOC). Surprisingly enough we showed that, in these patients, the COVID was moderate and did not result in fatalities. The pathogenesis of the COVID is characterized by the profound dysregulation of the immune system. To explain our findings, we speculated that the immunosuppression due to the brain injury could be protective against the development of the COVID in patients with DOC. More recently, a second group of authors (Marino and colleagues, PLoSOne, 2021-06-30) described the course of the COVID in an independent cohort of patients with DOC. Since our results were quite unexpected, we have been very comforted by the data reported by Marino and colleagues. Moreover, these data also offer a unique opportunity to further evaluate our theory regarding the COVID pathogenesis in patients with DOC. In the current Letter to the Editor it is shown that the independent data presented by Marino and colleagues do support our theory. Waiting for larger cohorts to further test it (and in case falsify it), our interpretation seems to remain valid.
我们最近在本刊（Caronni 及其同事，《脑损伤》，2021 年 4 月 16 日）上首次描述了 SARS-CoV-2 感染在一组伴有意识障碍（DOC）的脑损伤患者中的传播情况。令人惊讶的是，我们发现 COVID 在这些患者中是温和的，没有导致死亡。COVID 的发病机制以免疫系统的深刻失调为特征。为了解释我们的发现，我们推测，由于脑损伤导致的免疫抑制可能对 DOC 患者 COVID 的发展具有保护作用。最近，第二组作者（Marino 及其同事，《公共科学图书馆·综合》，2021 年 6 月 30 日）在一个独立的 DOC 患者队列中描述了 COVID 的病程。由于我们的结果出人意料，Marino 及其同事报告的数据给我们带来了极大的安慰。此外，这些数据还为进一步评估我们关于 DOC 患者 COVID 发病机制的理论提供了独特的机会。在本期的Letter to the Editor 中，显示 Marino 及其同事提供的独立数据支持我们的理论。我们在等待更大的队列来进一步检验它（并在有必要时否定它），我们的解释似乎仍然有效。
