George Minu, Baby Neena, Azad Ameen, Rajan Aswathy, Radhakrishnan Suresh Kumar
Department of Neurology, Renai Medicity Multi Super Speciality Hospital, Cochin, Kerala, India.
Department of Neurology, N. S. Memorial Institute of Medical Sciences, Kollam, Kerala, India.
Ann Indian Acad Neurol. 2021 Nov-Dec;24(6):917-926. doi: 10.4103/aian.aian_541_21. Epub 2021 Dec 17.
SARS-CoV-2 infections present with predominant respiratory symptoms. Only a few anecdotal reports of neurological involvement have come out from India so far. Adverse neurological events following immunization (AEFI) were also reported. We present the neurological symptoms seen either in association with vaccination or COVID-19 infection during the second wave.
This was a retrospective study that included consecutive COVID-19 patients' admissions during the second wave of COVID-19 pandemic in two tertiary health care centres in Kerala. Neurological symptoms two weeks prior or thirty days after a positive status of antigen or RTPCR was termed as COVID-19-Associated Neurological Disorders (CAND) and those with neurological symptoms within one month of COVID-19 vaccination was termed as Post-Vaccinal Neurological Disorders (PVND).
During the study period, 1270 COVID-19 admissions were reported. We identified neurological symptoms in 42 patients (3.3%), of which 35 were CAND and 7 were PVND. Stroke was the most common (50%), followed by seizures and peripheral nervous system disorders (14.2% each). Encephalitis/demyelination (11.9%) and COVID-19-associated infections (9.5%) were also seen.
During the SARS-CoV-2 pandemic, CAND and PVND have been emerging. Association of some of these may be fortuitous; however it is worth mentioning as pathogenic mechanisms of COVID-19 affecting various organ systems still remain unclear. Moreover, this may be helpful in future studies designing management options.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染主要表现为呼吸道症状。到目前为止，印度仅有少数关于神经受累的零星报道。也有免疫接种后不良神经事件（AEFI）的报告。我们呈现了在第二波疫情期间与疫苗接种或新冠病毒感染相关的神经症状。
这是一项回顾性研究，纳入了喀拉拉邦两家三级医疗中心在新冠疫情第二波期间连续收治的新冠患者。在抗原或逆转录聚合酶链反应（RTPCR）呈阳性状态前两周或之后30天出现的神经症状被称为新冠病毒相关神经障碍（CAND），在新冠疫苗接种后一个月内出现神经症状的被称为疫苗接种后神经障碍（PVND）。
在研究期间，共报告了1270例新冠患者入院情况。我们在42例患者（3.3%）中发现了神经症状，其中35例为CAND，7例为PVND。中风最为常见（50%），其次是癫痫发作和周围神经系统疾病（各占14.2%）。还观察到脑炎/脱髓鞘（11.9%）和新冠病毒相关感染（9.5%）。
在SARS-CoV-2大流行期间，CAND和PVND不断出现。其中一些关联可能是偶然的；然而，鉴于新冠病毒影响各个器官系统的致病机制仍不清楚，这一点值得一提。此外，这可能有助于未来设计治疗方案的研究。
