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重症新型冠状病毒肺炎后的复杂性区域疼痛综合征——一例报告

Complex regional pain syndrome after severe COVID-19 - A case report.

作者信息

Vaz Ana, Costa Andreia, Pinto André, Silva Ana Isabel, Figueiredo Paulo, Sarmento António, Santos Lurdes

机构信息

Physical Medicine and Rehabilitation Department, Centro Hospitalar Universitário de São João, Porto, Portugal.

Neurology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.

出版信息

Heliyon. 2021 Nov;7(11):e08462. doi: 10.1016/j.heliyon.2021.e08462. Epub 2021 Nov 24.

Abstract

Neurological complications are frequently reported in an intensive care unit (ICU), as a manifestation of a critical systemic illness or of its treatment. On the specific setting of COVID-19 patients, peripheral nerve lesions can have a multiplicity of causes, such as post-infectious neuropathy, positioning-related neuropathy or iatrogeny. An unusual but potentially disabling complication of any peripheral nerve lesion is Complex Regional Pain Syndrome (CRPS). Although there have been no mechanistic studies assessing how SARS-CoV-2 might directly impact nociception, it is hypothesized that the systemic hyperinflammation seen in severe COVID-19 may contribute to peripheral and central neuronal sensitization, possibly increasing the risk of developing CRPS. This case report highlights the potential hazards and consequences of peripheral nerve injuries on an ICU setting in COVID-19 patients, as well as the importance of a multidisciplinary approach for an early diagnosis and treatment, which are directly related to a better prognosis.

摘要

在重症监护病房(ICU)中,神经并发症经常被报道,这是严重全身性疾病或其治疗的一种表现。在新型冠状病毒肺炎(COVID-19)患者的特定情况下,周围神经病变可能有多种原因,如感染后神经病、体位相关神经病或医源性因素。复杂区域疼痛综合征(CRPS)是任何周围神经病变的一种不常见但可能致残的并发症。尽管尚未有评估严重急性呼吸综合征冠状病毒2(SARS-CoV-2)如何直接影响伤害感受的机制研究,但据推测,在重症COVID-19中出现的全身性过度炎症可能导致外周和中枢神经元致敏,可能增加发生CRPS的风险。本病例报告强调了COVID-19患者在ICU环境中周围神经损伤的潜在危害和后果,以及多学科方法对早期诊断和治疗的重要性,这与更好的预后直接相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba07/8640471/eb4aa5c41813/gr1.jpg

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