Sklinda Katarzyna, Dorobek Małgorzata, Wasilewski Piotr G, Dreżewski Karol, Dȩbicka Marta, Walecki Jerzy, Mruk Bartosz
Centre of Postgraduate Medical Education, Department of Radiology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland.
Department of Neurology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland.
Front Neurol. 2021 Oct 20;12:711026. doi: 10.3389/fneur.2021.711026. eCollection 2021.
Many reports suggest the SARS-CoV-2 infection may result in neurological complications. A wide spectrum of clinical syndromes have been reported, including both central and peripheral nervous system. Such symptoms may be a consequence of a direct viral injury, secondary to systemic inflammatory response, autoimmune processes, ischemic lesions or combination of these. Anosmia and dysgeusia are highly prevalent in the early stage of infection. Cerebrovascular events in patients with COVID-19 have also been documented with increasing frequency. Some cases of parainfectious autoimmune neurologic manifestations concurrent with active SARS-CoV-2 infection have been described, including hemorrhagic necrotizing encephalopathy, Guillain-Barré and Miller-Fisher syndromes. There are also a few reports documenting encephalitis and acute demyelinating encephalomyelitis (ADEM) in the course of COVID-19. There is also a growing number of cases of patients after recovery from COVID-19 with psychosomatic disorders, manifesting with memory disfunction, cognitive functions disorders, depression or other affective disorders, which may lead to a decrease of intellectual functions. Many of these neurological manifestations of the infection are possible to distinguish using radiological imaging techniques. It plays a very important role in evaluating the course of COVID-19 as well as diagnosing respiratory complications and choosing a proper management of infected patients. Similarly, radiological techniques play crucial role in identifying the cause of neurological symptoms connected to SARS-CoV-2 infection, being one of the most important elements of diagnostics. Especially in case of the presence of nervous system implication, using radiological imaging techniques to monitor the emerging onset of various symptoms is crucial to assess the severity and scope of involvement. Quick diagnostic process and identifying complications as fast as possible in order to implement specific treatment can be crucial to avoid long-term secondary conditions and accelerate the recovery period. In this review, we present the most important neurological complications that may occur in the course of SARS-CoV-2 infection and summarize their radiological manifestations.
许多报告表明，新型冠状病毒感染可能导致神经系统并发症。已报告了广泛的临床综合征，包括中枢神经系统和周围神经系统。这些症状可能是病毒直接损伤的结果，继发于全身炎症反应、自身免疫过程、缺血性病变或这些因素的组合。嗅觉减退和味觉障碍在感染早期非常普遍。新冠患者发生脑血管事件的频率也在增加。已经描述了一些与活动性新型冠状病毒感染同时出现的感染后自身免疫性神经表现的病例，包括出血性坏死性脑病、格林-巴利综合征和米勒-费雪综合征。也有一些报告记录了新冠病程中的脑炎和急性脱髓鞘性脑脊髓炎（ADEM）。从新冠中康复后的患者出现心身障碍的病例也越来越多，表现为记忆功能障碍、认知功能障碍、抑郁或其他情感障碍，这可能导致智力功能下降。感染的许多这些神经表现可以通过放射成像技术来区分。它在评估新冠病程、诊断呼吸并发症以及选择对感染患者的适当管理方面起着非常重要的作用。同样，放射技术在确定与新型冠状病毒感染相关的神经症状的原因方面起着关键作用，是诊断的最重要要素之一。特别是在存在神经系统受累的情况下，使用放射成像技术监测各种症状的出现对于评估受累的严重程度和范围至关重要。快速的诊断过程并尽快识别并发症以便实施特定治疗对于避免长期的继发状况和加速恢复期可能至关重要。在本综述中，我们介绍了新型冠状病毒感染过程中可能出现的最重要的神经并发症，并总结了它们的放射学表现。
