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新型冠状病毒肺炎感染对神经退行性疾病患者的影响,尤其关注阿尔茨海默病和帕金森病

Impact of COVID‑19 infection in patients with neurodegenerative diseases with particular focus on Alzheimer's and Parkinson's disease.

作者信息

Guntipalli Prathima, Gara Sirisha, Poudel Sujan, Hans Aakash, Usman Muhammad Abdullah, Dhar Deeksha, Pakala Ramya, Shah Sangam, Thapa Sangharsha, Acharya Sudarshan, Nedd Kester J, Kara Sam

机构信息

Department of Research and Academic Affairs, Larkin Community Hospital, South Miami, FL, USA.

Texas Woman's University, Denton, Texas, USA.

出版信息

Acta Neurobiol Exp (Wars). 2022;82(4):424-432. doi: 10.55782/ane-2022-040.

Abstract

Neurodegenerative disorders (NDD) are chronic neurological diseases characterized by loss and/or damage to neurons along with the myelin sheath, and patients are at higher risk of severe infection with the SARS‑CoV‑2. A comprehensive literature search was performed using relevant terms and inclusion‑exclusion criteria. Recent articles, subjects older than 50 years, and articles written in the English language were included, whereas letters to the editor and articles related to pregnant women were excluded from the review study. COVID‑19 appears to damage angiotensin‑II receptors which cause natural killer cells to lose the ability to clear virus‑infected cells, owing to worse outcomes in patients with NDD. COVID‑19 can worsen the symptoms of Alzheimer's disease. In addition, COVID‑19 worsens drug‑responsive motor symptoms in Parkinson's disease (PD) and other symptoms like fatigue and urinary complaints. Vitamin D is essential in decreasing pro‑inflammatory and increasing anti‑inflammatory cytokines in ongoing COVID‑19 infections and reducing angiotensin receptors and, hence, decreasing COVID‑19 infection severity. Telemedicine shows promise for patients with NDD but is yet to overcome legal issues and personal barriers. COVID‑19 has a significant effect on neurodegenerative conditions, which appears partly to the nature of the NDD and the neuro‑invasive capabilities of the SARS‑CoV‑2. The protective role of vitamin D in patients with NDD further supports this hypothesis. Modifications in current health care, like the telemedicine platform, are required to address the increased risk of serious infection in this population. Further studies will be required to clarify conflicting reports in many fields.

摘要

神经退行性疾病(NDD)是一类慢性神经疾病,其特征为神经元以及髓鞘的丧失和/或损伤,并且此类患者感染新型冠状病毒(SARS-CoV-2)后出现严重感染的风险更高。我们使用相关术语和纳入-排除标准进行了全面的文献检索。纳入了近期的文章、年龄大于50岁的受试者以及用英文撰写的文章,而编辑来信和与孕妇相关的文章则被排除在综述研究之外。由于NDD患者的预后较差,新型冠状病毒肺炎(COVID-19)似乎会损害血管紧张素II受体,导致自然杀伤细胞失去清除病毒感染细胞的能力。COVID-19会使阿尔茨海默病的症状恶化。此外,COVID-19会使帕金森病(PD)患者药物反应性运动症状以及疲劳和泌尿问题等其他症状恶化。维生素D对于在持续的COVID-19感染中减少促炎细胞因子并增加抗炎细胞因子以及减少血管紧张素受体从而降低COVID-19感染的严重程度至关重要。远程医疗对NDD患者显示出前景,但尚未克服法律问题和个人障碍。COVID-19对神经退行性疾病有重大影响,这似乎部分归因于NDD的性质以及SARS-CoV-2的神经侵袭能力。维生素D在NDD患者中的保护作用进一步支持了这一假说。需要对当前的医疗保健进行调整,如远程医疗平台,以应对该人群中严重感染风险增加的问题。还需要进一步研究来澄清许多领域中相互矛盾的报告。

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